The nurse is assessing a 68-year-old patient with a history of gout. On examination of the ears and fingers, the nurse observes firm, irregular nodules protruding from the skin. How should the nurse document these findings?
Cysts
Keloid
Petechiae
Tophi
The Correct Answer is D
A. Cysts: Cysts are closed, fluid-filled sacs under the skin, often smooth and round. They do not have the chalky, urate crystal composition characteristic of gout-related nodules.
B. Keloid: Keloids are overgrowths of scar tissue at sites of previous skin injury. They are not associated with gout and do not form from uric acid deposition.
C. Petechiae: Petechiae are small, pinpoint, non-blanching red or purple spots caused by capillary bleeding. They differ from firm nodules and are not seen in gout.
D. Tophi: Tophi are deposits of monosodium urate crystals that form firm, irregular nodules under the skin, commonly on the fingers, toes, and ears in chronic gout. Their presence indicates prolonged hyperuricemia and chronic disease progression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Ability to perform ADLs: Assessing the client’s ability to perform activities of daily living (ADLs) is the priority because osteoarthritis directly impacts functional mobility and quality of life. Pain and joint degeneration can limit self-care, and evaluating this helps guide immediate nursing interventions and care planning.
B. History of trauma: A history of trauma is relevant for understanding the etiology of secondary osteoarthritis, but it does not provide current information about the client’s functional status or immediate care needs.
C. Daily exercise routine: Exercise habits are important for managing joint health and pain, but they are secondary to assessing current functional limitations. This information helps with planning long-term interventions rather than addressing immediate priorities.
D. Family history of osteoarthritis: Family history may indicate genetic predisposition to OA, but it does not influence the client’s current functional limitations or immediate nursing priorities.
Correct Answer is D
Explanation
A. Epigastric discomfort: Epigastric pain is a common symptom of peptic ulcer disease and can usually be managed with medication and lifestyle modifications. While important, it is not immediately life-threatening.
B. Dyspepsia: Dyspepsia, or indigestion, is a chronic symptom associated with ulcer disease. It causes discomfort but does not indicate an acute or emergent complication.
C. Constipation: Constipation may occur due to medications or diet, but it is not directly related to peptic ulcer disease and is not a priority finding.
D. Hematemesis: Vomiting blood indicates active gastrointestinal bleeding, which is a potentially life-threatening complication of peptic ulcer disease. Immediate assessment and intervention are required to prevent shock and further complications, making this the priority finding.
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