A 35 year old patient presents with a skin rash, pain and sw…

A 35 year old patient presents with a skin rash, pain and swelling in the bilateral knees, hips, wrists and ankles.  The rheumatoid factor, uric acid  and ANA labs were normal.  Tests for lyme disease were negative. What subjective and objective data should the nurse practitioner be sure to include in the workup for this patient as they continue to explore a possible less common cause for the patient’s symptoms. 

The nurse practitioner examines a patient presenting with ba…

The nurse practitioner examines a patient presenting with back pain.   After observing and palpating the back the provider checks the range of motion. Lastly, the provider asks the patient to lay supine on the exam table.  The provider places one hand above the knee, cups the heel with the other hand and slowly raises the straight leg.  The patient states she feels pain below her knee when the leg is at 60 degrees and the pain worsens with dorsiflexion the ankle.  This finding should suggest: