A patient presents to the emergency department with severe pain in their leg, fever, and redness over a recent wound site. The patient reports having an open fracture two weeks ago, which was treated with a cast. Upon examination, the area over the fracture is swollen, warm to the touch, and extremely tender. The patient is also experiencing chills and difficulty bearing weight on the affected leg. Based on these symptoms, which of the following is most likely the diagnosis, and what are the primary signs and symptoms?
Septic arthritis: A joint infection causing redness, warmth, swelling, and pain in the affected joint, often with fever and chills.
Rheumatoid arthritis: A systemic autoimmune disorder causing joint pain, swelling, and stiffness, most common in the hands and feet.
Gout: A form of arthritis caused by the accumulation of uric acid crystals in the joints, leading to sudden, intense pain, often in the big toe.
Osteomyelitis: A bone infection characterized by fever, localized pain, swelling, and warmth at the site of infection.
The Correct Answer is D
Choice A reason: Septic arthritis affects joints, causing joint-specific swelling and pain, but this patient’s symptoms center on a fracture site, suggesting bone involvement. Osteomyelitis better matches pain, swelling, and warmth over a bone wound, with fever and chills, so this is incorrect.
Choice B reason: Rheumatoid arthritis is a chronic autoimmune condition affecting multiple joints, typically hands and feet, not a single fracture site. This patient’s acute fever, localized bone pain, and wound-related symptoms point to osteomyelitis, not systemic arthritis, making this incorrect.
Choice C reason: Gout causes acute joint pain, often in the big toe, due to uric acid crystals, not bone infections. The patient’s fracture site pain, swelling, and systemic symptoms like fever align with osteomyelitis, not gout, so this is incorrect.
Choice D reason: Osteomyelitis, a bone infection, matches the patient’s severe pain, swelling, warmth, and redness over a recent fracture site, with fever and chills. These are primary signs of bone infection post-trauma, making this the correct diagnosis and symptom description.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Inward-pointing feet, or pigeon-toed appearance, describe intoeing, often due to metatarsus adductus or tibial torsion. Genu varum involves the knees angling outward, causing a bowed leg appearance, not foot positioning, making this an incorrect description.
Choice B reason: Genu varum, or bowlegs, is characterized by knees angling outward, creating a bowed appearance of the legs. This condition, common in toddlers or due to conditions like rickets, matches the described deformity, making this the correct description.
Choice C reason: Knees angling inward, causing a knock-kneed appearance, describes genu valgum, not genu varum. These are opposite deformities, with genu varum involving outward knee angulation, making this an incorrect description of the condition.
Choice D reason: Hyperextension of the knee joint, causing excessive leg straightening, describes genu recurvatum, not genu varum. Genu varum involves lateral knee angulation, not hyperextension, making this an incorrect description of the condition.
Correct Answer is A
Explanation
Choice A reason: T cells, including cytotoxic and helper T cells, drive cell-mediated immunity by directly attacking infected cells and coordinating immune responses. They target intracellular pathogens and tumors, forming the core of cellular immunity, making this the correct choice.
Choice B reason: B cells mediate humoral immunity, producing antibodies against extracellular pathogens. While critical for immune defense, they do not directly drive cell-mediated responses, which rely on T-cell activity, making this incorrect for cell-mediated immunity.
Choice C reason: “None of the above” is incorrect, as T cells play a central role in cell-mediated immunity. Their functions, like cytotoxicity and cytokine production, are essential for this immune response, making this an invalid choice.
Choice D reason: “All of the above” is incorrect, as only T cells, not B cells, are primarily responsible for cell-mediated immunity. B cells support humoral immunity, not the cellular response driven by T cells, making this an incorrect choice.
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