A nurse is assessing a client who has Paget's disease of the bone. Which of the following findings should the nurse expect? (Select all that apply.)

Acetaminophen is commonly used for pain relief in osteoarthritis. It is recommended for clients who have mild to moderate pain. It does not reduce inflammation but can be effective in managing pain without the gastrointestinal side effects associated with NSAIDs.

Choice B reason:
Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that is specifically a COX-2 inhibitor. It is used to reduce pain and inflammation in osteoarthritis. Celecoxib can be a good option for those who need an anti-inflammatory and may have a lower risk of gastrointestinal bleeding compared to other NSAIDs.

Choice C reason:
Ibuprofen, another NSAID, is effective in reducing the inflammation and pain associated with osteoarthritis. It is available over the counter and can be used for short-term pain management, but it should be used cautiously due to potential side effects, including gastrointestinal bleeding and cardiovascular risks.

Choice D reason:
Cyclobenzaprine is a muscle relaxant and is not typically used as a first-line treatment for osteoarthritis. It may be prescribed in cases where muscle spasms are present, but it does not directly address the joint pain or inflammation caused by osteoarthritis.

Choice A reason:

Babinski's sign is a neurological reflex that's tested by stroking the sole of the foot. A positive Babinski's sign, which is normal in infants but abnormal in adults, is indicated by dorsiflexion of the great toe (the toe points up) while the other toes fan out. This reflex suggests dysfunction of the corticospinal tract, which may be due to various neurological conditions. In the context of a stuporous patient with an unrepaired femur fracture, a positive Babinski's sign could indicate an acute neurological change possibly related to the injury or a secondary complication such as a fat embolism syndrome, which can occur after fractures and may affect the brain.

Choice B reason:

Pronation of the arms is not associated with Babinski's sign. Pronation is a rotational movement where the hand and upper arm are turned inwards. While arm movements are part of the neurological examination, they do not constitute a response to the plantar reflex test used to elicit Babinski's sign.

Choice C reason:

Pinpoint pupils may indicate opioid overdose or damage to the pons due to various causes, but they are not a component of Babinski's sign. Pupil size and reaction to light are important in neurological assessments, but they are separate from the reflexes tested by the Babinski sign.

Choice D reason:

Jerking contractions of the head and neck are not related to Babinski's sign. These could be indicative of seizure activity or other neurological disorders but are not a response to the plantar reflex test.