The nurse is assessing a client who reports falling 2 days ago and has a history of gouty arthritis that is controlled with allopurinol. The client reports the left knee is swollen and extremely painful to touch. Which instruction should the nurse include in the discharge teaching?

Substitute natural fruit juices for carbonated drinks.

Eat high protein foods to achieve ideal body weight.

Report experiencing right upper quadrant discomfort.

Use electric heating pad when pain is at its worse.

Answer and Explanation

The Correct Answer is A

A. Substituting natural fruit juices for carbonated drinks can help reduce the intake of purines and decrease the risk of gout attacks. Carbonated drinks can contribute to dehydration and worsen gout.

B. High protein foods can increase uric acid levels and exacerbate gout, so this is not a recommended dietary practice for managing gout.

C. Reporting right upper quadrant discomfort is important for liver function monitoring but not directly related to the management of gout symptoms.

D. Using an electric heating pad might provide temporary relief but does not address the underlying issue of uric acid levels or dietary management.

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

Explanation

Diazepam is a benzodiazepine that can be effective in managing symptoms of serotonin syndrome, including agitation and myoclonus. It can help reduce muscle rigidity and provide sedation.

Inducing paralysis is not appropriate in this scenario. The patient’s symptoms suggest serotonin syndrome or another type of stimulant intoxication, and paralysis could worsen the situation or mask underlying symptoms.

The patient has a high fever (102°F or 38.8°C) and significant diaphoresis. Cooling blankets can help manage hyperthermia and reduce body temperature.

The patient’s oxygen saturation is 97% on room air, indicating adequate oxygenation. There is no immediate need for supplemental oxygen at this time.

If the patient is suspected to have serotonin syndrome, which can be triggered by the use of certain antidepressants (particularly SSRIs), discontinuing the offending medication is crucial.

A. Maintain strict intake and output. B. Assess warmth of extremities. C. Monitor blood glucose level. D. Keep head of bed raised 45 degrees.

Correct Answer is A

Explanation

A. Maintaining strict intake and output is crucial in managing septic shock as it helps to monitor fluid balance, which is essential for managing hypovolemia and ensuring adequate perfusion.

B. While assessing warmth of extremities is important, it is not as directly related to the immediate management of septic shock as monitoring intake and output.

C. Monitoring blood glucose levels is important, especially in septic patients, but it is not the primary focus in the initial management of septic shock.

D. Keeping the head of the bed raised 45 degrees can help with breathing but is not the most critical intervention in the immediate management of septic shock.

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The nurse is assessing a client who reports falling 2 days ago and has a history of gouty arthritis that is controlled with allopurinol. The client reports the left knee is swollen and extremely painful to touch. Which instruction should the nurse include in the discharge teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Exhibits The nurse reviews the prescriptions and assessment data. Click to indicate which interventions could help reduce symptoms if added to the plan of care. Each row must have one response option selected.

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

Explanation

The nurse is caring for a client who develops signs and symptoms of septic shock following a urinary tract infection one week ago. The healthcare provider prescribes a sepsis protocol to be initiated. Which intervention is most important for the nurse to include in the plan of care?

Correct Answer is A

Explanation

A client with heart failure (HF) develops cardiac tamponade. The client has muffled, distant heart sounds, and is anxious and restless. After Initiating oxygen therapy and IV hydration, which intervention is most important for the nurse to implement?

A client with advanced cirrhosis is being treated for hepatic encephalopathy. In reviewing the client's serum laboratory results, which finding requires the most immediate intervention by the nurse?

A client with purulent drainage from an abdominal surgical incision is admitted with a possible vancomycin-resistant enterococci (VRE) infection. Which nursing intervention(s) should the nurse include in the plan of care? Select all that apply.

A client with chronic kidney disease (CKD) has an arteriovenous (AV) fistula in the left forearm. Which observation by the nurse indicates that the fistula is patent? Select all that apply.

While preparing a client's routine 0800 medications, the nurse opens the medication packaging and discards in the trash prior to scanning the barcode label. Which action should the nurse implement?