Nokea
The nurse is caring for a client diagnosed with chronic gout. The nurse anticipates a prescription for which medication to lower uric acid levels?
- A. colchicine
- B. allopurinol
- C. naproxen
- D. prednisone
Correct Answer: B
Rationale: Allopurinol inhibits xanthine oxidase, reducing uric acid production and preventing gout flares in chronic gout. Colchicine and naproxen manage acute inflammation, and prednisone reduces inflammation but does not lower uric acid levels long-term.
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The nurse is planning care for a client with a newly diagnosed fractured pelvis. Which action would lessen the risk of fat embolism syndrome (FES)?
- A. Request a prescription for enoxaparin.
- B. Alternate with the application of ice and heat.
- C. Educate the client on pelvic immobilization.
- D. Encourage passive range of motion of the lower legs.
Correct Answer: C
Rationale: Pelvic immobilization reduces movement and the risk of fat globules entering the bloodstream, a key factor in fat embolism syndrome. Enoxaparin prevents clots, ice/heat manages swelling, and range of motion is beneficial but not primary for FES prevention.
The nurse is planning a staff development conference regarding contractures. Which of the following information should the nurse include? Select all that apply.
- A. Range-of-motion exercises of the extremities help prevent contractures.
- B. Splinting the extremities may increase the risk of contractures.
- C. Too many pillows under the head may cause a neck flexion contracture.
- D. Using multiple staff members to reposition a client may prevent a contracture.
- E. Contractures after a hip arthroplasty can be prevented with an abduction pillow.
Correct Answer: A, C, E
Rationale: Range-of-motion exercises maintain joint flexibility and help prevent contractures. Too many pillows under the head can cause the neck to remain flexed, increasing the risk of a flexion contracture. An abduction pillow keeps the legs properly aligned and prevents adduction contractures after hip surgery.
The nurse is teaching a client with low back pain. Which of the following statements, if made by the client, would require follow-up?
- A. I am planning to stop smoking cigarettes.'
- B. I should sleep on my stomach.'
- C. I have decided to purchase a firm mattress.'
- D. I will bend my knees when lifting objects.'
Correct Answer: B
Rationale: Sleeping on the stomach can strain the lower back, requiring follow-up teaching. Quitting smoking, a firm mattress, and bending knees when lifting are all beneficial for back health.
The nurse is assessing a client who reports left knee pain after playing baseball. The nurse should initially
- A. Feel the knee for warmth.
- B. Inspect the knee for any swelling.
- C. Palpate for crepitus in the knee.
- D. Have the client perform active range of motion in the knee.
Correct Answer: B
Rationale: Initial assessment starts with inspection for swelling, a visible sign of injury or inflammation post-activity. Warmth, crepitus, and range of motion are assessed next but are not the first step.
The nurse is developing a self-management teaching plan for a client with low back pain. Which of the following should the nurse include?
- A. Avoid bending at the waist and lifting heavy objects.'
- B. Weight-bearing exercises are recommended.'
- C. Wear shoes with a higher heel.'
- D. Lay on your stomach four times daily and flex your legs.'
Correct Answer: A
Rationale: Avoiding bending at the waist and heavy lifting prevents back strain. Weight-bearing exercises help bones but not always back pain, high heels strain the back, and stomach lying with leg flexion can worsen pain.