Nokea
A client with gouty arthritis reports tenderness and swelling of the right ankle and great toe. The nurse observes the area of inflammation extends above the ankle. The client receives prescriptions for colchicine and indomethacin. Which instruction should the nurse include in the discharge teaching?
- A. Eat high-protein foods to achieve ideal body weight
- B. Drink at least 8 cups (1920mL) of water per day
- C. Use an electric heating pad when pain is at its worst
- D. Encourage active range of motion to prevent stiffness
Correct Answer: B
Rationale: The correct answer is to instruct the client to drink at least 8 cups (1920mL) of water per day. Adequate hydration helps to prevent the formation of uric acid crystals, which can exacerbate gout symptoms. Choice A is incorrect because while maintaining a healthy weight is important, it doesn't directly address gout management. Choice C is incorrect because using an electric heating pad can worsen inflammation. Choice D is incorrect because active range of motion may exacerbate pain and inflammation in the affected joints.
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A client has had a pulmonary artery catheter inserted. In performing hemodynamic monitoring with the catheter, the nurse will wedge the catheter to gain information about which of the following?
- A. Cardiac output.
- B. Right atrial blood flow.
- C. Left end-diastolic pressure.
- D. Cardiac index.
Correct Answer: C
Rationale: The correct answer is C: Left end-diastolic pressure. Wedging the pulmonary artery catheter allows the nurse to obtain the pulmonary artery wedge pressure, which reflects the left end-diastolic pressure. This pressure is essential in assessing left ventricular function and diagnosing conditions like heart failure. Choices A, B, and D are incorrect because wedging the catheter does not directly provide information about cardiac output, right atrial blood flow, or cardiac index.
In a patient with asthma, which of the following is the most important indicator of respiratory function?
- A. Oxygen saturation.
- B. Respiratory rate.
- C. Arterial blood gases.
- D. Peak expiratory flow rate.
Correct Answer: D
Rationale: The peak expiratory flow rate is the most important indicator of respiratory function in asthma because it measures how quickly air can be exhaled, reflecting the severity of airflow limitation. Oxygen saturation (Choice A) is important in assessing oxygenation, but it does not directly reflect respiratory function. Respiratory rate (Choice B) can provide information on breathing patterns but does not quantify airflow limitation. Arterial blood gases (Choice C) give information about gas exchange but are not as specific for assessing asthma control and severity as peak expiratory flow rate.
A client tells the clinic nurse about experiencing burning on urination, and assessment reveals that the client had sexual intercourse four days ago with a person who was casually met. Which action should the nurse implement?
- A. Observe the perineal area for a chancroid-like lesion
- B. Obtain a specimen of urethral drainage for culture
- C. Assess for perineal itching, erythema, and excoriation
- D. Identify all sexual partners in the last four days
Correct Answer: B
Rationale: Obtaining a urethral drainage specimen for culture is crucial in diagnosing a potential sexually transmitted infection (STI) in this client. While assessing for perineal symptoms like itching, erythema, and excoriation (Choice C) may provide additional information, obtaining a culture is more definitive. Observing for a chancroid-like lesion (Choice A) is not as pertinent as obtaining a culture for a broader diagnostic approach. Identifying all sexual partners in the last four days (Choice D) is important for contact tracing but obtaining a specimen for culture takes priority in this scenario.
The client with chronic renal failure is being educated about the importance of a low-sodium diet. Which of the following statements by the client indicates a need for further teaching?
- A. I can eat canned vegetables as long as I rinse them first.
- B. I can use table salt sparingly.
- C. I can eat frozen dinners if they are labeled low-sodium.
- D. I can eat whatever I want as long as I avoid salty foods.
Correct Answer: B
Rationale: The correct answer is B. Clients with chronic renal failure need to strictly limit their sodium intake. Advising the client to use table salt sparingly is incorrect as they should avoid table salt altogether to adhere to a low-sodium diet. Choice A is correct as rinsing canned vegetables can help reduce their sodium content. Choice C is correct as consuming frozen dinners labeled low-sodium can be a suitable option. Choice D is incorrect as it implies that avoiding only salty foods is sufficient, when in fact, overall sodium intake needs to be monitored closely.
What is the primary action of insulin in the body?
- A. To lower blood pressure.
- B. To promote the absorption of glucose into cells.
- C. To increase blood glucose levels.
- D. To decrease blood glucose levels.
Correct Answer: B
Rationale: The correct answer is B: To promote the absorption of glucose into cells. Insulin facilitates the uptake of glucose by cells, thereby decreasing blood glucose levels. Choice A is incorrect as insulin does not directly affect blood pressure. Choice C is inaccurate as insulin works to lower, not increase, blood glucose levels. Choice D is incorrect because insulin's primary role is to lower, not increase, blood glucose levels by promoting glucose uptake into cells.