Mr. Rodriguez is admitted with severe pain in the knees. Which form of arthritis is characterized by urate deposits and joint pain, usually in the feet and legs, and occurs primarily in men over age 30?
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Solution
Gouty arthritis
Option D: Gouty arthritis, a metabolic disease, is characterized by urate deposits and pain in the joints, especially those in the feet and legs. Urate deposits don’t occur in septic or traumatic arthritis.
Option A: Septic arthritis results from bacterial invasion of a joint and leads to inflammation of the synovial lining.
Option B: Traumatic arthritis results from blunt trauma to a joint or ligament.
Option C: Intermittent arthritis is a rare, benign condition marked by regular, recurrent joint effusions, especially in the knees.
Before Jacob undergoes arthroscopy, the nurse reviews the assessment findings for contraindications for this procedure. Which finding is a contraindication?
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Solution
Joint flexion of less than 50%
Option C: Arthroscopy is contraindicated in clients with joint flexion of less than 50% because of technical problems in inserting the instrument into the joint to see it clearly. Other contraindications for this procedure include skin and wound infections.
Option A: Joint pain may be an indication, not a contraindication, for arthroscopy.
Options B and D: Joint deformity and joint stiffness aren’t contraindications for this procedure.
Nurse Cecile is teaching a female client about preventing osteoporosis. Which of the following teaching points is correct?
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Solution
The recommended daily allowance of calcium may be found in a wide variety of foods.
Option C: Premenopausal women require 1,000 mg of calcium per day. Postmenopausal women require 1,500 mg per day. It’s often, though not always, possible to get the recommended daily requirement in the foods we eat.
Option D: Supplements are available but not always necessary.
Option A: Osteoporosis doesn’t show up on ordinary X-rays until 30% of the bone loss has occurred. Bone densitometry can detect bone loss of 3% or less. This test is sometimes recommended routinely for women over 35 who are at risk.
Option B: Strenuous exercise won’t cause fractures.
Nurse Mandy is preparing a client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. During the MRI scan, which of the following would pose a threat to the client?
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Solution
The client wears a watch and wedding band.
Option D: During an MRI, the client should wear no metal objects, such as jewelry, because the strong magnetic field can pull on them, causing injury to the client and (if they fly off) to others.
Options A and B: The client must lie still during the MRI but can talk to those performing the test by way of the microphone inside the scanner tunnel.
Option C: The client should hear thumping sounds, which are caused by the sound waves thumping on the magnetic field.
A female client with cancer is being evaluated for possible metastasis. Which of the following is one of the most common metastasis sites for cancer cells?
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Solution
Liver
Option A: The liver is one of the five most common cancer metastasis sites. The others are the lymph nodes, lung, bone, and brain.
Options B, C, and D: The colon, reproductive tract, and WBCs are occasional metastasis sites.
During a breast examination, which finding most strongly suggests that the Luz has breast cancer?
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Solution
A fixed nodular mass with dimpling of the overlying skin
Option B: A fixed nodular mass with dimpling of the overlying skin is common during late stages of breast cancer.
Option A: Many women have slightly asymmetrical breasts.
Option C: Bloody nipple discharge is a sign of intraductal papilloma, a benign condition.
Option D: Multiple firm, round, freely movable masses that change with the menstrual cycle indicate fibrocystic breasts, a benign condition.
A male client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis?
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Solution
Sigmoidoscopy
Option C: Used to visualize the lower GI tract, sigmoidoscopy and proctoscopy aid in the detection of two-thirds of all colorectal cancers.
Option A: Stool Hematest detects blood, which is a sign of colorectal cancer; however, the test doesn’t confirm the diagnosis.
Option B: CEA may be elevated in colorectal cancer but isn’t considered a confirming test.
Option D: An abdominal CT scan is used to stage the presence of colorectal cancer.
What is the most important postoperative instruction that nurse Kate must give a client who has just returned from the operating room after receiving a subarachnoid block?
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Solution
“Remain supine for the time specified by the physician.”
Option D: The nurse should instruct the client to remain supine for the time specified by the physician.
Option A: Local anesthetics used in a subarachnoid block don’t alter the gag reflex.
Option B: No interactions between local anesthetics and food occur.
Option C: Local anesthetics don’t cause hematuria.
Vic asks the nurse what PSA is. The nurse should reply that it stands for:
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Solution
prostate-specific antigen, which is used to screen for prostate cancer.
Option A: PSA stands for prostate-specific antigen, which is used to screen for prostate cancer.
Options B, C, and D: The other answers are incorrect.