A nurse is teaching a group of patients about osteoarthritis.
Which of the following recommendations should the nurse include in the teaching?
Use Echinacea to manage joint pain.
Apply ice to the joint before exercising.
Significantly reduce the amount of purine in the diet.
Maintain a recommended body weight.
The Correct Answer is D
Choice A rationale
Echinacea is an herb often used to support the immune system, particularly for colds and flu. There is no strong scientific evidence to support its effectiveness in managing the joint pain associated with osteoarthritis, which is a degenerative joint disease.
Choice B rationale
Applying ice to a joint before exercising can decrease pain and inflammation, but it can also stiffen the joint and potentially limit range of motion during activity. Heat application is generally recommended before exercise in osteoarthritis to warm up the muscles and tissues.
Choice C rationale
Purines are compounds that break down into uric acid. Reducing purine intake is important for managing gout, a type of inflammatory arthritis caused by the deposition of uric acid crystals in the joints, not osteoarthritis, which is characterized by cartilage breakdown.
Choice D rationale
Maintaining a recommended body weight is crucial for managing osteoarthritis. Excess weight puts additional stress on weight-bearing joints like the hips and knees, accelerating cartilage breakdown and increasing pain. Weight loss can significantly reduce these stresses and alleviate symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Decreased hemoglobin is typically associated with chronic inflammation in rheumatoid arthritis, but it is not considered an early manifestation. Anemia of chronic disease develops over time due to the effects of inflammatory cytokines on iron metabolism and erythropoiesis. Normal hemoglobin ranges for females are 12 to 15.5 g/dL and for males are 13.5 to 17.5 g/dL.
Choice B rationale
Temporomandibular joint pain can occur in rheumatoid arthritis, but it is not a specific or consistent early manifestation. While RA can affect various joints, the small joints of the hands and feet are more commonly involved in the early stages. Pain in the TMJ can also be related to other conditions.
Choice C rationale
Fatigue is a common systemic symptom in rheumatoid arthritis and can occur early in the disease process. However, fatigue is also a nonspecific symptom that can be present in many other conditions, making it less definitive as an early diagnostic indicator compared to joint involvement.
Choice D rationale
Symmetric joint swelling of the fingers, particularly the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints, is a hallmark early manifestation of rheumatoid arthritis. The inflammation causes synovial thickening and effusion, leading to palpable swelling that affects the same joints on both sides of the body.
Correct Answer is B
Explanation
Choice A rationale
Basal cell carcinoma typically presents as a pearly or waxy bump, often with telangiectasia (small blood vessels) and a rolled border. While it can grow, it is less likely to exhibit irregular shape and significant color variation.
Choice B rationale
Malignant melanoma is characterized by the "ABCDE" criteria: asymmetry (irregular shape), border irregularity (notched, scalloped, or blurred), color variation (multiple shades of brown, black, red, white, or blue), diameter (usually larger than 6 mm), and evolving (change in size, shape, color, or elevation). The patient's report of an increased size and an irregularly shaped lesion with varying colors strongly suggests malignant melanoma, a serious form of skin cancer arising from melanocytes.
Choice C rationale
Squamous cell carcinoma often appears as a firm, red nodule or a scaly, crusty patch. While it can be irregular in shape and may grow, the description of varied colors is less typical of squamous cell carcinoma compared to melanoma.
Choice D rationale
Kaposi's sarcoma presents as red, purple, or brown blotches or nodules on the skin. It is associated with human herpesvirus 8 (HHV-8) and is more common in individuals with weakened immune systems. The description of an increasing, irregularly shaped, and multicolored lesion is not typical of Kaposi's sarcoma.
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