A nurse is providing client education to an older adult newly diagnosed with osteoarthritis.
Which of the following statements should the nurse include?
The body's own immune system attacks the joint tissue.
It is common to experience morning stiffness that lasts 10-20 minutes.
You should avoid sun exposure because it can trigger flare ups.
Heberden nodes frequently develop.
The Correct Answer is D
Choice A rationale
The description of the immune system attacking joint tissue refers to rheumatoid arthritis, which is a systemic autoimmune disease characterized by chronic inflammation of the synovium. In contrast, osteoarthritis is primarily a degenerative joint disease caused by the mechanical wear and tear of articular cartilage over time. Providing this information to a patient with osteoarthritis would be scientifically incorrect. Osteoarthritis involves cartilage breakdown and bone spur formation rather than an autoantibody-mediated inflammatory process against the joint.
Choice B rationale
Morning stiffness in osteoarthritis is typically brief, usually lasting less than 30 minutes, and often resolving within 10 to 20 minutes as the joint moves. This is a key clinical differentiator from rheumatoid arthritis, where morning stiffness often persists for more than one hour. While the statement about 10-20 minutes is common in osteoarthritis, the presence of Heberden nodes is a more definitive physical diagnostic hallmark of the disease process itself, making it a priority for patient education on physical changes.
Choice C rationale
Sun exposure is a known trigger for flare-ups in systemic lupus erythematosus, an autoimmune condition, but it does not have a direct physiological impact on the progression or symptoms of osteoarthritis. Osteoarthritis is influenced by factors such as age, obesity, repetitive joint stress, and genetics. Advising a patient with osteoarthritis to avoid the sun to prevent joint flares is scientifically unfounded. Education should instead focus on weight management, low-impact exercise, and joint protection techniques to manage symptoms.
Choice D rationale
Heberden nodes are bony outgrowths that develop at the distal interphalangeal joints of the fingers due to the formation of osteophytes. They are a classic physical finding in osteoarthritis, representing the underlying pathological changes of bone hypertrophy and cartilage loss. Educating an older adult about these nodes helps them understand the visible changes in their hands. These nodes are permanent and signify the degenerative nature of the condition, distinguishing it from the soft tissue swelling seen in other forms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["10"]
Explanation
Step 1 is 320 mg ÷ 160 mg × 5 mL.
Step 2 is 2 × 5 mL.
Step 3 is 10.0 mL. The final calculated answer is 10 mL.
Correct Answer is B
Explanation
Choice A rationale
Fresh fruit and vegetable juices are generally low in purines and are considered safe for individuals with gout. These fluids provide essential vitamins and antioxidants that may even assist in reducing systemic inflammation. Maintaining high fluid intake is recommended to facilitate the renal excretion of uric acid. Unless the juice contains high levels of fructose, which can subtly influence uric acid levels, it remains a healthy dietary choice.
Choice B rationale
Organ meats, such as liver or kidneys, and shellfish are extremely high in purines. When the body breaks down these purines, it produces uric acid as a byproduct. In patients with gout, high uric acid levels exceed the normal range of 3.5 to 7.2 mg/dL, leading to the crystallization of monosodium urate in the joints. Avoiding these foods is a primary dietary intervention to prevent painful acute gouty flares.
Choice C rationale
Whole grains are an important part of a balanced diet and typically contain moderate to low levels of purines. They provide necessary fiber and complex carbohydrates which do not significantly contribute to hyperuricemia. While some specific grains might have higher purine content than refined versions, they are generally encouraged for gout patients to support overall metabolic health and weight management, which indirectly helps control uric acid levels.
Choice D rationale
Lean chicken and turkey are moderate-purine protein sources and are generally preferred over red meats or organ meats. While they should be consumed in moderation, they do not pose the same high risk for triggering a gout attack as shellfish or game meats. For a patient managing gout, these poultry options represent a safer alternative for maintaining adequate protein intake without severely spiking serum uric acid concentrations.
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