The nurse is caring for a client with a history of gout. Which dietary recommendation should the nurse emphasize?

Choice A reason: Chest x-ray may show nonspecific findings in pulmonary embolism but is not diagnostic. D-dimer, a fibrin degradation product, is highly sensitive for detecting thrombosis, guiding further imaging like CT pulmonary angiography, making it the priority test in suspected cases.

Choice B reason: Electrocardiogram may show tachycardia or right heart strain in pulmonary embolism but is nonspecific. D-dimer is a sensitive screening test, indicating clot presence, which prompts definitive imaging, making it the preferred initial diagnostic step in suspected pulmonary embolism.

Choice C reason: D-dimer blood test is the most sensitive screening tool for pulmonary embolism, detecting fibrin degradation from clots. Elevated levels prompt CT pulmonary angiography for confirmation, guiding urgent treatment to prevent further embolization, making it the critical test to anticipate.

Choice D reason: Arterial blood gas may reveal hypoxemia in pulmonary embolism but is nonspecific, as other conditions cause similar findings. D-dimer is more diagnostic, identifying clot presence, guiding imaging, and ensuring timely intervention, making it the priority test in suspected cases.

Choice A reason: Open-angle glaucoma involves chronic optic nerve damage due to impaired aqueous humor drainage, not a reversible “angle” change. Medications reduce intraocular pressure but cannot restore anatomical angles. This response is inaccurate, as the condition requires lifelong management to prevent further nerve damage and vision loss.

Choice B reason: Open-angle glaucoma requires lifelong medication to maintain normal intraocular pressure, preventing optic nerve damage. Medications like prostaglandin analogs or beta-blockers enhance aqueous humor outflow or reduce production, controlling pressure long-term. This is the accurate response, as sustained pressure management is essential to preserve vision in chronic glaucoma.

Choice C reason: Reducing excess pressure is a goal of glaucoma treatment, but open-angle glaucoma is chronic, requiring ongoing medication even after pressure is lowered. This response is incomplete, as it suggests a temporary treatment, whereas lifelong therapy is needed to prevent pressure spikes and progressive optic nerve damage.

Choice D reason: Open-angle glaucoma is typically painless and not associated with swelling. Medications target intraocular pressure, not pain or inflammation. This response is inaccurate, as it misaligns with the pathophysiology of glaucoma, which involves optic nerve damage from pressure, not inflammatory or painful symptoms.