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Certain foods may increase the pain associated with gout. Which foods have the highest concentration of purines?
- A. Brain, liver, kidney
- B. Lettuce, corn, potatoes
- C. Beef, pork, chicken
- D. Fruits and fruit juices
Correct Answer: A
Rationale: Foods high in purines, such as brain, kidney, liver, and heart should be avoided, as well as alcohol. Lettuce, meat that does not include organ meats, and fruits do not have a high concentration of purines.
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The patient has been diagnosed as having gouty arthritis. The patient asks the nurse to explain the cause of the inflammation of the great toe. Which is the appropriate nursing response?
- A. You have calcium oxalate deposits that are seen in gouty arthritis.'
- B. The inflammation is from small accumulations of uric acid crystals, which are called tophi.'
- C. The small nodules are not related to the arthritis condition.'
- D. You have fat deposits that are common with gouty arthritis.'
Correct Answer: B
Rationale: Gout is a metabolic disease resulting from an accumulation of uric acid in the blood. It is an acute inflammatory condition associated with ineffective metabolism of purines. Although some patients with gout also have kidney stones, and some kidney stones are caused by calcium oxalate deposits, gout is not caused from calcium oxalate deposits. A patient with gout usually has excruciating pain, edema and inflammation in the affected joint, not small nodules. Fat deposits are not associated with gouty arthritis.
Which instructions should the nurse reinforce for the patient before the initiation of the hydroxychloroquine to treat joint inflammation from systemic lupus erythematosus(SLE)?
- A. Report mouth ulcerations.
- B. Get a chest x-ray.
- C. Get an eye examination.
- D. Take prophylaxis for malaria.
Correct Answer: C
Rationale: An eye examination should be completed before starting the drug and an eye examination should be done every 6 months while on the drug, because the drug can damage the retina and lead to blindness. Gold salts may cause mouth ulcerations. Hydroxychloroquine administration does not require monitoring of the chest x-ray because it does not cause lung damage. Hydroxychloroquine is also prescribed for malaria prophylaxis. This patient is taking the medication as an anti-inflammatory agent for SLE.
Which will the nurse stress to a patient, who recently had a hip replacement, in quadriceps setting exercises?
- A. Push knee down to mattress and raise heel off the bed.
- B. Flex knee and extend foot.
- C. Adduct leg and flex foot.
- D. Lift leg and heel off the bed.
Correct Answer: A
Rationale: Pushing the knee down into the mattress and raising the heel will strengthen the quadriceps muscles. Flexing the knee and extending the foot will not strengthen the quadriceps muscles. Likewise, adducting the legs and flexing the knee will not strengthen the quadriceps muscles.
What is the movement of an extremity away from the midline of the body called?
- A. Abduction
- B. Adduction
- C. Flexion
- D. Extension
Correct Answer: A
Rationale: Abduction is movement of an extremity away from the midline of the body.
Which foods should the home health nurse suggest for the patient with osteoporosis to help slow the disease?
- A. Leafy green vegetables
- B. Foods high in sodium
- C. Tea and coffee
- D. Vitamin A
Correct Answer: A
Rationale: To slow the bone loss, a patient with osteoporosis should eat green leafy vegetables, such as spinach and turnip greens, foods low in sodium, and avoid caffeine. Vitamin D helps with the absorption of calcium and stimulates bone formation.