A client with a history of gout comes to the clinic with an inflamed left knee. The client reports the knee is extremely painful to touch for the second time in 6 months. The healthcare provider prescribes colchicine and ibuprofen.
What instruction should the nurse include in the discharge teaching?

Utilize an electric heating pad when the pain is at its worst.

Refrain from taking medications containing acetylsalicylic acid.

Consume high protein foods to achieve ideal body weight.

Encourage active range of motion to limit stiffness.

Answer and Explanation

The Correct Answer is B

Choice A rationale
Using an electric heating pad when the pain is at its worst is not recommended for a client with gout. Heat can increase inflammation and exacerbate pain. Instead, applying a cold pack to the inflamed joint can help reduce inflammation and relieve pain.
Choice B rationale
Acetylsalicylic acid, also known as aspirin, can increase uric acid levels in the blood and exacerbate gout symptoms. Therefore, clients with gout should avoid taking medications containing acetylsalicylic acid.
Choice C rationale
Consuming high-protein foods can increase uric acid levels in the blood and trigger a gout attack. Clients with gout are usually advised to follow a low-purine diet, which involves limiting the intake of high-purine foods such as red meat and seafood.

Choice D rationale
Encouraging active range of motion to limit stiffness may not be appropriate for a client with an acute gout attack. During an attack, moving the affected joint can be extremely painful. Rest and immobilization of the affected joint are usually recommended during this time.

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Correct Answer is A

Explanation

Choice A rationale
Reassuring the adolescent that experiencing phantom limb pain can be a normal post-surgical sensation is the correct choice. Phantom limb pain is a common occurrence after amputation and can be very distressing for the patient. The nurse should validate the patient’s experience and provide reassurance. Non-pharmacological interventions such as mirror therapy, visualization, and other cognitive-behavioral strategies can also be helpful.

Choice B rationale
Guiding the patient in moving the non-affected limb to override the sensation being experienced is not the most appropriate intervention. While some therapies for phantom limb pain involve focusing on the remaining limb, this should be done under the guidance of a trained therapist.

Choice C rationale
Telling the patient that the sensations of tingling and pain are not real is not an appropriate intervention. Although the limb is no longer there, the pain that the patient is experiencing is very real. It is important to validate the patient’s experience and provide appropriate interventions.

Choice D rationale
Affirming that a prosthetic with physical therapy will gradually improve the symptoms is not the most appropriate intervention. While using a prosthetic and engaging in physical therapy can help with overall recovery and adaptation after amputation, they do not directly address phantom limb pain. The pain is a result of mixed signals from the brain and nerves, and it requires specific interventions.

A. This is a routine blood test required by law to screen for metabolic deficiencies. B. Dosages for thyroid replacement therapy will be determined by this test. C. This technique is used for early detection of intellectual disabilities. D. These laboratory values will provide data to anticipate delays in growth and development.

Correct Answer is A

Explanation

Choice A rationale
The neonatal screening test, which includes thyroxine (T4) and thyroid-stimulating hormone (TSH) levels, is a routine blood test required by law to screen for metabolic deficiencies. This test helps diagnose thyroid conditions. T4 is a thyroid hormone, and too much or too little of it can indicate an issue with the thyroid. TSH is a hormone your pituitary gland makes. It stimulates your thyroid to produce T4 and T3 (triiodothyronine) hormones. A TSH test is the best way to initially assess thyroid function. In fact, T4 tests more accurately reflect thyroid function when combined with a TSH test. Measuring T4 levels might not be necessary in all thyroid conditions. Other names for a T4 test include: Free thyroxine, Total T4 concentration, Thyroxine screen, Free T4 concentration, Free T4 index (FTI)1.

Choice B rationale
While the T4 and TSH tests can help diagnose thyroid conditions, they are not specifically used to determine dosages for thyroid replacement therapy. The dosage of thyroid replacement therapy is usually determined by a healthcare provider based on the patient’s medical condition, weight, age, laboratory test results, and response to treatment.
Choice C rationale
The neonatal screening test is not specifically used for the early detection of intellectual disabilities. However, it is important to note that untreated congenital hypothyroidism can lead to intellectual disabilities. Therefore, early detection and treatment of hypothyroidism generally result in normal growth and development.
Choice D rationale
While these laboratory values can provide data about the thyroid function of the newborn, they do not directly provide data to anticipate delays in growth and development. However, untreated congenital hypothyroidism can lead to growth and developmental delays. Therefore, early detection and treatment of hypothyroidism generally result in normal growth and development.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing postoperative care for an adolescent who underwent a left leg amputation due to osteosarcoma. The adolescent reports experiencing phantom limb pain. Which non-pharmacological intervention should the nurse provide?

Correct Answer is A

Explanation

The nurse is collecting a heel-stick blood specimen for a neonatal screen, which includes thyroxine (T4) and thyroid- stimulating hormone (TSH) levels, prior to discharging a 2-day-old patient. When the parents ask why these tests are being conducted, which explanation should the nurse provide?

Correct Answer is A

Explanation

An adult patient visits the clinic expressing concern about a lump that appeared on their neck about a week ago. Upon examination, the nurse finds a large, non-tender, hardened left subclavian lymph node without any overlying tissue inflammation. What could these findings indicate?

A patient admitted to the hospital with a suspected ruptured diverticulum develops signs and symptoms of septic shock. The healthcare provider prescribes a sepsis protocol. Which intervention is most important for the nurse to include in the plan of care?

What intervention(s) should the nurse initiate if elder mistreatment is suspected? Select all that apply.

A caregiver brings a client with end-stage Alzheimer’s disease to the clinic for an appointment with the healthcare provider. The caregiver confides in the nurse about experiencing sleepless nights and frequent bouts of crying. What action should the nurse take?

A mother rushes into the emergency department carrying her toddler who has been exposed to some cleaning products. The child has a chemical smell on their hands, face, and clothes. After ensuring the airway is patent, which action should the nurse take first?

The nurse observes an unlicensed assistive personnel (UAP) preparing to provide personal care for a patient who requires contact precautions. The UAP has put on a gown and gloves and has secured the tops of the gloves over the gown sleeves. What action should the nurse take?