Exhibits

The nurse is reviewing the client's medical record to better understand the previous gout attacks.

Click to indicate if the findings are consistent with an acute gout attack, chronic gout, or both. Each column may have more than one response. Each column must have at least one response selected.

Pain at the affected joint

Low grade fever

Occurs in more than 1 joint

Renal dysfunction

Visible tophi

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"}}

Pain at the affected joint

Acute gout attack: Yes. During an acute gout attack, the pain is typically sudden, intense, and localized to one joint, often the big toe.
Chronic gout: No. Chronic gout usually involves recurrent attacks over time, but the pain at any given moment may not be as intense or localized to a single joint unless there is a flare-up.

2. Low grade fever

Acute gout attack: Yes. During an acute attack, inflammation caused by uric acid crystals can lead to mild fever (100°F to 101°F).
Chronic gout: No. Chronic gout usually does not cause fever unless there is a secondary infection or other complicating factor.

3. Occurs in more than 1 joint

Acute gout attack: No. Typically, an acute gout attack involves only one joint, especially the big toe (podagra).
Chronic gout: Yes. Over time, gout can involve multiple joints, especially with untreated or poorly managed cases.

4. Renal dysfunction

Acute gout attack: No. Acute gout attacks generally do not cause renal dysfunction.
Chronic gout: Yes. Chronic gout can lead to kidney damage or urate nephropathy due to long-term hyperuricemia and uric acid crystal deposition in the kidneys.

5. Visible tophi

Acute gout attack: No. Tophi, which are uric acid crystal deposits under the skin, typically appear in later stages of gout, not during an acute attack.
Chronic gout: Yes. Visible tophi are a characteristic feature of chronic gout and occur after repeated and prolonged gout attacks, leading to the accumulation of uric acid crystals in soft tissues.

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Correct Answer is C

Explanation

A. Clear, dark amber-colored urine may indicate dehydration or concentrated urine, which does not necessarily signify improvement in liver function or treatment efficacy.

B. A prothrombin time within normal limits may indicate improved liver function; however, it is not the primary goal of the treatment plan focused on managing ascites and fluid retention in cirrhosis.

C. Decreased abdominal girth is a key indicator of progress in managing fluid retention associated with cirrhosis, as the treatment plan aims to reduce ascites through a low sodium diet and albumin infusions.

D. Improved level of consciousness is essential for overall recovery but is not the primary measure of progress related to fluid management and treatment effects in this context.

A. Monitor urine and stool for occult blood regularly. B. Ensure a large gauge catheter is used to obtain blood samples. C. Remove cold and frozen foods from dietary trays. D. Wrap bruised areas with elastic bandage dressings.

Correct Answer is A

Explanation

A. Monitoring for occult blood in urine and stool is crucial in clients with low platelet counts to detect any potential bleeding early, as they are at increased risk of bleeding due to thrombocytopenia.

B. Using a large gauge catheter may be necessary for some procedures, but it is not the priority intervention regarding the client’s current state and platelet count.

C. Removing cold and frozen foods from dietary trays does not directly address the critical concern of bleeding associated with low platelet levels.

D. While protecting bruised areas is important, it is secondary to monitoring for active bleeding, which is more critical at this stage.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An older adult client with cirrhosis of the liver and hepatic failure is placed on a low sodium diet and is receiving periodic albumin infusions. Which assessment finding indicates progress toward the desired effect of this treatment plan?

Correct Answer is C

Explanation

A client with leukemia is receiving chemotherapy. The nurse observes the client is weak, pale, and febrile. After reviewing the client's most recent laboratory results which reveals a platelet count of 25,000/mm3 (25 x 10^9/L), which intervention should the nurse include in the plan of care?

Correct Answer is A

Explanation

A client receives a prescription for 1 L of lactated Ringers to be infused IV over 8 hours. The IV administration set delivers 15 gtt/mL. How many mL/hr should the nurse program the infusion pump to deliver? (Enter numerical value only.)

The nurse is developing a plan of care for a client who reports blurred vision and who is newly diagnosed with cardiovascular disease. Which outcome should the nurse include in the plan of care for this client?

A client with bilateral carpal tunnel syndrome reports to the nurse that the pain and tingling experienced worsens at night. Which client teaching should the nurse provide?

Which dietary instruction is most important for the nurse to explain to a client who has had gastric bypass surgery?

The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving psoralen and ultraviolet A light (PUVA) treatment. Which assessment finding indicates that the client has been overexposed to the treatment?

A client who has developed acute kidney injury (AKI) due to an aminoglycoside antibiotic has moved from the oliguric phase to the diuretic phase of AKI. Which parameters are most important for the nurse to plan to carefully monitor?

Exhibits The nurse has implemented additional needed actions. Click the assessment data which indicates the interventions were successful and which assessment data provides no indication that the interventions were successful. Each column must have at least one answer selected.