A client reports sudden pain, redness, and swelling in the knee. Which clinical feature indicates an acute gout flare?
Symmetrical small joint involvement
Gradual joint stiffness over months
Rapid onset of severe pain and erythema
Muscle weakness and fatigue
The Correct Answer is C
A. Symmetrical small joint involvement: Symmetrical involvement is more characteristic of rheumatoid arthritis rather than gout. Gout typically affects one joint at a time, most commonly the lower extremities. Symmetry is not a hallmark of an acute flare.
B. Gradual joint stiffness over months: Slow, progressive stiffness suggests chronic degenerative conditions such as osteoarthritis. Acute gout flares present suddenly rather than gradually.
C. Rapid onset of severe pain and erythema: Acute gout is characterized by sudden, intense pain, redness, swelling, and warmth in the affected joint. These features reflect urate crystal deposition and the inflammatory response, making this the defining presentation of an acute flare.
D. Muscle weakness and fatigue: These are nonspecific systemic symptoms and do not directly indicate a gout flare. They may be associated with chronic illness but are not diagnostic for acute joint inflammation in gout.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Receive daily glucocorticoid injections: Frequent intra-articular steroid injections are not recommended due to potential joint damage and systemic side effects. They are reserved for specific flare-ups rather than routine pain management.
B. Take warm showers in the morning: Warmth helps relax stiff joints, improve circulation, and reduce pain and morning stiffness associated with osteoarthritis. Heat therapy is a safe, non-pharmacologic strategy that enhances mobility and comfort.
C. Engage in high-impact exercises: High-impact activities can exacerbate joint damage and pain in osteoarthritis. Low-impact exercises, such as swimming or cycling, are safer and more effective for maintaining joint function.
D. Avoid all physical activity: Complete inactivity leads to muscle atrophy, joint stiffness, and decreased function. Moderate, appropriate activity is essential for pain management and maintaining mobility in osteoarthritis.
Correct Answer is B
Explanation
A. Taking lispro 30 minutes before eating increases the risk of hypoglycemia because rapid-acting insulin begins working within 10–15 minutes. Food intake may not yet match the insulin’s onset of action.
B. Rapid-acting insulin such as lispro is designed to be given within 15 minutes of starting a meal so insulin action closely matches postprandial glucose rise. This timing reduces hyperglycemia while minimizing hypoglycemia risk.
C. Administering lispro after finishing a meal delays insulin action relative to glucose absorption. This can result in postprandial hyperglycemia because blood glucose may already be elevated.
D. Taking lispro at the same time each night is inconsistent with its purpose of controlling mealtime glucose spikes. Long-acting insulin, not rapid-acting insulin, is scheduled independently of meals.
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