A nurse is conducting a physical examination of the musculoskeletal system of a client who reports having joint pain. Which signs indicate there is inflammation in the joints? Select all that apply.

subcutaneous nodules

crepitus

warmth

swelling

redness

tenderness

Answer and Explanation

Correct Answer : C,D,E,F

A.   Subcutaneous nodules are lumps or masses that can occur beneath the skin, sometimes seen in conditions like rheumatoid arthritis.
B.   Crepitus refers to a crackling or popping sound heard or felt during joint movement. It is often associated with osteoarthritis or other joint conditions.
C.   Warmth or increased temperature over the joint area is a common sign of inflammation. It occurs because inflammation increases blood flow to the affected area.
D.   Swelling, or edema, is the accumulation of fluid in the joint space or surrounding tissues. It is a clear sign of inflammation and can be due to increased fluid production or leakage from blood vessels.
E.   Redness, or erythema, around the joint is a result of increased blood flow to the area due to inflammation. It is often accompanied by warmth.
F.   Tenderness refers to pain or discomfort in the joint area when touched or palpated. It indicates an inflammatory process in the joint.

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Correct Answer is A

Explanation

A. muscle strength grade of 3 indicates that the client can move the arm (or other limb) against gravity but not against any additional resistance. In this case, if the client is able to actively move the right arm against gravity, this is a correct grading. The ability to move the arm against gravity alone aligns with a grade of 3.
B. A muscle strength grade of 2 indicates that the client can move the arm (or other limb) only with gravity eliminated. This means that the client can move the limb when it is placed in a horizontal position but not against gravity. Since the client can move the arm against gravity, this grade is not applicable.
C. A muscle strength grade of 1 indicates that there is muscle contraction but no movement of the limb. This means there is some visible muscle activity but insufficient to cause any joint movement. Since the client is able to move the arm actively against gravity, this grade does not fit the observed finding.

D. A muscle strength grade of 5 indicates normal strength, where the client can move the limb against gravity and against full resistance. If the client can move the right arm against gravity but not necessarily against full resistance, this is not indicative of a grade of 5. The grade of 5 would be reserved for when the muscle can move against full resistance without difficulty.

A. Decorticate Rigidity B. Flaccid C. Decerebrate Rigidity D. Hemiplegia

Correct Answer is A

Explanation

A. Decorticate rigidity is characterized by flexion of the arms and extension of the legs. In this posture, the upper arms are flexed and held tightly to the sides, with the elbows, wrists, and fingers also flexed. The legs are extended and internally rotated.
B. Flaccid posture, or flaccidity, is characterized by a complete lack of muscle tone, which leads to a limp and lifeless appearance. There is no resistance to passive movement, and the muscles are weak or paralyzed.

C. Decerebrate rigidity is characterized by extension of both the arms and the legs. In this posture, the arms are extended at the sides with the wrists and fingers flexed, and the legs are extended and internally rotated. This type of rigidity indicates damage to the brainstem below the red nucleus.
D. Hemiplegia refers to paralysis of one side of the body, which can result from brain injury or stroke affecting one hemisphere of the brain. The affected side will have limited or no movement and muscle tone.

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A nurse is conducting a physical examination of the musculoskeletal system of a client who reports having joint pain. Which signs indicate there is inflammation in the joints? Select all that apply.

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is A

Explanation

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