A patient is diagnosed with advanced osteoarthritis of the right knee joint. What is the reasoning behind the decrease in range of motion at the joint?
osteophytes and degenerated cartilage
wider joint space
inflammation of compact bone
decrease in synovial fluid
fibrosis of joint capsule
The Correct Answer is A
A. Osteophytes and degenerated cartilage: In osteoarthritis, the articular cartilage progressively degenerates, and bone spurs (osteophytes) develop at joint margins. These structural changes create mechanical obstruction and pain, directly limiting joint movement and decreasing range of motion.
B. Wider joint space: Osteoarthritis is characterized by narrowing, not widening, of the joint space due to cartilage loss. A wider joint space would not contribute to decreased mobility and is not a feature of this condition.
C. Inflammation of compact bone: Osteoarthritis primarily affects the articular cartilage and subchondral bone rather than causing inflammation of compact bone. While subchondral changes can occur, inflammation of compact bone is not the main factor reducing range of motion.
D. Decrease in synovial fluid: Synovial fluid may become less effective due to cartilage damage, but its volume usually does not decrease significantly in osteoarthritis. Limited joint movement is more related to cartilage degeneration and osteophyte formation rather than fluid reduction.
E. Fibrosis of joint capsule: Joint capsule fibrosis can occur in late-stage osteoarthritis, contributing to stiffness, but the initial and primary cause of decreased range of motion is cartilage loss and osteophyte formation. Fibrosis is a secondary change rather than the primary mechanism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Insulin toxicity: Insulin toxicity is not associated with pancreatitis. Insulin affects glucose metabolism and does not directly cause pancreatic tissue injury. This mechanism is unrelated to the pathophysiology of pancreatic inflammation.
B. Autoimmune destruction of the pancreas: Autoimmune processes can lead to chronic pancreatitis or type 1 diabetes, but acute tissue damage in pancreatitis is not typically due to immune-mediated destruction. While autoimmune pancreatitis exists, it is not the most common cause of pancreatic tissue injury.
C. Leakage of pancreatic enzymes: In pancreatitis, premature activation and leakage of pancreatic enzymes such as trypsin and lipase cause autodigestion of pancreatic tissue. This enzymatic activity leads to inflammation, edema, necrosis, and systemic complications. It is the primary mechanism of tissue damage in acute pancreatitis.
D. Viral infection of the gallbladder: Viral infections affecting the gallbladder do not directly cause pancreatitis. Gallstones or biliary obstruction may precipitate pancreatitis, but viral infection of the gallbladder itself is not a common etiologic factor.
Correct Answer is C
Explanation
A. Superior vena cava: The superior vena cava returns deoxygenated blood from the upper body to the right atrium, not the left atrium. It is part of the systemic venous circulation.
B. Aorta: The aorta carries oxygenated blood from the left ventricle to the systemic circulation. It does not return blood to the heart and is an arterial, not venous, vessel.
C. Pulmonary veins: Pulmonary veins carry oxygenated blood from the lungs back to the left atrium. This is the only vessel in the systemic circulation that delivers oxygen-rich blood directly to the heart.
D. Inferior vena cava: The inferior vena cava returns deoxygenated blood from the lower body to the right atrium. Like the superior vena cava, it does not transport blood to the left atrium.
E. Pulmonary arteries: Pulmonary arteries carry deoxygenated blood from the right ventricle to the lungs for oxygenation. They do not return blood to the heart and do not connect to the left atrium.
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