Which statement describes osteosarcoma?

Correct Answer: B

Rationale: In this question, the correct answer is B) Very malignant and metastasizes early. Osteosarcoma is a primary malignant bone tumor that arises from primitive bone-forming mesenchymal cells. It is known for its aggressive behavior, high malignancy, and tendency to metastasize early, commonly to the lungs. This option accurately describes the nature of osteosarcoma, making it the correct choice. Option A) High rate of local recurrence is incorrect because osteosarcoma is more known for its metastatic potential rather than local recurrence. While local recurrence can occur, it is not a defining characteristic of osteosarcoma. Option C) Arises in cancellous ends of long bones is incorrect because osteosarcoma commonly arises in the metaphyseal region of long bones, which is the area between the diaphysis and epiphysis, rather than specifically in the cancellous ends. Option D) Develops in the medullary cavity of long bones is incorrect because osteosarcoma typically arises in the metaphysis rather than within the medullary cavity of long bones. Educationally, understanding the characteristics of osteosarcoma is crucial for healthcare professionals, especially those working in oncology or orthopedics. Recognizing the aggressive nature of osteosarcoma and its typical presentation in long bones can aid in early diagnosis and appropriate management of this challenging condition.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Adding misoprostol (Cytotec) to the patient's drug regimen. Misoprostol is a prostaglandin analog that helps protect the stomach lining from the irritating effects of NSAIDs like ibuprofen. By adding misoprostol, the patient can continue to benefit from the pain relief of ibuprofen while reducing the risk of gastrointestinal side effects such as dyspepsia and nausea. Option B) Substituting naproxen for ibuprofen may not necessarily address the issue of dyspepsia and nausea, as naproxen is also an NSAID and can cause similar gastrointestinal side effects. Option C) Increasing the dose of acetaminophen is not a suitable solution as acetaminophen is not an NSAID and does not have the same mechanism of action as ibuprofen. Additionally, exceeding the recommended daily dose of acetaminophen can lead to liver damage. Option D) Administering ibuprofen with antacids may provide temporary relief for dyspepsia, but it does not address the underlying issue of GI irritation caused by NSAIDs. Antacids may also interfere with the absorption of ibuprofen, reducing its effectiveness in providing pain relief. In an educational context, understanding the rationale behind choosing the appropriate adjunct therapy like misoprostol is crucial in managing patients with OA who require NSAID therapy but are experiencing gastrointestinal side effects. It emphasizes the importance of considering the mechanism of action of medications and how they interact with the body to make informed decisions for optimal patient care.

Correct Answer: B

Rationale: The correct answer is B) There is joint stiffness after periods of inactivity. In osteoarthritis (OA), joint stiffness after periods of inactivity is a hallmark symptom. This occurs because during inactivity, there is less synovial fluid production in the joint, leading to stiffness when movement is resumed. This stiffness typically improves with gentle movement as the joint warms up. Option A is incorrect because in OA, larger weight-bearing joints like the hips and knees are usually affected first, not smaller joints. Option C is incorrect as the symptoms mentioned (fatigue, anorexia, weight loss) are not typically associated with OA. These are more commonly seen in systemic conditions like rheumatoid arthritis. Option D is incorrect because pain and immobility in OA are not typically aggravated by changes in barometric pressure. This phenomenon is more commonly seen in conditions like arthritis. Educationally, understanding the characteristic symptoms of OA is crucial for healthcare professionals to accurately diagnose and manage the condition. Recognizing the pattern of joint stiffness after inactivity helps differentiate OA from other forms of arthritis and guides appropriate treatment strategies focused on improving joint function and reducing pain.

Correct Answer: B

Rationale: In the context of treating a patient with an acute attack of gout, the nurse would expect to administer colchicine (Option B) due to its specific mechanism of action in reducing inflammation and pain associated with gout attacks. Colchicine works by inhibiting the inflammatory response to the deposition of urate crystals in joints, which is a hallmark of gout. Option A, aspirin, is not typically used in the treatment of acute gout attacks because it may actually exacerbate the condition by interfering with uric acid excretion. Aspirin can increase uric acid levels in the blood, worsening gout symptoms. Options C and D, allopurinol and probenecid, are drugs used for chronic management of gout by reducing uric acid levels in the body or increasing its excretion. These medications are not typically indicated for acute gout attacks like colchicine. In an educational context, understanding the appropriate pharmacological management of acute gout attacks is crucial for nurses caring for patients with this condition. By knowing the specific actions and indications of medications commonly used in gout treatment, nurses can effectively contribute to improved patient outcomes and symptom management.

Correct Answer: D

Rationale: The correct answer is D) High level of involvement of sacroiliac joints and the axial skeleton. This is a key characteristic of spondyloarthritides associated with HLA-B27. These conditions, such as ankylosing spondylitis, are characterized by inflammation primarily in the sacroiliac joints and the axial skeleton, leading to stiffness and pain in the lower back and hips. Option A) Symmetric polyarticular arthritis is more characteristic of conditions like rheumatoid arthritis, not spondyloarthritides associated with HLA-B27. Option B) Absence of extraarticular disease is not a defining feature of spondyloarthritides associated with HLA-B27 as these conditions can have extraarticular manifestations. Option C) Presence of rheumatoid factor and autoantibodies is more indicative of rheumatoid arthritis, not spondyloarthritides associated with HLA-B27. In an educational context, understanding the clinical characteristics and associations of different types of arthritis is crucial for accurate diagnosis and appropriate management. Recognizing the specific patterns of joint involvement and associated features can guide healthcare providers in formulating treatment plans and improving patient outcomes.