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.
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The division of the skeletal system that comprises the skull, hyoid, vertebral column, and thorax is the division.
Correct Answer: axial
Rationale: The axial division of the skeletal system is comprised of the skull, hyoid, vertebral column, and the thorax.
The nurse administering the drug colchicine for gout will give $0.5 \mathrm{mg}$ hourly for hours.
Correct Answer: 12
Rationale: Colchicine is given orally in a dose of $0.5 \mathrm{mg}$ for a period of 12 hours or until relief from pain is achieved or diarrhea occurs.
Which instruction will the nurse reinforce for a patient who is taking alendronate?
- A. Take drug with any meal.
- B. Take drug first thing in the morning.
- C. Drink at least $5 \mathrm{oz}$ of milk before taking drug.
- D. Take drug with an antacid to avoid heartburn.
Correct Answer: B
Rationale: Alendronate should be taken on an empty stomach first thing in the morning with $6 \mathrm{oz}$ of water, accompanied by no other medication. The patient should remain upright for 30 minutes after a dose to minimize risk of esophageal irritation.
A patient had an open reduction with internal fixation (ORIF) for a compound fracture of the left tibia and has been placed in a long leg cast. The findings by the nurse are: left foot warm/pink, pedal pulse weaker than right, capillary refill 3 seconds, and small $1 \mathrm{~cm}$ area of blood on cast. Which action will the nurse take?
- A. Notify charge nurse of impending compartment syndrome.
- B. Document that all findings are within normal limits.
- C. Inform charge nurse about probable hemorrhage.
- D. Place warm compresses on left foot.
Correct Answer: B
Rationale: All of the findings are within normal limits. A small amount of blood on the cast is expected and should be monitored. There is no evidence of impending compartment syndrome or hemorrhage. Warm compresses are not necessary, and could cause swelling to develop.
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.
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