During a health assessment, the client reports being treated for osteoarthritis. The nurse examines the client's hands and finds Heberden's nodes. Which finding should the nurse document in the client's medical record?

Distal interphalangeal joint nodules that deviate.

Proximal intertarsal joint swelling of big toe.

Frozen, non-movable phalangeal joints.

Non-painful enlarged interphalangeal joints.

Answer and Explanation

The Correct Answer is D

A. Distal interphalangeal joint nodules that deviate: While Heberden's nodes can cause some stiffness or limited movement, "deviate" implies a significant bend or dislocation, which is not a typical characteristic of Heberden's nodes.

B. Proximal intertarsal joint swelling of big toe: This describes a swollen joint at the base of the big toe (likely gout) and is not related to Heberden's nodes, which affect the fingers.

C. Frozen, non-movable phalangeal joints: Heberden's nodes do not cause joints to become frozen or immobile. This description more accurately fits conditions like severe arthritis or advanced stages of rheumatoid arthritis where joint mobility can be significantly impaired

D. Non-painful enlarged distal interphalangeal (DIP) joints: This accurately describes Heberden's nodes, which are bony growths that typically occur on the DIP joints (closest to the fingertip) and are often painless in the early stages

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Correct Answer is D

Explanation

A. 3-year-old walking on tiptoes: While some children may walk on their tiptoes occasionally, it's not necessarily a cause for concern unless it's persistent or accompanied by other developmental delays.

B. 1.5-year-old attempting to scribble: This is a typical stage for exploring hand and finger movements, leading to early attempts at drawing.

C. 5-month-old with whole hand grasp: At this age, infants use their whole hand to grasp objects, which is a normal developmental step before developing a more refined pincer grasp.

D. 3.5-month-old with diminished Moro reflex. The Moro reflex is a normal reflex in newborns that typically disappears by around 4 to 6 months of age. A diminished or absent Moro reflex before this age could indicate neurological concerns or developmental delays. Referral to a healthcare provider is necessary for further evaluation.

A. Obtain a dietary consultation for nutrition teaching. B. Instruct the client in the need to use iodized salt. C. Request diagnostic laboratory testing for the client. D. Schedule a follow-up appointment in one month.

Correct Answer is C

Explanation

A. Obtain a dietary consultation for nutrition teaching: Diet might play a role in some thyroid conditions, but a referral for dietary consultation wouldn't be the first step.

B. Instruct the client in the need to use iodized salt: Iodine deficiency can cause goiter (enlarged thyroid gland), but most table salt in developed countries is iodized.

C. Request diagnostic laboratory testing for the client: This is the most appropriate next step. Blood tests can help determine the cause of the enlarged thyroid gland.

D. Schedule a follow-up appointment in one month: A follow-up might be needed, but further workup is essential to determine the cause of the finding.

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During a health assessment, the client reports being treated for osteoarthritis. The nurse examines the client's hands and finds Heberden's nodes. Which finding should the nurse document in the client's medical record?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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Correct Answer is C

Explanation

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