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. Obtaining a sample of the drainage is not an immediate priority after evisceration; the patient's safety and stabilization come first.

B. Auscultating the abdomen for bowel sounds is important but secondary to addressing the immediate crisis of evisceration.

C. Preparing the client to return to the operating room is the priority action because evisceration indicates a surgical emergency that requires prompt intervention to repair the abdominal wall and prevent complications.

D. While additional sterile dressing supplies may be needed, addressing the evisceration takes precedence to prevent further injury and manage the patient’s condition.

A. Tenderness upon palpation and generalized erythema. B. Thick skin plaques topped by silvery white scales. C. Requires sunglasses because sunlight hurts eyes. D. Brown, rough, greasy, wart-like papules on the face.

Correct Answer is A

Explanation

A. Tenderness upon palpation and generalized erythema indicate skin irritation and possible sunburn, which are signs of overexposure to PUVA treatment. This finding suggests that the client may have received excessive ultraviolet exposure, leading to skin damage.

B. Thick skin plaques topped by silvery white scales are characteristic of psoriasis vulgaris itself, not a sign of overexposure to PUVA.

C. Requiring sunglasses because sunlight hurts the eyes may indicate sensitivity but is not a specific indicator of overexposure to PUVA treatment; it could relate to other issues such as underlying eye conditions.

D. Brown, rough, greasy, wart-like papules on the face are not typically associated with PUVA overexposure but could be related to other skin conditions or lesions.

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Naxlex Comprehensive Predictor Exams

A client who had colon surgery 3 days ago is anxious and requesting assistance to reposition. While the nurse is turning the client, the wound dehisces and eviscerates. The nurse moistens an available sterile dressing and places it over the wound. Which intervention should the nurse implement next?

Correct Answer is C

Explanation

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?

Correct Answer is A

Explanation

The nurse is caring for a client who tests positive for the sexually transmitted infection (STI) gonorrhea. The client reports having sex with someone who has many partners. Which response should the nurse provide?

Exhibits Client history has been collected, and the nurse performs a physical assessment and records vital signs. Which finding(s) in the client's health record should the nurse recognize places the client at a greater risk of developing gout? Select all that apply.

A client with a fracture of the right femur has had skeletal traction applied. Which intervention should the nurse include in the client's nursing plan of care?

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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The nurse is caring for a client who is receiving teletherapy radiation for a malignant tumor. Which instructions regarding skin care of the portal site should the nurse provide?

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?