A patient who is obese reports severe pain and is unable to bear weight on the right ankle after making dietary changes 3 weeks ago for weight loss.
The patient’s medical history includes hypertension, gouty arthritis, and cholecystitis.
Which instruction should the nurse include in the discharge teaching?
Substitute natural fruit juices for carbonated drinks.
Avoid the consumption of wine, beer, and coffee.
Use an electric heating pad when pain is at its worst.
Encourage active range of motion to limit stiffness.
The Correct Answer is D
Choice A rationale
While substituting natural fruit juices for carbonated drinks can be a healthy dietary change, it is not directly related to the patient’s reported symptoms of severe pain and inability to bear weight on the right ankle.
Choice B rationale
Avoiding the consumption of wine, beer, and coffee can have various health benefits, but it is not directly related to the patient’s current symptoms. Furthermore, there is no indication in the patient’s history that these beverages are contributing to the patient’s condition.
Choice C rationale
Using an electric heating pad when pain is at its worst can provide temporary relief, but it does not address the underlying issue causing the pain. Additionally, heat therapy is not typically recommended for acute gout attacks, which could be a potential cause of the patient’s symptoms given their history of gouty arthritis.
Choice D rationale
Encouraging active range of motion can help to limit stiffness and improve joint function, which could potentially alleviate the patient’s pain and improve their ability to bear weight on the right ankle. This advice is relevant to the patient’s symptoms and medical history.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Reducing the infant’s fruit intake for 24 hours is not the best approach in this situation. While certain fruits can cause diarrhea, the parent reports no signs of watery stools. Therefore, this intervention may not address the issue of the red and raw diaper area.
Choice B rationale
Cleaning with soap and water at each diaper change can actually worsen the condition. Soap can dry out the skin and disrupt the skin’s natural barrier, potentially leading to more irritation. It’s generally recommended to use water and a soft cloth, or a gentle non-soap cleanser, to clean the diaper area.
Choice C rationale
Changing the child’s diaper more frequently is the most appropriate intervention. A wet or dirty diaper can irritate the skin, leading to diaper rash. By changing the diaper more often, the skin is kept clean and dry, which can help the rash heal.
Choice D rationale
Applying lotion with each diaper change is not typically recommended for diaper rash. Some lotions can contain fragrances or other ingredients that can further irritate the rash. Instead, a barrier cream or ointment, such as one containing zinc oxide, is often recommended.
Correct Answer is B
Explanation
Choice A rationale
Noting the presence of an auscultatory gap, which is a period of abnormal silence in Korotkoff sounds during blood pressure measurement, is important. However, in this case, the silence followed by a Korotkoff sound is a normal finding and does not indicate an auscultatory gap.
Choice B rationale
After inflating a blood pressure cuff and releasing the valve, the nurse hears silence followed by a Korotkoff sound. This is a normal finding and indicates that the nurse should continue with the blood pressure assessment.
Choice C rationale
Re-inflating the cuff to a higher number is not necessary in this case as the initial silence followed by a Korotkoff sound is a normal finding.
Choice D rationale
Repositioning the stethoscope over the brachial artery may not resolve the issue of hearing silence followed by a Korotkoff sound. It is important to assess the situation further before making adjustments.
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