Exhibits

Nurse analyzes the assessment findings.

Click to indicate which findings are indicative of rheumatoid arthritis or are not applicable to that disease. Each row must have only one response option selected.

Joint swelling

Heberden nodes

Symmetrical involvement

Pain increases with motion

Fatigue and fever

Morning stiffness quickly resolves

Small joints of the hand

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"},"G":{"answers":"A"}}

Finding: Joint swelling

Rheumatoid arthritis

Rationale: Joint swelling is a common finding in rheumatoid arthritis (RA). RA typically causes inflammation in the joints, leading to swelling, pain, and stiffness. This is an indicator of the disease as it often involves multiple joints in a symmetrical pattern.

Finding: Heberden nodes

Not applicable

Rationale: Heberden nodes are not associated with rheumatoid arthritis but rather with osteoarthritis. These nodes are bony swellings that develop at the distal interphalangeal joints (DIP) of the fingers and are characteristic of osteoarthritis, not RA.

Finding: Symmetrical involvement

Rheumatoid arthritis

Rationale: Symmetrical joint involvement is a hallmark of rheumatoid arthritis. RA commonly affects joints on both sides of the body in a symmetrical fashion, which helps differentiate it from other forms of arthritis that may not have symmetrical patterns.

Finding: Pain increases with motion

Rheumatoid arthritis

Rationale: Pain that increases with motion is typical of rheumatoid arthritis. In RA, the affected joints often become more painful with activity, particularly when the joints are inflamed. This contrasts with some other forms of arthritis, where pain might be more constant or relieved by movement.

Finding: Fatigue and fever

Rheumatoid arthritis

Rationale: Fatigue and fever are systemic symptoms that can be associated with rheumatoid arthritis. RA is an autoimmune disease that can cause general malaise, fever, and significant fatigue along with joint symptoms.

Finding: Morning stiffness quickly resolves

Not applicable

Rationale: Morning stiffness that persists for a significant period is a characteristic feature of rheumatoid arthritis. The stiffness in RA typically does not quickly resolve and can last for several hours. Quick resolution of morning stiffness is more characteristic of other conditions, such as osteoarthritis.

Finding: Small joints of the hand

Rheumatoid arthritis

Rationale: Rheumatoid arthritis commonly affects the small joints of the hands, including the metacarpophalangeal joints (MCP) and proximal interphalangeal joints (PIP). This is a distinguishing feature of RA, as it often targets these joints in a symmetrical manner.

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Correct Answer is D

Explanation

A. Using the fingertips to compress tissue over the lungs for a crackling sensation is not an appropriate method for assessing tactile fremitus. This approach is more related to detecting crepitus or subcutaneous emphysema.
B. Using a stethoscope to listen to and compare breath sounds is useful for assessing lung function and detecting abnormalities like wheezes or crackles but does not assess tactile fremitus.
C. Observing the size and shape of the chest wall provides information about overall lung expansion and structural abnormalities but does not assess tactile fremitus, which involves feeling vibrations.
D. Placing the palm of the hand on the chest wall to feel vibrations while the client speaks is the correct method to assess tactile fremitus. Increased fremitus may indicate pneumonia or other lung abnormalities, as the vibrations are transmitted more effectively through consolidated lung tissue.

A. Rebound tenderness B. Sharp, severe pain C. Audible thud without pain D. Rigidity and firmness

Correct Answer is B

Explanation

A. Rebound tenderness is typically associated with peritoneal irritation and is not expected in pyelonephritis. It is more commonly observed in conditions like appendicitis or peritonitis.
B. Sharp, severe pain upon percussion of the costovertebral angle (CVA) is a hallmark sign of pyelonephritis, indicating inflammation or infection in the kidneys. This response, known as CVA tenderness, is a key diagnostic indicator of this condition.
C. An audible thud without pain would be considered a normal finding and does not suggest the presence of pyelonephritis or other kidney-related issues. The absence of pain would likely rule out significant kidney inflammation.
D. Rigidity and firmness are typically associated with muscle guarding or abdominal wall tension rather than kidney involvement. This finding would not be expected in the context of pyelonephritis.

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Exhibits Nurse analyzes the assessment findings. Click to indicate which findings are indicative of rheumatoid arthritis or are not applicable to that disease. Each row must have only one response option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In assessing tactile fremitus in the client with suspected pneumonia, the nurse should perform which action?

Correct Answer is D

Explanation

The nurse is performing an admission assessment for a client with pyelonephritis who has urgency and burning while urinating. Which finding indicates an expected response when the nurse percusses the costovertebral angle?

Correct Answer is B

Explanation

While completing an admission assessment for a client with gastrointestinal bleeding, the nurse inspects the perianal area and anus. Which findings indicate a normal appearance of the anus?

While auscultating a client's abdomen, the nurse hears a low-pitched blowing sound in the upper midline area. Which is the likely indication of this finding?

While completing an admission assessment, the nurse is unable to palpate the client's left dorsalis pedis (DP) pulse. Which intervention is most important for the nurse to implement?

During an admission assessment, which approach should the nurse use to assess a client's speech patterns?

An adult client exhibits an allergic reaction to an insect bite. The nurse should observe the client's skin for which finding?

A male client arrives at the clinic for a follow-up health assessment after recent antibiotic treatment for pneumonia without hospitalization. Which technique should the nurse implement to assess for adventitious lung sounds?

A client presents with itching and pain in the left ear that started several days after beginning swim lessons. The nurse observes a discharge coming from the ear with a musty odor. How should the nurse expect the ear to appear when performing an otoscopic examination?

The nurse is examining an older female client and suspects that she has a dysfunction in her hip region. Which procedure should the nurse perform to further assess for hip dysfunction?

Exhibits

Nurse analyzes the assessment findings.

Click to indicate which findings are indicative of rheumatoid arthritis or are not applicable to that disease. Each row must have only one response option selected.