An older client with osteoarthritis reports increasing pain and stiffness in the right knee and asks how to reduce these symptoms. In responding to the client, the nurse recognizes what pathology as the cause of the symptoms?
Destruction of joint cartilage.
Systemic inflammatory response.
Loss of bone mineral density.
Infectious process in the synovial fluid.
The Correct Answer is A
Rationale
A. Osteoarthritis is characterized by the gradual destruction of joint cartilage. Cartilage serves as a cushion between the bones in a joint, and its deterioration leads to pain, stiffness, and reduced joint function. As the cartilage wears away, bones may rub directly against each other, causing further pain and damage.

B. Osteoarthritis is primarily a degenerative condition rather than an inflammatory one. While mild inflammation can occur in OA, it is not as prominent as in autoimmune conditions like rheumatoid arthritis. In OA, inflammation is secondary to cartilage damage rather than a primary driver of the disease process.
C. Loss of bone mineral density is more characteristic of osteoporosis, a condition where bones become weak and brittle. Osteoporosis involves a decrease in bone mass throughout the skeleton, whereas osteoarthritis specifically targets the joints and affects cartilage rather than bone density.
D. An infectious process in the synovial fluid could indicate septic arthritis, which is characterized by infection in the joint space. This is typically associated with acute symptoms such as severe joint pain, swelling, warmth, and fever.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale
A. Granola and strawberries may be high in fiber, which could potentially worsen diarrhea in some individuals. Tea is generally fine, but it should be non-caffeinated to avoid further irritation to the digestive system.
B. Whole wheat toast can be a good option as it provides carbohydrates for energy without being too heavy. However, coffee is caffeinated and can stimulate bowel movements and increase gastric acid secretion, potentially aggravating diarrhea.
C. Oatmeal is gentle on the stomach and provides soluble fiber, which can help absorb water and bulk up stools. Banana is a good source of potassium, which may be lost during episodes of diarrhea. Herbal tea is non-caffeinated and can help hydrate.
D. Sausage and milk can be high in fat and lactose, which may be difficult to digest, especially during diarrhea. Poached eggs are generally well tolerated, but the overall combination may not be ideal for someone with diarrhea.
Correct Answer is C
Explanation
Rationale
A. In heart failure exacerbation, decreased cardiac output can lead to poor peripheral perfusion, potentially manifesting as weak or diminished pedal pulses. However, in the context of acute symptoms such as palpitations or chest discomfort, assessing the rhythm and rate of central pulses (like the apical pulse) may be more immediate and informative.
B. Capillary refill time assesses peripheral perfusion and can indicate circulatory status. Prolonged capillary refill (>2 seconds) may indicate poor perfusion, which could occur in heart failure exacerbation due to reduced cardiac output. It is a valuable assessment, but in this scenario, focusing on more central aspects such as the heart rhythm is typically more immediate.
C. Assessing the rhythm of the apical pulse is crucial in this scenario. The client's sensation of "flopping" in the chest suggests palpitations or irregular heartbeats, which could indicate arrhythmias such as atrial fibrillation or other dysrhythmias.
D. Skin elasticity primarily assesses hydration status and may provide information about overall skin integrity but is less directly related to the acute symptoms described by the client. While important in general assessments, it does not directly address the urgent need to assess for arrhythmias or irregular heartbeats.
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