A 47-Year-Old Man Comes to the Office Due to Several

question 132

Multiple Choice

A 47-year-old man comes to the office due to several months of worsening pain, stiffness, and swelling of the bilateral wrists and hand joints.  The symptoms are worse in the morning or after prolonged rest and gradually improve with continued use.  He also has had occasional pain in the ankles and low back, which he attributes to working in the construction industry for many years.  The patient has no significant medical history.  He takes ibuprofen as needed for the pain and over-the-counter emollients for dry skin, but otherwise takes no medications.  He has smoked a pack of cigarettes daily for 20 years and drinks 4 or 5 beers on weekends.  Vital signs are within normal limits.  Physical examination shows swelling and tenderness of the bilateral wrists and hand joints, including the distal interphalangeal joints.  Nail examination findings are shown in the exhibit below.  Which of the following is the most likely cause of this patient's symptoms?

• A)Gouty arthritis
• B)Hypertrophic osteoarthropathy
• C)Osteoarthritis
• D)Psoriatic arthritis
• E)Rheumatoid arthritis

Comprehend the phases of perioperative care and the transitions between them.

Recognize the importance of and strategies for preoperative preparation, including patient education and physical readiness.

Demonstrate knowledge of postoperative care priorities, including pain management, infection prevention, and promoting healing and recovery.

Understand the collaborative roles within the surgical team and the importance of communication within the team and with the patient.

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Definitions:

Procedural Guidelines

Documented instructions designed to guide the actions and decision-making processes of professionals in specific procedures or processes.

Monitoring

The continual assessment of a patient's health and the effectiveness of their treatment plan.

Nursing Intervention

Actions undertaken by a nurse to solve or alleviate a patient's health problem, which can be therapeutic, preventive, or promotive in nature.

Pain Medication

Medicines used to alleviate or reduce pain, ranging from over-the-counter options to prescription opioids.