Which disease conditions are associated with hard, nontender Heberden and Bouchard nodules?
Osteoporosis
Carpal tunnel syndrome
Scoliosis
Osteoarthritis.
The Correct Answer is D
Osteoarthritis is a degenerative joint disease characterized by the loss of articular cartilage and the formation of new bone at the joint margins. Heberden nodules occur at the distal interphalangeal (DIP) joints, while Bouchard nodules appear at the proximal interphalangeal (PIP) joints. These hard, bony overgrowths are permanent structural changes resulting from chronic osteophyte development.
A. Osteoporosis: This is a systemic skeletal disorder characterized by low bone mass and microarchitectural deterioration, leading to increased bone fragility. It typically presents with vertebral or hip fractures. It does not cause the localized, bony nodular swellings in the finger joints described.
B. Carpal tunnel syndrome: This is a compressive neuropathy of the median nerve at the wrist. It presents with paresthesia, numbness, and potential thenar atrophy. It is a soft tissue and nerve entrapment issue and does not involve the formation of bony nodules on the finger joints.
C. Scoliosis: Scoliosis is a lateral curvature of the spine. While it is a musculoskeletal deformity, it does not have any clinical association with the small joints of the hands. It is a disorder of the axial skeleton rather than the peripheral joints.
D. Osteoarthritis: The presence of Heberden and Bouchard nodules is a classic diagnostic sign of nodal osteoarthritis. These represent the body's attempt to repair joint damage through bone proliferation. They are the characteristic physical findings for this degenerative joint condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Body Mass Index (BMI) is a standardized screening tool that correlates body weight with height to estimate adiposity and nutritional risk. A value below the healthy threshold suggests protein-energy malnutrition or underlying wasting diseases. This category is associated with increased risks of impaired wound healing, sarcopenia, and compromised immune function.
A. 25.0 to 29.9 kg/m2: This range is classified as the "Overweight" category for adults. While it may carry risks for metabolic syndrome or cardiovascular disease, it does not indicate malnutrition in terms of caloric or protein deficiency. It represents a surplus of body mass relative to height.
B. <18.5 kg/m2: A BMI of less than 18.5 is the internationally recognized threshold for "Underweight." In a clinical nutritional assessment, this finding is a primary indicator of potential malnutrition. It necessitates further evaluation of dietary intake and screening for malabsorption or systemic illness.
C. 18.5 to 24.9 kg/m2: This is the "Normal" or "Healthy Weight" range for the majority of the adult population. It indicates that the individual's weight is appropriate for their height, posing the lowest risk for weight-related health problems. It is the target range for optimal nutritional status.
D. 30.0 to 39.9 kg/m2: This range identifies "Obesity" (Classes I and II). While an individual in this category can suffer from micronutrient deficiencies, the BMI itself indicates an excess of body mass rather than the depletion associated with clinical malnutrition.
Correct Answer is A
Explanation
The Adam's forward bend test is the primary clinical screening tool for identifying adolescent idiopathic scoliosis. As the patient flexes forward, the nurse observes for rib humps or spinal rotation, which indicate a structural rather than functional curve. This maneuver accentuates the asymmetry caused by the vertebral rotation that accompanies the lateral curvature.
A. Ask the client to bend forward at the waist: This position makes any rib asymmetry or unilateral prominence of the back more visible. It is the most sensitive non-radiographic method for screening students for scoliosis. It allows the nurse to see the rotation of the spine that occurs in structural curves.
B. Palpate the spinous processes: While palpation can identify tenderness or significant lateral deviation, it is less effective than the forward bend test for detecting early or mild scoliosis. In many cases, the spinous processes appear aligned even when the vertebral bodies have rotated significantly.
C. Measure the length of the spine from neck to waist: Measuring the absolute length of the spine does not provide information about its lateral curvature or rotation. It is not a diagnostic or screening maneuver for scoliosis. It is a measurement of vertical growth rather than spinal alignment.
D. Palpate for crepitus: Crepitus is a grating sound or sensation produced by friction between bone and cartilage, often associated with osteoarthritis or fractures. It is not a feature of scoliosis, which is a structural deformity of the spinal axis. Palpation for crepitus does not identify lateral curvature.
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