A nurse instructs her client with gout to avoid which of the following foods?
Fresh fruit and vegetable juices.
Organ meats and shellfish.
Whole grains.
Lean chicken and turkey.
The Correct Answer is B
Choice A rationale
Fresh fruit and vegetable juices are generally low in purines and are considered safe for individuals with gout. These fluids provide essential vitamins and antioxidants that may even assist in reducing systemic inflammation. Maintaining high fluid intake is recommended to facilitate the renal excretion of uric acid. Unless the juice contains high levels of fructose, which can subtly influence uric acid levels, it remains a healthy dietary choice.
Choice B rationale
Organ meats, such as liver or kidneys, and shellfish are extremely high in purines. When the body breaks down these purines, it produces uric acid as a byproduct. In patients with gout, high uric acid levels exceed the normal range of 3.5 to 7.2 mg/dL, leading to the crystallization of monosodium urate in the joints. Avoiding these foods is a primary dietary intervention to prevent painful acute gouty flares.
Choice C rationale
Whole grains are an important part of a balanced diet and typically contain moderate to low levels of purines. They provide necessary fiber and complex carbohydrates which do not significantly contribute to hyperuricemia. While some specific grains might have higher purine content than refined versions, they are generally encouraged for gout patients to support overall metabolic health and weight management, which indirectly helps control uric acid levels.
Choice D rationale
Lean chicken and turkey are moderate-purine protein sources and are generally preferred over red meats or organ meats. While they should be consumed in moderation, they do not pose the same high risk for triggering a gout attack as shellfish or game meats. For a patient managing gout, these poultry options represent a safer alternative for maintaining adequate protein intake without severely spiking serum uric acid concentrations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Cataracts involve the gradual opacification and clouding of the crystalline lens within the eye. This pathology affects visual acuity and light transmission but does not involve the inner ear structures or the balance mechanisms located in the bony labyrinth. Consequently, there is no physiological or anatomical link between lens protein degradation and the endolymphatic hydrops associated with Meniere disease development.
Choice B rationale
Bacterial pneumonia is a severe systemic infection that can trigger an inflammatory cascade and immune response. While Meniere disease is primarily related to fluid imbalances in the inner ear, recent infections, including viral or bacterial respiratory illnesses, are recognized as potential precursors. The resulting immune-mediated inflammation or secondary metabolic changes can disrupt endolymphatic sac regulation, thereby increasing the risk of episodic vertigo and hearing loss.
Choice C rationale
Macular degeneration is a progressive condition affecting the central portion of the retina, known as the macula. It leads to central vision loss due to drusen accumulation or choroidal neovascularization. This is a localized neurosensory deficit of the visual system. It does not interfere with the vestibular system or the cochlear fluids, and therefore lacks a causative relationship with Meniere disease pathology.
Choice D rationale
Osteoporosis is characterized by a systemic reduction in bone mineral density and microarchitectural deterioration of bone tissue. While it increases the risk of fractures, particularly in the hip and spine, it does not directly impact the fluid dynamics of the inner ear. The pathophysiology of bone resorption is distinct from the mechanisms of endolymphatic pressure regulation that define the onset of Meniere disease.
Correct Answer is ["A","C","D","E"]
Explanation
Choice A rationale
Hypertension is a known risk factor for the development of glaucoma because high systemic blood pressure can damage the delicate microvasculature of the optic nerve. Impaired blood flow or high vascular resistance within the eye contributes to the progression of optic neuropathy. Maintaining a blood pressure within the normal range of less than 120/80 mmHg is essential for ocular health. Chronic vascular stress increases the vulnerability of the eye to pressure changes.
Choice B rationale
Glaucoma is characterized by an increase in intraocular pressure, not a decrease. Normal intraocular pressure ranges from 10 to 21 mmHg. When the drainage of aqueous humor is obstructed, the pressure rises, which compresses the retinal ganglion cells and the optic nerve. A sudden decrease in pressure is not a typical risk factor for glaucoma; rather, elevated or fluctuating high pressure is the primary mechanism that leads to the loss of peripheral vision.
Choice C rationale
Genetic predisposition plays a significant role in the etiology of glaucoma. Individuals with a positive family history of the disease have a much higher risk of developing it themselves. Specific genetic mutations can affect the structural integrity of the trabecular meshwork or the sensitivity of the optic nerve to pressure. Understanding family medical history allows for earlier screening and intervention, which is crucial because the vision loss associated with glaucoma is irreversible.
Choice D rationale
Advancing age is one of the most significant risk factors for glaucoma. As individuals get older, the efficiency of the aqueous humor drainage system often declines, leading to a gradual increase in intraocular pressure. This is especially true for individuals over the age of 60. Changes in the collagen structure of the eye and cumulative oxidative stress over decades make the optic nerve more susceptible to damage from even moderate pressure elevations.
Choice E rationale
Diabetes mellitus is a systemic metabolic disorder that increases the risk of primary open-angle glaucoma. High blood glucose levels over time can cause damage to the blood vessels in the retina and may lead to the growth of abnormal new blood vessels that block the drainage angles of the eye. This is known as neovascular glaucoma. Diabetics must undergo regular comprehensive eye exams to monitor for both retinopathy and elevations in intraocular pressure.
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