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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Free Nursing Study Resources

Correct Answer is ["A","C","E"]

Explanation

Rationale for correct choices:

• Pain level presently 3 on a 0 to 10 scale: A reduction in pain from 8/10 to 3/10 indicates that the morphine is effectively alleviating the client’s pain. Effective analgesia allows for improved comfort, participation in breathing exercises, and reduced stress response.

• Client is able to take deep breaths, achieving 1,000 mL on incentive spirometer: Increased inspiratory volume demonstrates improved lung expansion, indicating that pain control is facilitating better respiratory effort. This is especially important to prevent atelectasis and maintain adequate oxygenation after rib fractures.

• Repositions in bed with minimal assistance: Ability to move with less assistance reflects improved comfort and mobility due to effective pain management. This shows the therapeutic effect of analgesia in enabling functional activity without excessive pain.

Rationale for incorrect choices:

• Client reports feeling "sleepy": Sleepiness is a common side effect of morphine, reflecting central nervous system depression rather than a therapeutic effect of pain relief. While mild sedation can accompany effective analgesia, it does not directly indicate improvement in the underlying condition.

• New mild cough noted: The appearance of a new cough is not a direct indicator of therapeutic pain relief. It may reflect airway irritation, increased secretions, or a response to deeper breathing, but it is not a measure of analgesic effectiveness.

• Attempted to get up to the chair, but experienced dizziness with standing: Dizziness indicates a side effect of the opioid (orthostatic hypotension or sedation), not a therapeutic response. This finding requires monitoring and safety interventions.

A. IV site without redness or swelling B. Temperature: 98.8° F (37.1° C) C. Respirations: 28 breaths/minute D. Heart rate: 92 beats/minute E. Taking shallow breaths F. Alert and oriented to person, place, time and situation G. Pain 8 on a 0 to 10 scale H. Blood pressure: 138/82 mm Hg I. Blood pressure: 138/82 mm Hg

Correct Answer is ["C","E","G"]

Explanation

A. IV site without redness or swelling: The IV site appears normal with no signs of infiltration or infection, so no immediate follow-up is required. This finding indicates proper IV insertion and maintenance.

B. Temperature: 98.8° F (37.1° C): This is within normal limits and does not indicate fever or infection, so it does not require immediate follow-up.

C. Respirations: 28 breaths/minute: This is above the normal adult range (12–20 breaths/minute) and may indicate respiratory distress due to pain, shallow breathing, or possible pulmonary complications such as atelectasis or pneumonia, requiring close monitoring and follow-up.

D. Heart rate: 92 beats/minute: Slightly elevated but within mild tachycardia range, which could be related to pain or anxiety. It should be monitored but does not require urgent follow-up.

E. Taking shallow breaths: Shallow breathing is concerning in a client with rib fractures, as it increases the risk for hypoventilation, atelectasis, and pneumonia. This requires immediate intervention, such as pain management and respiratory support.

F. Alert and oriented to person, place, time, and situation: Cognitive status is normal, so no follow-up is needed.

G. Pain 8 on a 0 to 10 scale: Severe pain limits deep breathing and mobility, increasing the risk of complications. Pain management should be addressed promptly to improve comfort and respiratory function.

H. Blood pressure: 138/82 mm Hg: Slightly elevated, likely related to pain or stress. Monitor trends, but it does not require immediate follow-up at this time.

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C","E"]

Explanation

Patient Data Exhibits The nurse is reviewing the client's initial assessment findings. Which assessment findings require follow-up? Select all that apply.

Correct Answer is ["C","E","G"]

Explanation

A client who is receiving zidovudine reports the appearance of pinpoint, red, round spots on the skin. Which result should the nurse report to the healthcare provider (HCР)?

The wife of a newly diagnosed client with Parkinson's disease asks the nurse if alternative or complimentary medical therapies might cure the disease. Which response should the nurse provide?

A pre-school age child with a congenital heart defect is brought to the clinic by the parent because of a fever and an earache. During the assessment, the parent asks the nurse why the child is at the 5th percentile for weight and height for age. Which response is best for the nurse to provide?

Which laboratory values are critical for the nurse to monitor for a client who is experiencing a thyrotoxic crisis?

The nurse is caring for a client with chronic kidney disease (CKD). Which meal selection should the nurse recommend to the client?

Patient Data Exhibits The client has started to wake up more, opening her eyes without stimulation and looking around the room. Which should the nurse do as the client becomes more aware of her surroundings? Select all that apply.

Patient Data <pre> Exhibits <p>For each assessment finding, click to indicate whether the findings from the client's assessment are generally associated with rotator cuff injury and/or humeral fracture. Each column must have at least one response selected.</p>