During the assessment of a patient with joint pain, the nurse observes Heberden's nodes on the distal interphalangeal joints. What condition is most associated with this finding?
Fibromyalgia
Osteoarthritis
Rheumatoid arthritis
Systemic lupus erythematosus
The Correct Answer is B
A. Fibromyalgia: Fibromyalgia is characterized by widespread musculoskeletal pain, fatigue, and tender points, but it does not cause bony nodules or joint deformities. The presence of Heberden’s nodes is not associated with this condition.
B. Osteoarthritis: Heberden’s nodes are bony enlargements of the distal interphalangeal joints commonly seen in osteoarthritis. They result from cartilage degeneration and bone remodeling, and are a hallmark sign of osteoarthritic joint changes.
C. Rheumatoid arthritis: Rheumatoid arthritis primarily affects the proximal interphalangeal and metacarpophalangeal joints with symmetric inflammation. Nodules in RA are typically subcutaneous, not bony, and Heberden’s nodes are not characteristic.
D. Systemic lupus erythematosus: SLE can cause joint pain and swelling, but it does not lead to Heberden’s nodes or osteoarthritic bony changes. Joint involvement in SLE is typically non-erosive and inflammatory rather than degenerative.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Joint aspiration of synovial fluid: Analysis of synovial fluid obtained via joint aspiration is the definitive diagnostic test for gout. The presence of monosodium urate crystals under polarized light microscopy confirms the diagnosis.
B. MRI of the joint: MRI can detect joint inflammation and soft tissue changes but cannot specifically identify urate crystals. It is not a definitive test for gout.
C. Serum uric acid level: Elevated uric acid may support a diagnosis, but it is not definitive because levels can be normal during an acute flare or elevated without gout. It is a supportive, not confirmatory, test.
D. X-ray of the affected joint: X-rays can reveal chronic joint changes such as erosions in long-standing gout but do not confirm an acute diagnosis. Imaging is useful for assessing complications but not for definitive diagnosis.
Correct Answer is C
Explanation
A. A sputum culture is performed to assess the client's immune response to TB infection: Immune response is evaluated using tests such as the tuberculin skin test (TST) or interferon-gamma release assays (IGRAs), not sputum cultures. Sputum culture does not measure immunity.
B. A sputum culture is used to monitor the effectiveness of TB treatment and evaluate disease progression: While serial sputum cultures can track treatment response over time, the primary purpose of the initial culture is to identify the causative organism. Monitoring treatment is secondary.
C. A sputum culture is used to detect the presence of TB bacteria in the lungs: The sputum culture allows growth and identification of Mycobacterium tuberculosis from expectorated material, confirming the diagnosis. It is the gold standard for detecting active pulmonary TB.
D. A sputum culture is performed to assess lung function and determine the severity of TB infection: Lung function is assessed via pulmonary function tests or imaging, not sputum cultures. Culture results indicate bacterial presence, not the functional capacity of the lungs.
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