The nurse assesses the client for which clinical manifestation associated with a bone fracture?

Choice A reason: Elevated rheumatoid factor (RF), an autoantibody, is present in 70-80% of rheumatoid arthritis (RA) patients. It contributes to immune complex formation, driving synovial inflammation and joint damage. This lab result is a key diagnostic marker, making it consistent with RA and critical for confirming the diagnosis.

Choice B reason: Decreased C-reactive protein (CRP) is inconsistent with RA, which typically shows elevated CRP due to systemic inflammation. CRP reflects acute-phase response in active RA, and low levels suggest inactive disease or another condition, making this result inaccurate for supporting an RA diagnosis.

Choice C reason: Normal erythrocyte sedimentation rate (ESR) is not typical in active RA, where ESR is elevated due to inflammation-driven increases in plasma proteins. Normal ESR may occur in remission but does not support an active RA diagnosis, making this result inconsistent with the condition.

Choice D reason: Low antinuclear antibody (ANA) levels are not specific to RA and are more associated with systemic lupus erythematosus. While some RA patients may have low ANA, it is not a diagnostic marker for RA, making this result irrelevant and inconsistent with confirming rheumatoid arthritis.

Choice A reason: Glipizide, a sulfonylurea, stimulates insulin release from pancreatic beta cells by blocking ATP-sensitive potassium channels, increasing insulin secretion. This can cause hypoglycemia, especially if meals are skipped or with excessive dosing. Monitoring blood glucose is critical, as hypoglycemia can lead to symptoms like sweating, shakiness, or confusion, making this the primary adverse effect.

Choice B reason: Glipizide does not significantly affect potassium levels. Hyperkalemia is more associated with drugs like ACE inhibitors or potassium-sparing diuretics. Sulfonylureas primarily impact glucose metabolism, not electrolyte balance, making this an inaccurate adverse effect to monitor in patients taking glipizide.

Choice C reason: Glipizide often causes weight gain, not weight loss, due to increased insulin levels promoting glucose uptake and fat storage. Weight loss is more associated with drugs like metformin or SGLT-2 inhibitors. This statement is inaccurate, as weight gain is a more likely concern with sulfonylureas.

Choice D reason: Hypertension is not a common adverse effect of glipizide. Sulfonylureas primarily affect glucose metabolism, not blood pressure. While diabetes increases cardiovascular risk, glipizide does not directly cause hypertension, making this an inaccurate adverse effect to prioritize in monitoring for this medication.