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 D

Explanation

A. While hematocrit levels provide information about blood volume status, they are not directly relevant to infection status or wound healing in burn patients.

B. Blood pH levels can indicate acid-base imbalances, but they do not specifically inform the nurse about the presence of infection.

C. Platelet count is important for assessing coagulation and bleeding risks, but it does not provide direct information regarding infection.

D. White blood cell (WBC) count is critical in assessing for infection, as an elevated WBC count can indicate the presence of an infection, particularly in a client with significant burns who is at increased risk for sepsis.

A. Hemoglobin levels. B. Red blood cell count. C. White blood cell count. D. Platelet count.

Correct Answer is D

Explanation

A. Hemoglobin levels can indicate anemia but are not directly related to the presence of petechiae and ecchymosis, which suggest bleeding issues.

B. The red blood cell count is also important for understanding anemia but does not specifically address the bleeding disorders indicated by the client’s symptoms.

C. The white blood cell count provides information on the immune status but does not relate to bleeding manifestations.

D. The platelet count is critical to assess because petechiae and ecchymosis can be indicative of thrombocytopenia (low platelet count), which can lead to increased bleeding tendencies. Monitoring platelet levels will help determine the cause of these symptoms.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While caring for a client with a full thickness burn covering 40% of the body, the nurse observes purulent drainage at the wound. Before reporting this finding to the healthcare provider, the nurse should review which of the client's laboratory values?

Correct Answer is D

Explanation

The nurse assesses a client with petechiae and ecchymosis scattered across the arms and legs. Which laboratory result should the nurse review?

Correct Answer is D

Explanation

Exhibits The nurse is reviewing the client's dietary choices for opportunities to promote better outcomes by limiting gout attacks. Select the 3 dietary choices that are not part of the recommended diet for a client with gout.

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Exhibits The nurse has identified the priority problem for the client and now must determine proper care interventions. Based on the client history and the assessment data, which action(s) should the nurse anticipate? Select all that apply.

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?

When conducting discharge teaching for a client diagnosed with diverticulosis, which diet instruction should the nurse include?

Following a lumbar puncture, a client voices several concerns. Which concern indicates to the nurse that the client is experiencing a complication of the procedure?

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