Nokea
What pathophysiologic process is producing the symptoms of gout in a client with sudden onset of big toe joint pain and swelling?
- A. Deposition of crystals in the synovial space of the joints produces inflammation and irritation.
- B. Degeneration of joint cartilage causing inflammation.
- C. Infection of the joint space leading to inflammation.
- D. Increased synovial fluid causing joint swelling and pain.
Correct Answer: A
Rationale: The correct answer is A. Gout is characterized by the deposition of uric acid crystals in the synovial fluid of joints, which triggers inflammation and pain. This process is known as crystal-induced arthritis. Choice B is incorrect as gout does not involve degeneration of joint cartilage. Choice C is incorrect as gout is not caused by an infection of the joint space. Choice D is incorrect as gout does not result from increased synovial fluid but rather from the deposition of uric acid crystals.
You may also like to solve these questions
What is the priority patient problem for the parents of a newborn born with cleft lip and palate?
- A. Parental role conflict
- B. Risk for delayed growth and development
- C. Risk for impaired attachment
- D. Anticipatory grieving
Correct Answer: C
Rationale: The correct answer is C: Risk for impaired attachment. Parents of a newborn with cleft lip and palate may face challenges in bonding with their child due to the physical appearance, impacting attachment. Promoting bonding between parents and the infant is crucial in this situation. Choice A (Parental role conflict) is incorrect as it focuses on conflicting roles rather than the attachment issue. Choice B (Risk for delayed growth and development) is not the priority issue in this scenario as the immediate concern is establishing a healthy attachment. Choice D (Anticipatory grieving) is not the priority patient problem as it pertains more to the emotional response to an anticipated loss, which is not the primary concern at this stage.
A client who had a radical neck dissection returns to the surgical unit with 2 JP drains in the right side of the incision. One JP tube is open and has minimal drainage. Which action should the nurse take to increase drainage into the JP?
- A. Reinforce the incisional dressings and assess behind the neck for drainage.
- B. Place the client in a right lateral side-lying position and elevate the head of the bed.
- C. Irrigate the JP tubing with 1 ml NSS, then close the opening with its tab.
- D. Compress the bulb with the tab open and then reinsert the tab into its opening.
Correct Answer: D
Rationale: Compressing the bulb with the tab open creates suction, which helps increase drainage into the JP drain. This action can aid in removing accumulated fluids from the surgical site. Reinforcing the incisional dressings and assessing behind the neck for drainage (Choice A) is not directly related to increasing drainage into the JP. Placing the client in a right lateral side-lying position and elevating the head of the bed (Choice B) may not directly impact drainage into the JP drain. Irrigating the JP tubing with 1 ml NSS and then closing the opening with its tab (Choice C) is unnecessary and could introduce contaminants into the drain.
An unlicensed assistive personnel (UAP) reports to the nurse that a client with a postoperative wound infection has a temperature of 103.8°F, blood pressure 90/70, pulse 124 beats/min, and respirations of 28 breaths/min. When the nurse assesses the client's findings, they include a mottled skin appearance and confusion. Which action should the nurse take first?
- A. Obtain a wound specimen for culture.
- B. Initiate an infusion of intravenous (IV) fluids.
- C. Transfer the client to the ICU.
- D. Assess the client's core temperature.
Correct Answer: B
Rationale: The correct action for the nurse to take first is to initiate an infusion of intravenous (IV) fluids. In this scenario, the client is showing signs of sepsis, indicated by a high temperature, low blood pressure, rapid heart rate, and increased respiratory rate. Mottled skin appearance and confusion are also signs of poor perfusion. Initiating IV fluids is crucial in treating sepsis to maintain blood pressure and perfusion. Obtaining a wound specimen for culture (Choice A) can be important but is not the priority at this moment. Transferring the client to the ICU (Choice C) can be considered after stabilizing the client. Assessing the client's core temperature (Choice D) is not the immediate priority compared to addressing the signs of sepsis and poor perfusion.
A postoperative client reports incisional pain. The client has two prescriptions for PRN analgesia that accompanied the client from the post-anesthesia unit. Before selecting which medication to administer, which action should the nurse implement?
- A. Document the client's report of pain in the electronic medical record.
- B. Determine which prescription will have the quickest onset of action.
- C. Compare the client's pain scale rating with the prescribed dosing.
- D. Ask the client to choose which medication is needed for the pain.
Correct Answer: C
Rationale: The correct action the nurse should implement before selecting which medication to administer to a postoperative client who reports incisional pain is to compare the client's pain scale rating with the prescribed dosing. This ensures that the client receives the appropriate medication based on their pain level. Documenting the client's report of pain in the electronic medical record (Choice A) is important but should come after ensuring the right medication is given. Determining which prescription will have the quickest onset of action (Choice B) may not be the most relevant factor to consider when choosing the appropriate medication. Asking the client to choose the medication needed for the pain (Choice D) may not be appropriate as the nurse should rely on the pain scale rating and prescribed dosing to make a clinical decision.
When speaking to young parents, the nurse states that lead poisoning is one of the most common preventable health problems affecting children. What condition occurs when the level of lead ingested exceeds the amount that can be absorbed by the bone?
- A. Malnutrition
- B. Anemia
- C. Bone pain
- D. Diarrhea
Correct Answer: B
Rationale: The correct answer is B: Anemia. When the amount of lead ingested exceeds the amount that can be absorbed by the bone, it leads to anemia. Malnutrition (Choice A) is a state of inadequate nutrition, not directly related to lead poisoning. Bone pain (Choice C) is a symptom of lead poisoning due to its effects on bones but not directly related to lead ingestion exceeding absorption. Diarrhea (Choice D) is not a direct consequence of lead ingestion exceeding absorption by bones.