HESI A2 Reading Comprehension 2024 Related

Gout is a form of arthritis that typically comes on suddenly, causing intense joint pain, especially in the feet, ankles, wrists, or fingers. It is caused by the accumulation of urate crystals in the joint. Whereas normally, uric acid dissolves in the bloodstream and passes out of the body in the urine, at times, uric acid builds up, forming crystals. A diet rich in the foods that increase levels of uric acid—meat, seafood, fructose—may be a risk factor for gout.
It now appears that nurse-led treatments focusing on lifestyle may provide significant aid for gout patients. Medical treatment for gout has usually involved pain relievers and corticosteroids. In addition, doctors may prescribe uric acid inhibitors for patients who have recurrent gout attacks. A recent British study indicates that nurse-led care, which includes holistic education, lifestyle advice, and some form of urate-lowering therapy, is not only cheaper but also more successful than the usual physician-led treatment. Nurses were thoroughly trained in the causes and management of gout and were encouraged to include patients in decisions involving their own treatment. After two years, outcomes largely favored the nurse-led patients.

Which is the best title for this passage?

• A. "Medical Treatment for Gout"
• B. "Uric Acid Affects the Joints"
• C. "Risk Factors for One Type of Arthritis"
• D. "Nurse-Led Care Aids Gout Patients"

Gout is a form of arthritis that typically comes on suddenly, causing intense joint pain, especially in the feet, ankles, wrists, or fingers. It is caused by the accumulation of urate crystals in the joint. Whereas normally, uric acid dissolves in the bloodstream and passes out of the body in the urine, at times, uric acid builds up, forming crystals. A diet rich in the foods that increase levels of uric acid—meat, seafood, fructose—may be a risk factor for gout.
It now appears that nurse-led treatments focusing on lifestyle may provide significant aid for gout patients. Medical treatment for gout has usually involved pain relievers and corticosteroids. In addition, doctors may prescribe uric acid inhibitors for patients who have recurrent gout attacks. A recent British study indicates that nurse-led care, which includes holistic education, lifestyle advice, and some form of urate-lowering therapy, is not only cheaper but also more successful than the usual physician-led treatment. Nurses were thoroughly trained in the causes and management of gout and were encouraged to include patients in decisions involving their own treatment. After two years, outcomes largely favored the nurse-led patients.

What does the term inhibitors mean, as used in the second paragraph?

• A. Protectors
• B. Deterrents
• C. Stressors
• D. Transporters

According to the Centers for Disease Control and Prevention (CDC), tickborne diseases doubled in the United States between the years 2004 and 2016. Lyme disease, in particular, is difficult to diagnose due to its disparate symptoms that mimic other diseases, making it greatly underreported. As a result, the prevalence of Lyme disease is thought to be even higher than the CDC suggests.
Lyme disease is caused by the bacterium Borrelia burgdorferi, which is spread through a relationship involving three animals. This relationship starts with the white-footed mouse (or in California, the Western gray squirrel), which is prone to infection by the bacterium. Ticks in their larval form feed on the blood of these mice. If the mouse is infected, the tick becomes infected as well. After passing through a dormant phase, the tick nymph, usually the size of a poppy seed, seeks another blood meal. This meal might come from another mouse, a human, or a dog or cat.
The nymphs then molt into active adults, whose primary food source is the whitetail deer. They mate on the deer, drop off, and lay their eggs, thus starting the cycle over again. Humans can be bitten by either an infected nymph or a full-grown adult tick. For Lyme disease transmission, the tick needs to attach for about 36 hours. Unfortunately, tick bites are easy to overlook; they do not itch like mosquito bites or sting like deerfly bites. Many people go without treatment for months until a test clarifies their seemingly unrelated symptoms, which may include joint pain, a rash, fatigue, swollen glands, chills or fever, headache, or even paralysis.
If you know you have been bitten by a tick, time is of the essence. It is important to see a doctor, get tested, and receive treatment promptly.

What is the meaning of the word disparate as used in the first paragraph?

• A. Unusual
• B. Diverse
• C. Trivial
• D. Damaging

SOPHIA:
In a student union at the University of Michigan is a conference room named the Sophia B. Jones Room. The woman for whom it is named came from a family of impressive activists and revolutionaries and went on to have a remarkable career in medicine and education. Sophia was born in 1857 in Chatham, Ontario, Canada. Her father was one of the first Black graduates of Oberlin College in Ohio and was a strong abolitionist. Sophia had an older sister, Anna, and a younger sister, Fredericka. Both became teachers, and Anna was a suffragist who later helped create the National Association of Colored Women’s Clubs.
Sophia took a different path; she started at the University of Toronto, but dissatisfied with the medical education afforded to women there, she moved to Michigan and graduated in 1885 as the university’s first Black female doctor of medicine. She was quickly hired by the historically Black women’s school of higher learning, Spelman College, to create a nursing program, thus becoming Spelman’s first Black faculty member.
Following her work at Spelman, Sophia moved on to Wilberforce University in Ohio, a school that was the first to be owned and run by African-Americans, and one at which W. E. B. Du Bois had been an esteemed professor. She continued to believe and teach that education was the path to public health. She worked in hospitals in Philadelphia, St. Louis, and Kansas City until her retirement, at which time she and her sister Anna moved to California. A society named for Sophia continues to provide medical students and alumni at Spelman with scholarships and financial support. In this way, Spelman maintains Sophia’s inspiring goals of educating health workers and improving public health.

The term afforded to, as used in the third paragraph, can best be defined as ___________.

• A. Traversed by
• B. Presented to
• C. Removed from
• D. Paid for by

HEAT EXHAUSTION:
One of the human effects of the climate crisis is that as temperatures climb, more and more people are in danger of heat exhaustion. A recent spate of triple-digit temperatures occurred in states where such temperatures are rare. Municipalities provided cooling centers, which doubtless saved some lives. Knowing the signs of heat exhaustion can help you protect yourself on the hottest of days. Left untreated, heat exhaustion may lead to heatstroke, which can be fatal.
If you are forced to be outside and active in a place where high temperatures combine with high humidity, monitor your body for unusual reactions. People with heat exhaustion may sweat heavily yet have skin that feels clammy or cold. They may have a sudden sharp headache or muscle cramps and experience dizziness when standing up, which can lead to nausea. If you notice that your heart is racing and you feel faint, stop your activity at once. Find a cool place to rest, and hydrate immediately with water or an electrolyte-fortified sports drink.
If you suddenly stop sweating entirely, become confused, or cannot drink, you need immediate medical attention. Be aware that certain medical conditions—such as obesity or any condition that requires you to take beta blockers, tranquilizers, or antipsychotics—may exacerbate your reaction to excessive heat. If your weight or medications make you susceptible to heat exhaustion, avoid all physical activity when the heat index is over 90 degrees.

The term exacerbate, as used in the last paragraph, can best be defined as ___________.

• A. To soothe
• B. To intensify
• C. To adapt
• D. To disclose