Exhibits
The nurse is reviewing the client's medical record to better understand the previous gout attacks.
Click to indicate if the findings are consistent with an acute gout attack, chronic gout, or both. Each column may have more than one response. Each column must have at least one response selected.
Pain at the affected joint
Low grade fever
Occurs in more than 1 joint
Renal dysfunction
Visible tophi
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"}}
Pain at the affected joint
- Acute gout attack: Yes. During an acute gout attack, the pain is typically sudden, intense, and localized to one joint, often the big toe.
- Chronic gout: No. Chronic gout usually involves recurrent attacks over time, but the pain at any given moment may not be as intense or localized to a single joint unless there is a flare-up.
2. Low grade fever
- Acute gout attack: Yes. During an acute attack, inflammation caused by uric acid crystals can lead to mild fever (100°F to 101°F).
- Chronic gout: No. Chronic gout usually does not cause fever unless there is a secondary infection or other complicating factor.
3. Occurs in more than 1 joint
- Acute gout attack: No. Typically, an acute gout attack involves only one joint, especially the big toe (podagra).
- Chronic gout: Yes. Over time, gout can involve multiple joints, especially with untreated or poorly managed cases.
4. Renal dysfunction
- Acute gout attack: No. Acute gout attacks generally do not cause renal dysfunction.
- Chronic gout: Yes. Chronic gout can lead to kidney damage or urate nephropathy due to long-term hyperuricemia and uric acid crystal deposition in the kidneys.
5. Visible tophi
- Acute gout attack: No. Tophi, which are uric acid crystal deposits under the skin, typically appear in later stages of gout, not during an acute attack.
- Chronic gout: Yes. Visible tophi are a characteristic feature of chronic gout and occur after repeated and prolonged gout attacks, leading to the accumulation of uric acid crystals in soft tissues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Administering opioid and non-opioid medications together is an effective pain management strategy for severe pain. This approach can provide better pain relief by targeting different pain pathways and may reduce the total dosage of opioids needed, thus minimizing side effects.
B. Alternating IV and IM analgesic medications is not the best approach; instead, consistent pain management is necessary to keep pain levels under control.
C. Waiting until the pain score reaches 10 before administering the maximum dosage is inappropriate and could lead to inadequate pain control. Pain management should be proactive, not reactive.
D. While educating the client on narcotic dependency is important, it is not the priority intervention in this acute situation where pain control is essential. The immediate focus should be on effective pain relief.
Correct Answer is C
Explanation
A. Oxycodone is an opioid analgesic used for moderate to severe pain management but is not typically the first-line medication in acute coronary syndrome scenarios.
B. Fentanyl is a potent opioid that may be used for severe pain; however, morphine is more commonly used in emergency situations for chest pain related to potential myocardial infarction.
C. Morphine is commonly used in emergency departments for the management of acute chest pain, particularly when associated with myocardial ischemia. It helps reduce pain and anxiety, lowers myocardial oxygen demand, and has vasodilatory effects that can alleviate the burden on the heart.
D. Hydromorphone is another opioid analgesic but is not usually the preferred choice for chest pain in the acute setting compared to morphine.
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