A client who is obese reports severe pain and inability to bear weight in the right knee after making dietary changes 3 weeks ago for weight loss. The client's medical history includes hypertension, gouty arthritis, and cholecystitis. Which instruction should the nurse include in the discharge teaching?

Use electric heating pad when pain is at its worse.

Increase fluid intake to 2000 mL per day.

Exercise daily for at least 30 minutes.

Eat high protein foods to achieve ideal body weight.

Answer and Explanation

The Correct Answer is B

A. Use electric heating pad when pain is at its worse: Heat can help relieve stiffness in arthritis, but during acute gout flares, applying heat may exacerbate inflammation. Cold therapy is generally recommended during severe joint pain episodes.

B. Increase fluid intake to 2000 mL per day: Adequate hydration helps prevent uric acid crystal formation, which can reduce the frequency and severity of gout attacks. Encouraging increased fluid intake is an important part of long-term management in clients with gouty arthritis.

C. Exercise daily for at least 30 minutes: While regular exercise supports weight loss and overall joint health, exercising during an acute flare can worsen pain and potentially injure the affected joint. Activity should be resumed gradually once inflammation subsides.

D. Eat high protein foods to achieve ideal body weight: High-protein diets, especially those rich in purines (e.g., red meat, organ meats), can exacerbate gout. Discharge teaching should focus on balanced nutrition with attention to foods that minimize uric acid levels.

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Correct Answer is A

Explanation

A. Sugar cookies: Sugar cookies are low in fat and not highly acidic, making them less likely to trigger reflux. This choice demonstrates understanding of dietary restrictions because it avoids common GERD triggers such as high-fat, spicy, or acidic foods.

B. Pizza: Pizza is high in fat, contains tomato sauce, and often includes spices—all of which can increase gastric acid secretion and exacerbate reflux symptoms. This food is not an appropriate choice for a child with GERD.

C. Tacos: Tacos typically contain seasoned meat, spices, and fatty ingredients that are known to aggravate reflux. The combination of fat and spice makes them unsuitable for someone managing GERD symptoms.

D. Chocolate milkshake: Chocolate and high-fat dairy products can lower esophageal sphincter tone and delay gastric emptying, both of which contribute to worsening reflux. This makes it an inappropriate snack option.

A. Ensure that the restraints are snug against the client's wrists. B. Move the ties so the restraints are secured to the side rails. C. Ensure that the knot can be quickly released. D. Tie the knot with a double turn or square knot.

Correct Answer is C

Explanation

A. Ensure that the restraints are snug against the client's wrists: Restraints should be snug enough to prevent injury but not so tight as to impair circulation. However, this does not address the safety concern related to the type of knot used.

B. Move the ties so the restraints are secured to the side rails: Restraints should never be tied to the side rails because this can cause injury if the rail moves or the client attempts to climb over it.

C. Ensure that the knot can be quickly released: Using a quick-release knot, such as a half bow or slip knot, is essential to ensure the nurse can rapidly remove the restraints in an emergency, such as sudden respiratory distress or circulatory compromise.

D. Tie the knot with a double turn or square knot: Square knots are secure but not quick to release. In contrast, safety guidelines recommend quick-release knots for client restraints to allow for prompt intervention.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which snack selection indicates to the nurse that a school-age child with gastroesophageal reflux understands the dietary restrictions?

Correct Answer is A

Explanation

Before leaving the room of a client who is confused, the nurse observes that a half bow knot was used to attach the client's wrist restraints to the movable portion of the client's bed frame. Which action should the nurse take before leaving the room?

Correct Answer is C

Explanation

The nurse assesses a client being treated for Herpes zoster (shingles). Which assessment(s) should the nurse include when evaluating the effectiveness of treatment? Select all that apply.

Patient Data Exhibits Click to indicate if the listed characteristic is consistent with a fat embolism or blood clot embolism. Each column must have at least one response option selected.

A 4-month-old with hydrocephalus is admitted to the hospital for shunt revision. When assessing for increased intracranial pressure, the nurse should observe the child for which finding(s)? Select all that apply.

A parent brings their child, who has a history of asthma, to the emergency department (ED). The child is wheezing and speaking one word between each breath. The child is anxious, tachycardic, and has labored respirations. Which assessment is most important for the nurse to obtain?

Patient Data Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

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The nurse is caring for a client who tests positive for gonorrhea. The client reports having had prior sexually transmitted infections (STIs). Which response should the nurse provide?

The nurse is performing an admission assessment for a newborn who has asymmetrical buttocks. Which assessment test results should the nurse report to the healthcare provider?