The nurse is caring for a client with a history of gout. Which dietary recommendation should the nurse emphasize?

Limit purine-rich foods

Increase dairy consumption

Restrict carbohydrate intake

Encourage red meat consumption

Answer and Explanation

The Correct Answer is A

Choice A reason: Limiting purine-rich foods (e.g., organ meats, shellfish) reduces uric acid production, preventing gout flares. Purines metabolize into uric acid, which forms joint crystals in gout. This dietary restriction is critical to manage symptoms and prevent painful exacerbations effectively.

Choice B reason: Increasing dairy may reduce gout risk by lowering uric acid, but it is secondary to purine restriction. Limiting purines directly decreases uric acid synthesis, addressing the primary cause of gout flares, making it the priority dietary recommendation.

Choice C reason: Restricting carbohydrates is irrelevant to gout, which results from uric acid accumulation. Purine-rich foods are the primary dietary trigger, as they increase uric acid. Limiting purines is the priority, as it directly prevents crystal formation and gout exacerbations.

Choice D reason: Encouraging red meat, high in purines, worsens gout by increasing uric acid production. Limiting purine-rich foods is critical, as it reduces uric acid and joint crystal formation, making red meat consumption counterproductive to effective gout management.

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Correct Answer is A

Explanation

Choice A reason: Priming an ipratropium inhaler typically requires 2 pumps, not 7, to ensure proper dosing. Excessive priming wastes medication and may reduce the inhaler’s lifespan. This action indicates misunderstanding of device preparation, necessitating further teaching to ensure effective administration and therapeutic outcomes.

Choice B reason: Attaching a spacer device enhances ipratropium delivery by improving aerosol deposition in the lungs, especially in COPD patients with poor inhalation technique. This is correct, as spacers reduce oropharyngeal deposition, minimizing side effects and maximizing bronchodilation, requiring no additional teaching.

Choice C reason: Storing ipratropium at room temperature is correct, as extreme temperatures can degrade the medication’s efficacy. This action aligns with manufacturer guidelines, ensuring the inhaler’s stability and effectiveness, indicating proper understanding and eliminating the need for further teaching on storage.

Choice D reason: Rinsing the mouth after ipratropium use is appropriate, as it reduces local side effects like dry mouth or throat irritation from residual medication. This correct action prevents complications, showing proper technique and understanding, so no additional teaching is required for this step.

A. Increased urine output B. Elevated blood pressure C. Increased heart rate D. Weight gain

Correct Answer is A

Explanation

Choice A reason: Furosemide, a loop diuretic, promotes urine output by inhibiting sodium reabsorption in the kidneys, reducing fluid overload in heart failure. Increased urine output indicates effective diuresis, alleviating pulmonary and peripheral edema, making it the primary sign of therapeutic efficacy.

Choice B reason: Elevated blood pressure is not an expected effect of furosemide, which reduces preload and blood volume, often lowering pressure. Effective diuresis is shown by increased urine output, as this directly reflects fluid removal, critical for heart failure management.

Choice C reason: Increased heart rate is not a direct indicator of furosemide efficacy. Diuresis reduces cardiac workload, potentially stabilizing heart rate, but urine output is the primary measure, as it confirms fluid excretion, the medication’s main action in heart failure.

Choice D reason: Weight gain indicates fluid retention, the opposite of furosemide’s goal. Effective diuresis causes weight loss due to fluid excretion. Increased urine output is the key sign, as it directly measures the diuretic’s action in reducing heart failure-related fluid overload.

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The nurse is caring for a client with a history of gout. Which dietary recommendation should the nurse emphasize?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic obstructive pulmonary disease receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

Correct Answer is A

Explanation

A client with a history of heart failure is prescribed furosemide. Which assessment finding indicates the medication is effective?

Correct Answer is A

Explanation

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