A client who is experiencing a first gouty arthritis attack and reports excruciating pain in the right great toe. The nurse inspects the inflamed joint and administers ibuprofen 800 mg by mouth as prescribed. Which instruction should the nurse include in the discharge teaching?

Avoid acetylsalicylic acid containing medications.

Support joints in an extended position while resting.

Use electric heating pad when pain is at its worse.

Limit use of mobility equipment to avoid muscle atrophy.

Answer and Explanation

The Correct Answer is A

A. Avoiding acetylsalicylic acid (aspirin) and medications that contain it is a crucial component of discharge teaching for a client with an acute gout attack. Aspirin can interfere with renal excretion of uric acid, either increasing or decreasing serum uric acid levels depending on the dose, which may trigger or worsen an acute flare. Clients should be educated to read over-the-counter medication labels carefully, avoid aspirin-containing combination products (such as some cold or pain medications), and consult their healthcare provider before taking any new medication. This instruction helps prevent recurrent attacks and protects joint health.

B. Supporting joints in an extended position is not recommended during an acute gout flare. Forcing the affected joint into full extension can increase pain and inflammation. Instead, the joint should be positioned in a comfortable, slightly flexed position, sometimes elevated on a pillow, to reduce swelling and promote comfort. Teaching the client proper positioning helps manage pain effectively without aggravating the joint.

C. Using a heating pad during an acute gout attack is not advised because heat can increase blood flow to the inflamed area, potentially worsening swelling and pain. Cold therapy, such as applying an ice pack for 15–20 minutes at a time, is the preferred method for managing acute joint inflammation. Cold therapy helps reduce local tissue swelling, numbs pain, and provides temporary relief during severe attacks.

D. Limiting the use of mobility equipment to avoid muscle atrophy is inappropriate in the context of a gout flare. While rest of the affected joint is important initially, gentle movement of the unaffected joints and using mobility aids as needed for safe ambulation is encouraged to prevent deconditioning, maintain circulation, and promote overall function. Teaching clients to balance rest with gentle activity supports recovery without causing further joint trauma.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Administering a prescribed diuretic is the most important intervention because the client is showing signs of fluid volume overload, including bounding peripheral pulses, rapid weight gain, pitting edema, and bilateral lung crackles. Diuretics help remove excess fluid, reduce edema, improve cardiac output, and relieve pulmonary congestion. Prompt administration addresses the immediate risk of worsening heart failure or respiratory compromise.

B. Maintaining accurate intake and output is essential for ongoing monitoring of fluid status, but it does not provide immediate relief of fluid overload. It is supportive but secondary to active treatment with a diuretic.

C. Weighing the client every morning is important for tracking fluid retention over time. However, daily weight monitoring is a preventive and monitoring strategy, not an immediate therapeutic intervention for acute fluid overload.

D. Restricting daily fluid intake may help prevent further fluid accumulation, but it does not remove the excess fluid already present. Fluid restriction is a secondary measure that complements diuretic therapy but does not address the immediate risk posed by pulmonary congestion and edema.

A. Proteinuria. B. Pulse increase of 10 beats/minute. C. Glucosuria. D. Fundal height of 22 cm.

Correct Answer is B

Explanation

A. Proteinuria is not normal in pregnancy. The presence of protein in the urine may indicate kidney involvement or preeclampsia, which requires further evaluation. Any persistent proteinuria should be investigated promptly.

B. A pulse increase of 10 beats per minute is within normal physiological changes in pregnancy. During the second and third trimesters, maternal heart rate normally increases by 10–20 beats per minute to accommodate the increased cardiac output needed for the growing fetus. This is an expected adaptation and considered normal.

C. Glucosuria is not typically normal and may indicate impaired glucose tolerance or gestational diabetes. While small amounts of glucose can occasionally appear in urine, consistent glucosuria should prompt further assessment.

D. A fundal height of 22 cm at 28 weeks is below the expected range. Fundal height in centimeters roughly corresponds to gestational age in weeks after 20 weeks, so at 28 weeks, a normal fundal height would be approximately 26–30 cm. A measurement of 22 cm may indicate intrauterine growth restriction or inaccurate measurement and should be evaluated.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client who is experiencing a first gouty arthritis attack and reports excruciating pain in the right great toe. The nurse inspects the inflamed joint and administers ibuprofen 800 mg by mouth as prescribed. Which instruction should the nurse include in the discharge teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client's morning assessment includes bounding peripheral pulses, weight gain of 2 pounds (0.91 kg), pitting ankle edema, and moist crackles bilaterally. Which intervention is most important for the nurse to include in this client's plan of care?

Correct Answer is A

Explanation

A low-risk primigravida at 28-weeks gestation arrives for her regular antepartal clinic visit. Which assessment finding should the nurse consider within normal limits for this client?

Correct Answer is B

Explanation

Which problem reported by a client taking lovastatin requires the most immediate follow-up by the nurse?

The nurse is teaching a postmenopausal client about osteoporosis prevention. The client reports that she smokes 2 packs of cigarettes a day and takes 750 mg calcium supplements daily. Which information should the nurse include when teaching this client about osteoporosis prevention?

A client with atrial fibrillation receives a new prescription for dabigatran etexilate. Which instruction is important for the nurse to emphasize when teaching the client about this medication?

Patient Data Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

The charge nurse is making assignments for one practical nurse (PN) and three registered nurses (RN) who are caring for neurologically compromised clients. Which client with which change in status is best to assign to the PN?

The nurse is caring for a group of clients with the help of a practical nurse (PN). Which nursing action(s) should the nurse assign to the PN? Select all that apply.

Which characteristic of a hypertensive crisis should the nurse recognize?

The nurse is caring for a client with the sexually transmitted infection (STI) human papillomavirus (HPV). The client reports having had prior sexually transmitted infections. Which response should the nurse provide?