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100% Graded A+\ Chamberlain University-Illinois-NURS 509
A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain
is new,
located in the wrists and fingers bilaterally, with some subjective fever. The patient
denies a
rash; she also denies recent travel or camping activities. She has a family history
significant for
rheumatoid arthritis. Based on this information, which of the following pathologic
processes
would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic
B) Inflammatory
The description is most consistent with an inflammatory process, although all the other
etiologies should be considered. Lyme disease is an infection which
commonly causes
arthritis, hemophilia is a hematologic condition which can cause bleeding in the
joints, and trauma can obviously cause joint pain.
,A 47-year-old contractor presents for evaluation of neck pain, which has been
intermittent for several years. He normally takes over-the-counter medications to ease
the pain, but this time they haven't worked as well and he still has
discomfort. He recently wallpapered the entire second floor in his house, which
caused him great discomfort. The pain resolved with rest. He denies fever, chills,
rash, upper respiratory symptoms, trauma, or injury to the neck. Based on this
description, what is the most likely pathologic process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic
C) Degenerative
The description is most consistent with degenerative arthritis in the neck. The
patient has had intermittent symptoms and the questions asked to elicit pertinent
negative and
positive findings are negative for infectious, traumatic, or neoplastic disease.
,A 15-year-old high school sophomore comes to the clinic for evaluation of a 3- week
history
of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and nonproductive
cough. Which
is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular
C) Allergic
This description is most consistent with allergic rhinitis.
, A 19-year old-college student presents to the emergency room with fever,
headache, and
neck pain/stiffness. She is concerned about the possibility of meningococcal
meningitis.
Several of her dorm mates have been vaccinated, but she hasn't been. Which of the
following
physical examination descriptions is most consistent with meningitis?
A) Head is normocephalic and atraumatic, fundi with sharp discs, neck supple
with full range
of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous
muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
tender to
palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
supple with
full range of motion
C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
tender to
palpation, unable to perform range of motion
Blurred disc margins are consistent with papilledema, and neck tenderness and lack
of range of motion are consistent with neck stiffness, which in this scenario is likely
to be caused
by meningeal inflammation. Kernig's and Brudzinski's signs are also helpful in
testing for meningeal irritation on exam.