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A client is informed of having a benign bone tumor but that this type of tumor may become malignant. The nurse knows that this is characteristic of which type of tumor?
- A. Osteochondroma
- B. Enchondroma
- C. Osteoclastoma
- D. Osteoid osteoma
Correct Answer: C
Rationale: An osteoclastoma is a giant cell tumor that may invade local tissue; usually soft and hemorrhagic and may become malignant. An osteochondroma occurs as a large projection of bone at the ends of long bones, developing during growth periods and then becoming static bone mass. An enchondroma is a hyaline cartilage tumor that develops in the hand, ribs, femur, tibia, humerus, or pelvis. An osteoid osteoma is a painful tumor surrounded by reactive bone tissue.
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A client has had several diagnostic tests to determine systemic lupus erythematosus (SLE). What result is very specific indicator of this diagnosis?
- A. Positive Anti-dsDNA antibody test
- B. Positive Anti-Sm antibodies
- C. Positive ANA titer
- D. Elevated ESR
Correct Answer: A
Rationale: Anti-double-stranded DNA (anti-dsDNA) antibody test is a test that shows high titers of antibodies against native DNA. This is very specific for SLE because this test is not positive for other autoimmune disorders. Anti-Smith (anti-Sm) antibodies are specific for SLE, but are found in only 20% to 30% of clients with SLE. ANA titer shows the presence of an autoimmune disease but is not specific to SLE. The other lab studies may also indicate multisystem involvement.
The nurse is gathering objective data for a client at the clinic reporting arthritic pain in the hands. The nurse observes that the fingers are hyperextended at the proximal interphalangeal joint with fixed flexion of the distal interphalangeal joint. What does the nurse recognize this deformity as?
- A. Swan neck deformity
- B. Boutonniere deformity
- C. Ulnar deviation
- D. Rheumatoid nodules
Correct Answer: A
Rationale: A swan neck deformity is a hyperextension of the proximal interphalangeal joint with fixed flexion of the distal interphalangeal joint. A Boutonniere deformity is a persistent flexion of the proximal interphalangeal joint with hyperextension of the distal interphalangeal joint. Ulnar deviation is when the fingers are deviating laterally toward the ulna. A rheumatoid nodule is a subcutaneous nodule.
A family member is caring for an older adult client with osteomalacia in the home. When the home health nurse comes to evaluate the client, what should be a focus point of the visit?
- A. Making sure the client is receiving a daily bath
- B. Ensuring that the client is eating enough
- C. Observing for safety hazards that could be a fall risk
- D. Making sure the client has adequate financial resources
Correct Answer: C
Rationale: Clients with osteomalacia exhibit a waddling type of gait, putting them at risk for falls and fractures. Safety would be the priority in this circumstance such as scatter rugs, loose boards, and stairs. Older adult clients do not require a daily bath, and it may harm the skin. Nutrition is a necessity to question but the priority would be safety. Whether the client has adequate financial resources would be referred to social service.
A client is receiving treatment for rheumatoid arthritis but reports being allergic to eggs. What medication would the client be unable to receive?
- A. Methotrexate (Rheumatrex)
- B. Synvisc
- C. Anakinra (Kineret)
- D. Prednisone
Correct Answer: B
Rationale: Clients allergic to eggs should not receive Synvisc injections because they will also be allergic to this. The other medications can be taken with an egg allergy.
A client is taking large amounts of salicylates for the treatment of bursitis of the left shoulder. The client should be aware to report which symptoms of salicylism?
- A. Ringing in the ears
- B. Diarrhea
- C. Dry hacking cough
- D. Dry eyes
Correct Answer: A
Rationale: Signs of salicylate toxicity include headache, nausea, vomiting, tinnitus, increased pulse and respiratory rate, fever, mental confusion, and drowsiness. Dry hacking cough, diarrhea, and dry eyes are not symptoms of salicylate toxicity.