Exhibits

Review H and P, nurse's note, and flow sheet.

Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

Answer and Explanation

The Correct Answer is []

Potential Condition

- Dilated Cardiomyopathy: This condition is most likely because the client presents with symptoms of heart failure (chest pain, dizziness, inspiratory crackles, systolic murmur, and ankle edema) alongside a history of hypertension, which can contribute to the development of dilated cardiomyopathy.

Actions to Take

1. Apply Oxygen: The client is showing signs of potential heart failure, and oxygen can help alleviate symptoms associated with decreased oxygenation.

2. Perform 12-lead EKG: An EKG will provide information about any potential cardiac abnormalities, especially in the presence of chest pain and systolic murmur.

Parameters to Monitor

1. Blood Pressure: It is essential to monitor blood pressure due to the client's hypertension and heart failure symptoms, which may be exacerbated by elevated blood pressure.

2. Urine Output: Monitoring urine output helps assess kidney perfusion and fluid status, which can be affected by heart failure and hypertension, particularly in cases of cardiomyopathy.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["B","C","E","F"]

Explanation

A. Nonsmoker: Smoking does not directly contribute to the development of gout. While smoking is a risk factor for many health conditions, it is not a major contributor to the elevated uric acid levels associated with gout.

B. Obesity: Obesity is a well-established risk factor for gout because it leads to increased production of uric acid and reduced renal excretion of uric acid. Higher body fat increases the likelihood of developing hyperuricemia (elevated uric acid levels in the blood), which can form crystals in the joints, leading to gout.

C. Drinks beer nightly: Alcohol, particularly beer, is a significant risk factor for gout. Beer contains high levels of purines, which are broken down into uric acid in the body. Chronic alcohol consumption, especially beer, increases uric acid levels, contributing to the formation of uric acid crystals in the joints, which leads to gout attacks.

D. Daily aspirin: Aspirin, particularly at low doses, can reduce the excretion of uric acid by the kidneys, which can increase the risk of hyperuricemia and gout. However, this effect is typically observed with chronic, low-dose aspirin use, which is not indicated here in the patient's history.

E. Type 2 diabetes mellitus: Type 2 diabetes mellitus is associated with insulin resistance, which impairs the kidney's ability to excrete uric acid. As a result, uric acid builds up in the bloodstream, increasing the risk of gout. Additionally, people with type 2 diabetes often have comorbidities (such as obesity) that further increase the risk of gout.

F. Sleep apnea: Obstructive sleep apnea is associated with intermittent hypoxia (lack of oxygen), which can contribute to the production of uric acid and decreased renal clearance. This increase in uric acid levels raises the risk of hyperuricemia and subsequently gout. Sleep apnea can also be related to metabolic syndrome, which is another risk factor for gout.

A. Tenderness upon palpation and generalized erythema. B. Thick skin plaques topped by silvery white scales. C. Requires sunglasses because sunlight hurts eyes. D. Brown, rough, greasy, wart-like papules on the face.

Correct Answer is A

Explanation

A. Tenderness upon palpation and generalized erythema indicate skin irritation and possible sunburn, which are signs of overexposure to PUVA treatment. This finding suggests that the client may have received excessive ultraviolet exposure, leading to skin damage.

B. Thick skin plaques topped by silvery white scales are characteristic of psoriasis vulgaris itself, not a sign of overexposure to PUVA.

C. Requiring sunglasses because sunlight hurts the eyes may indicate sensitivity but is not a specific indicator of overexposure to PUVA treatment; it could relate to other issues such as underlying eye conditions.

D. Brown, rough, greasy, wart-like papules on the face are not typically associated with PUVA overexposure but could be related to other skin conditions or lesions.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits Client history has been collected, and the nurse performs a physical assessment and records vital signs. Which finding(s) in the client's health record should the nurse recognize places the client at a greater risk of developing gout? Select all that apply.

Correct Answer is ["B","C","E","F"]

Explanation

The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving psoralen and ultraviolet A light (PUVA) treatment. Which assessment finding indicates that the client has been overexposed to the treatment?

Correct Answer is A

Explanation

The nurse is developing a plan of care for a client with type 2 diabetes mellitus (DM). When providing teaching on lowering blood glucose levels and increasing serum high-density lipoprotein (HDL) levels, which instruction should the nurse include?

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The nurse is providing teaching to a client about self-management of type 2 diabetes mellitus. Which information provided by the client indicates understanding?

The nurse is caring for a client that is unconscious and having seizures. Which nursing intervention is most essential in this client's plan of care (POC)?

The nurse is performing a physical assessment of a client. Which finding should the nurse recognize is a result of compromised peripheral arterial circulation of the lower extremity?

A client with stage IV bone cancer is admitted to the hospital for pain control. The client verbalizes continuous, severe pain of 8 on a 0 to 10 scale. Which intervention should the nurse implement?