A nurse is caring for a client who underwent an appendectomy 2 days ago and now reports sudden, unbearable pain in the left great toe. The client has a medical history of type 2 diabetes mellitus, gouty arthritis, and gastroesophageal reflux disease (GERD). Which instruction should the nurse include in the discharge teaching?
Eat high-protein foods to achieve ideal body weight.
Avoid acetylsalicylic acid-containing medications.
Wrap joints with an elastic bandage when swollen.
Support joints in an extended position while resting.
The Correct Answer is B
Choice A reason: Eating high-protein foods to achieve ideal body weight is generally a healthy practice, but it is not directly related to the management of the client's current condition involving pain in the toe.
Choice B reason: Patients with gouty arthritis should avoid acetylsalicylic acid (aspirin) as it can lead to an increase in uric acid levels, potentially exacerbating gout attacks. Instead, medications that do not affect uric acid levels should be used for pain relief.
Choice C reason: Wrapping joints with an elastic bandage can provide support and reduce swelling, but it is not the primary intervention for sudden pain in the toe following an appendectomy, especially when the patient has a history of gouty arthritis.
Choice D reason: Supporting joints in an extended position while resting can provide comfort and may prevent stiffness, but it does not address the acute management of gouty arthritis or diabetic complications that could be causing toe pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: While knowing if the client can lie prone is useful, it is not the most critical piece of information prior to an intravenous pyelogram.
Choice B reason: Asking about a shellfish allergy is crucial because the contrast dye used in an intravenous pyelogram may contain iodine, which can cause an allergic reaction in individuals with shellfish allergies.
Choice C reason: Knowing the last time the client had a bowel movement is less critical than knowing about potential allergies to the contrast dye.
Choice D reason: While it's important to know about medication schedules, the risk of an allergic reaction to the contrast dye is a more immediate concern that could affect the safety of the procedure.
Correct Answer is D
Explanation
Choice A reason: Application of heat and cold therapy can help manage symptoms but does not encompass the broader aspects of health promotion and teaching.
Choice B reason: Avoidance of foods containing purine is more specific to conditions like gout rather than rheumatoid arthritis, and while diet is important, it does not fully represent health promotion and teaching.
Choice C reason: Immobilization of affected joints is not a health promotion strategy and can actually worsen symptoms over time. Active and passive range-of-motion exercises are recommended instead.
Choice D reason: Prevention through nutrition and exercise is the most comprehensive approach that aligns with health promotion and teaching for clients with rheumatoid arthritis. It includes educating clients on a balanced diet and physical activity to manage symptoms and improve overall health.
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