A nurse is admitting a client who has suspected retinal detachment.
Which of the following Questions should the nurse include when gathering a client history? Select all that apply.

Choice C rationale

Osteoporosis significantly increases the risk of fractures due to decreased bone mineral density, making fall prevention the highest priority for safety. Using handrails in the bathroom provides stability during transitions, while non-skid socks prevent slipping on smooth surfaces. These interventions directly address the physical environment to reduce the likelihood of a fall, which could lead to a devastating hip or spinal fracture in a client with compromised bone structural integrity.

Choice B rationale

Using chairs without armrests is unsafe for a client with osteoporosis because armrests provide necessary leverage and support when standing up or sitting down. Without them, the client is more likely to lose their balance or experience a fall. Safe furniture for those with bone density issues should be sturdy and provide ergonomic support to assist with mobility, rather than making it easier to slide off, which increases the risk of injury.

Choice C rationale

The use of handrails and non-skid socks represents an effective strategy for fall prevention by enhancing grip and stability. For women with osteoporosis, even a minor slip can result in a serious fracture. Bathroom safety is particularly critical due to wet surfaces. Implementing these environmental modifications demonstrates that the client understands how to mitigate their specific risk factors and maintain a safe living environment to protect their fragile skeletal system.

Choice D rationale

Using a longer telephone cord creates a significant tripping hazard, which is exactly what a client with osteoporosis must avoid. If the client finds it difficult to stand from a sitting position, the nurse should recommend a chair with a higher seat and armrests or a physical therapy consultation for strengthening. Suggesting a longer cord ignores the primary safety goal of keeping walkways clear of obstructions to prevent falls and subsequent bone fractures.

Choice A rationale

Whole milk contains proteins like lactalbumin and casein which may actually help in the excretion of uric acid from the body. While it contains fats, low-fat or full-fat dairy is generally considered safe or even beneficial for gout patients because it does not contain high levels of purines. Therefore, avoiding milk is not a primary recommendation for managing gout symptoms or preventing painful flare-ups in the joints.

Choice B rationale

Orange juice is high in fructose, which can increase uric acid production by accelerating the breakdown of adenosine triphosphate. However, it is not as detrimental as alcoholic beverages or high-purine liquids. While monitoring fructose intake is wise for gout management, orange juice is typically not the first beverage a nurse would instruct a client to strictly avoid compared to alcohol, which has a much more significant impact on renal uric acid clearance.

Choice C rationale

Cherry juice is actually recommended for clients with gout because it contains anthocyanins which have potent anti-inflammatory properties. Studies suggest that cherry consumption is associated with a lower risk of gout attacks because it helps lower serum urate levels. Teaching a client to avoid cherry juice would be counterproductive to their treatment plan, as it is a natural remedy often used to decrease the frequency of painful inflammatory episodes.

Choice D rationale

Organic wine contains alcohol which is a major trigger for gout flares because it competes with uric acid for excretion in the kidneys. When the kidneys prioritize processing alcohol, uric acid levels rise in the blood, leading to crystal formation in the joints. Even organic versions contain ethanol, which increases purine nucleotide metabolism. Alcohol consumption also leads to dehydration, which further concentrates uric acid and facilitates the crystallization process.