A patient asks the difference between osteoarthritis and RA. Which manifestations does the nurse explain are characteristic of RA?

(Select all that apply.)

Heberden nodes

Early morning stiffness

Pain increasing by activity

Autoimmune disease

Low-grade fever

Answer and Explanation

Correct Answer : B,D,E

A. Heberden nodes: These are bony swellings commonly seen in osteoarthritis, particularly affecting the distal interphalangeal joints of the fingers, not typically associated with rheumatoid arthritis (RA).
B. Early morning stiffness: RA is characterized by prolonged morning stiffness lasting more than 30 minutes, which improves with activity, distinguishing it from the short-lived stiffness seen in osteoarthritis.
C. Pain increasing by activity: This is more characteristic of osteoarthritis, where joint pain typically worsens with use and activity. RA pain often improves with movement as the joints "warm up."
D. Autoimmune disease: RA is an autoimmune condition where the body's immune system attacks its own tissues, leading to inflammation and joint damage.
E. Low-grade fever: Low-grade fever can be a systemic symptom of RA due to the autoimmune inflammatory process, which is not a feature of osteoarthritis.

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Correct Answer is []

Explanation

Condition the Patient is Most Likely Experiencing:

Intracerebral Haemorrhage (ICH) : The patient presents with a severe headache, lethargy, decreased level of consciousness, and slurred, incomprehensible speech, which are common signs of a stroke or intracerebral haemorrhage. A history of hypertension and atrial fibrillation increases the risk for both ischemic and hemorrhagic strokes. The use of apixaban, an anticoagulant, suggests the patient is at risk for bleeding complications, including intracerebral haemorrhage.

Interventions to Perform/Anticipate:

Perform a CT Scan of the Head:
- Rationale: A CT scan will help determine if there is bleeding or an ischemic event in the brain. It is crucial for differentiating between ischemic and hemorrhagic stroke, guiding subsequent treatment.
Administer Intravenous Antihypertensives:
- Rationale: Controlling blood pressure is critical to reduce the risk of further bleeding in the brain. Immediate BP management is essential in the acute setting of suspected stroke.

Parameters to Monitor:

Neurological Status:
- Rationale: Monitoring changes in the patient’s level of consciousness, pupil reactions, and motor response will help assess the progression of the neurological deficit and effectiveness of interventions.
Blood Pressure:
- Rationale: Maintaining blood pressure within a safe range is essential to prevent exacerbation of the hemorrhage. Hypertension management is key to avoid further complications.

A. Monitor blood glucose levels. B. Lifestyle modifications and medication adherence will not prevent blindness, C. Lifestyle modifications can prevent strokes. D. End organ damage is inevitable because of microvascular changes that occur. E. Take medications as ordered.

Correct Answer is ["A","C","E"]

Explanation

A. Monitor blood glucose levels: Patients with diabetes need to keep their blood glucose levels under control to prevent complications, including those that can exacerbate hypertension or lead to cardiovascular problems.
B. Lifestyle modifications and medication adherence will not prevent blindness: This is incorrect. Proper management of diabetes through lifestyle changes and medication adherence can help prevent complications like diabetic retinopathy, which can lead to blindness.
C. Lifestyle modifications can prevent strokes: Effective management of diabetes and hypertension through lifestyle changes (diet, exercise, smoking cessation) can significantly reduce the risk of strokes and other cardiovascular events.
D. End organ damage is inevitable because of microvascular changes that occur: This is misleading. While microvascular changes are a risk in diabetes, proper management and lifestyle modifications can greatly reduce the risk and progression of end-organ damage.
E. Take medications as ordered: Adherence to prescribed medications is crucial for controlling both blood glucose and blood pressure, reducing the risk of complications such as stroke, heart disease, and kidney damage.

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A patient asks the difference between osteoarthritis and RA. Which manifestations does the nurse explain are characteristic of RA? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

Correct Answer is []

Explanation

The LPN/LVN is reinforcing education with an elderly patient diagnosed with diabetes and hypertension. Which topics would be vital for the nurse to emphasize? Select all that apply.

Correct Answer is ["A","C","E"]

Explanation

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A patient asks the difference between osteoarthritis and RA. Which manifestations does the nurse explain are characteristic of RA?

(Select all that apply.)