A nurse is completing a physical assessment of a client who has early osteoarthritis. Which of the following manifestations should the nurse expect?
Ulnar deviation
Symmetric joints affected
Pain worsens with activity
Weight loss
The Correct Answer is C
Choice A reason: Ulnar Deviation
Ulnar deviation, or the bending of the fingers towards the ulna (the outer bone of the forearm), is more commonly associated with rheumatoid arthritis rather than osteoarthritis. Rheumatoid arthritis typically affects the joints symmetrically and can lead to deformities such as ulnar deviation due to chronic inflammation.
Choice B reason: Symmetric Joints Affected
Symmetric joint involvement is characteristic of rheumatoid arthritis, not osteoarthritis. Osteoarthritis usually affects joints asymmetrically, meaning it can affect one joint more than the other. It commonly affects weight-bearing joints such as the knees, hips, and spine.
Choice C reason: Pain Worsens with Activity
Pain that worsens with activity is a hallmark symptom of osteoarthritis. This condition is caused by the breakdown of cartilage in the joints, leading to pain and stiffness, especially after physical activity. The pain typically improves with rest but can become more persistent as the disease progresses.
Choice D reason: Weight Loss
Weight loss is not a typical manifestation of osteoarthritis. In fact, being overweight or obese is a risk factor for developing osteoarthritis, particularly in weight-bearing joints. Weight management is often recommended to help reduce the stress on affected joints and alleviate symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Check the drainage for glucose: Clear drainage from the nasal packing after a transsphenoidal hypophysectomy could indicate a cerebrospinal fluid (CSF) leak. CSF leaks are a serious complication that can occur after this type of surgery. Testing the drainage for glucose is a quick and effective way to determine if the fluid is CSF, as CSF contains glucose, whereas normal nasal secretions do not. Identifying a CSF leak promptly is crucial to prevent further complications such as meningitis.
Choice B reason:
Notify the client’s provider: While notifying the provider is important, it should be done after confirming the nature of the drainage. If the drainage is indeed CSF, the provider needs to be informed immediately. However, the initial step should be to check the drainage for glucose to confirm the suspicion.
Choice C reason:
Document the amount of drainage: Documentation is always important in nursing care, but it is not the immediate priority in this situation. The primary concern is to identify the nature of the drainage to address any potential complications promptly.
Choice D reason:
Obtain a culture of the drainage: Obtaining a culture can help identify any infections, but it is not the first step in this scenario. The immediate concern is to determine if the drainage is CSF, which requires checking for glucose.
Correct Answer is []
Explanation
The correct answers are:
Condition:
- a. Pneumothorax
(After a thoracotomy and chest tube insertion, pneumothorax is a potential complication as air can accumulate in the pleural space, compromising lung expansion.)
Actions:
- b. Administer oxygen as prescribed.
(To ensure adequate oxygenation while resolving the pneumothorax) - b. Ensure the chest tube is functioning properly.
(Ensuring the chest tube is removing air from the pleural space to restore lung expansion)
Parameters to Monitor:
- c. Respiratory rate and effort.
(To assess the client's respiratory status and detect any changes indicating distress or worsening pneumothorax) - c. Oxygen saturation levels.
(To continuously assess oxygenation and detect any hypoxia)
Rationale:
A pneumothorax is more likely post-thoracotomy, especially with a chest tube insertion, as air is a primary concern in the pleural space. Monitoring respiratory parameters like oxygen saturation and respiratory effort helps evaluate the client's respiratory function and chest tube efficacy.
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