The client is a 70-year-old female training for a triathlon. She was hit by a car while jogging and has an abrasion that is 25 cm by 12 cm on her right leg and a liver laceration. She underwent an exploratory laparotomy to repair the liver laceration and to search for other internal injuries.

The client has no chronic medical conditions and is in good health. She takes a calcium and magnesium supplement daily. She denies smoking or drinking alcohol.

What age-related factors may factor into this client's wound healing? Select all that apply.

Insulin resistance

Decreased epidermal turnover

Pigmentation changes

T-cell function decrease

Answer and Explanation

Correct Answer : B,D

The age-related factors that may factor into this client's wound healing are: Decreased epidermal turnover: As people age, the turnover of skin cells decreases, resulting in slower wound healing. This can prolong the healing process and increase the risk of complications.

T-cell function decrease: The immune system's function, including T-cell function, tends to decline with age. T-cells play a crucial role in the immune response and wound healing. Decreased T-cell function can impair the body's ability to fight infection and promote efficient healing.

Insulin resistance and pigmentation changes are not directly age-related factors that impact wound healing. Insulin resistance is a condition related to impaired glucose metabolism and can affect wound healing in individuals with diabetes or other metabolic disorders, but it is not necessarily an age-related factor. Pigmentation changes are primarily cosmetic and do not directly affect the physiological processes involved in wound healing.

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Correct Answer is A

Explanation

Following a pneumonectomy, it is important for the client to gradually resume normal activities and engage in social interactions. Encouraging family gatherings can provide emotional support, facilitate social connections, and help reduce feelings of isolation that the client may be experiencing.

While it is generally important for clients who have undergone a pneumonectomy to take precautions to reduce the risk of respiratory infections, such as avoiding crowded places and individuals with respiratory infections, completely avoiding social contact for several weeks is not necessary or realistic in most cases. It is essential to find a balance between protecting the client's health and promoting their emotional well-being and social integration.

Wearing a face mask during family events may not be necessary unless there is a specific concern about respiratory infections. The nurse can educate the client about the importance of good hand hygiene and avoiding close contact with individuals who are actively ill with respiratory infections.

A. Eat high protein foods to achieve ideal body weight. B. Report experiencing right upper quadrant discomfort. C. Use electric heating pad when pain is at its worse. D. Replace dietary table salt with salt substitutes.

Correct Answer is B

Explanation

Febuxostat is a medication used to manage hyperuricemia and prevent gout attacks. However, it has been associated with hepatotoxicity, including liver enzyme elevations and liver failure. Therefore, it is important for the nurse to instruct the client to report any signs or symptoms of liver dysfunction, such as right upper quadrant discomfort. This will allow for prompt evaluation and appropriate management if hepatotoxicity occurs.

While maintaining a healthy weight and dietary modifications may be beneficial for managing gout, specific instructions regarding protein intake should be individualized and provided by a healthcare provider or a registered dietitian.

Using an electric heating pad when pain is at its worst may provide temporary symptomatic relief for gout attacks, but it is not specific to the use of febuxostat. The focus of discharge teaching should be on medication adherence, monitoring for adverse effects, and lifestyle modifications to prevent gout attacks.

Replacing dietary table salt with salt substitutes is not a specific instruction for a client taking febuxostat. While reducing sodium intake may be recommended as part of an overall healthy diet, it is not directly related to the use of febuxostat or management of gout attacks. Dietary modifications for gout management should be individualized and based on the client's specific needs and preferences.

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Naxlex Comprehensive Predictor Exams

The nurse is providing discharge teaching to a client who underwent a pneumonectomy. The client wants to resume social activities with family. How should the nurse respond?

Correct Answer is A

Explanation

A client who has been taking allopurinol prophylactically comes into the clinic with reoccurring gout attack episodes in left ankle. The healthcare provider changes the prescription to febuxostat. Which instruction should the nurse include in the discharge teaching?

Correct Answer is B

Explanation

An adult client is admitted for severe pain in his side and back and is sent for an intravenous pyelogram. Which report from the client is the earliest indication to the nurse that the client is experiencing an adverse reaction to this procedure?

An older woman who has difficulty hearing is being discharged from day surgery following a cataract extraction and lens implantation. Which intervention is most important for the nurse to implement to help ensure the client's compliance with self-care?

The nurse is assessing a 4-year-old child with eczema. The child's skin is dry and scaly, and the mother reports that the child frequently scratches the lesions on the skin to the point of causing bleeding. Which guideline is indicated for care of this child?

Patient Data What other treatments might be helpful for this client? Select all that apply.

The nurse is triaging several children as they present to the emergency room after a school bus accident. Which child requires the most immediate intervention by the nurse?

The nurse is managing the care of a client with Cushing's syndrome. Which intervention(s) should the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)

An older client comes to the clinic with a family member. When the nurse attempts to take the client's health history, the client does not respond to questions in a clear manner. Which action should the nurse implement first?