Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
The nurse is caring for a group of patients on a medical surgical unit. Which of the following patients is at most risk for developing gout?
A. A 39-year-old female hospitalized with anorexia nervosa and has a BMI of 14
Anorexia nervosa is a condition characterized by severe weight loss and malnutrition. People with anorexia nervosa are often deficient in nutrients, including purines. Purines are broken down in the body to produce uric acid. When there is an excess of purines in the body, uric acid levels can rise, leading to gout.
B. A 56-year-old male who is consuming foods low in purines
While consuming foods low in purines can help to prevent gout attacks, it is not a risk factor for developing gout.
C. A 5-year-old male with a BMI of 24 who reports a vegetarian diet
Children are not at risk for developing gout. Gout is more common in adults, especially men.
D. A female with ulcerative colitis .
Ulcerative colitis is an inflammatory bowel disease that is not associated with an increased risk of gout.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Med Surg Rn Helene Fuld College Nurs 221a Proctored Exam. Take the full exam now
Full Explanation
Anorexia nervosa is a condition characterized by severe weight loss and malnutrition. People with anorexia nervosa are often deficient in nutrients, including purines. Purines are broken down in the body to produce uric acid. When there is an excess of purines in the body, uric acid levels can rise, leading to gout.
Choice B is incorrect. While consuming foods low in purines can help to prevent gout attacks, it is not a risk factor for developing gout.
Choice C is incorrect. Children are not at risk for developing gout. Gout is more common in adults, especially men.
Choice D is incorrect. Ulcerative colitis is an inflammatory bowel disease that is not associated with an increased risk of gout.
Similar Questions
A nurse is caring for a client who requests prescription pain medication. Which of the following actions should the nurse perform first?
A. Administer the medication
Administering the medication without first assessing the pain could lead to inappropriate medication administration and potentially mask underlying issues. It's crucial to gather more information about the pain before providing any medication.
B. Determine the location of the pain
Determining the location of the pain is the crucial first step in pain assessment. It helps to: Identify the potential source of the pain, which can guide treatment choices. Understand the pain's characteristics, such as its quality, intensity, and duration. Evaluate for any associated symptoms or patterns, which can provide further insights into the underlying cause. Assess for any aggravating or alleviating factors, which can help tailor treatment strategies. Monitor the effectiveness of interventions by comparing changes in pain location and characteristics.
C. Reposition the client
While repositioning might offer some relief in certain cases, it's not the first step in pain management. A thorough assessment to understand the nature, location, and severity of the pain is essential for determining the most appropriate intervention.
D. Review the effects of the pain medication
Reviewing the effects of previous pain medication is important, but it doesn't take priority over assessing the current pain. Understanding the current pain experience is necessary to make informed decisions about medication administration and other interventions.
Full Explanation
Choice A rationale:
Administering the medication without first assessing the pain could lead to inappropriate medication administration and potentially mask underlying issues. It's crucial to gather more information about the pain before providing any medication.
Choice C rationale:
While repositioning might offer some relief in certain cases, it's not the first step in pain management. A thorough assessment to understand the nature, location, and severity of the pain is essential for determining the most appropriate intervention.
Choice D rationale:
Reviewing the effects of previous pain medication is important, but it doesn't take priority over assessing the current pain. Understanding the current pain experience is necessary to make informed decisions about medication administration and other interventions.
Choice B rationale:
Determining the location of the pain is the crucial first step in pain assessment. It helps to: Identify the potential source of the pain, which can guide treatment choices.
Understand the pain's characteristics, such as its quality, intensity, and duration.
Evaluate for any associated symptoms or patterns, which can provide further insights into the underlying cause. Assess for any aggravating or alleviating factors, which can help tailor treatment strategies.
Monitor the effectiveness of interventions by comparing changes in pain location and characteristics.
A nurse is in a client's room when the client begins having a tonic-clonic seizure. Which of the following actions should the nurse take first?
A. Turn the client's head to the side
Protecting the airway is the highest priority during a tonic-clonic seizure. Tonic-clonic seizures involve intense muscle contractions, which can lead to biting the tongue, aspiration of secretions, or even respiratory arrest if the airway is obstructed. Turning the client's head to the side helps to maintain a clear airway and prevent these complications. It is essential to act quickly to prevent injury and ensure adequate oxygenation. Delaying airway management could have serious consequences.
B. Check the client's motor strength
Checking motor strength is not a priority during the active phase of a seizure. It is more important to focus on protecting the airway and preventing injury. Motor strength can be assessed after the seizure has subsided.
C. Loosen the clothing around the client's waist
Loosening clothing around the waist may be helpful to promote comfort and breathing, but it is not the first priority. It is more important to address the airway and prevent aspiration.
D. Document the time the seizure began
Documenting the time the seizure began is important for accurate record-keeping and assessment of seizure patterns, but it is not the first priority in the immediate management of the seizure. Documentation can be done after the client's airway and safety are ensured.
Full Explanation
Choice A rationale:
Protecting the airway is the highest priority during a tonic-clonic seizure. Tonic-clonic seizures involve intense muscle contractions, which can lead to biting the tongue, aspiration of secretions, or even respiratory arrest if the airway is obstructed. Turning the client's head to the side helps to maintain a clear airway and prevent these complications.
It is essential to act quickly to prevent injury and ensure adequate oxygenation. Delaying airway management could have serious consequences.
Choice B rationale:
Checking motor strength is not a priority during the active phase of a seizure. It is more important to focus on protecting the airway and preventing injury.
Motor strength can be assessed after the seizure has subsided.
Choice C rationale:
Loosening clothing around the waist may be helpful to promote comfort and breathing, but it is not the first priority. It is more important to address the airway and prevent aspiration.
Choice D rationale:
Documenting the time the seizure began is important for accurate record-keeping and assessment of seizure patterns, but it is not the first priority in the immediate management of the seizure. Documentation can be done after the client's airway and safety are ensured.
A nurse is completing discharge instructions with a client following an acute onset of gout. Which of the following client statements indicates an understanding of the treatment regimen?
A. I will closely follow a high-purine diet
A high-purine diet is actually contraindicated in gout because purines are metabolized into uric acid, which can accumulate in the joints and trigger gout attacks. Therefore, a low-purine diet is recommended.
B. I will take one aspirin per day
Aspirin is not typically recommended for gout because it can interfere with the excretion of uric acid and potentially worsen the condition. While low-dose aspirin might be used for specific cardiovascular benefits in some gout patients, it's not a general treatment for gout itself.
C. I will limit my alcohol intake
Alcohol intake is a common trigger for gout attacks because it can increase uric acid levels in the blood. Therefore, limiting alcohol intake is an important part of managing gout.
D. I will limit my fluid intake to 1 liter per day
Fluid intake should be increased, not limited, in gout patients. This is because adequate hydration helps to flush uric acid out of the body and reduce the risk of gout attacks.
Full Explanation
Choice A rationale:
A high-purine diet is actually contraindicated in gout because purines are metabolized into uric acid, which can accumulate in the joints and trigger gout attacks. Therefore, a low-purine diet is recommended.
Choice B rationale:
Aspirin is not typically recommended for gout because it can interfere with the excretion of uric acid and potentially worsen the condition. While low-dose aspirin might be used for specific cardiovascular benefits in some gout patients, it's not a general treatment for gout itself.
Choice C rationale:Alcohol intake is a common trigger for gout attacks because it can increase uric acid levels in the blood. Therefore, limiting alcohol intake is an important part of managing gout.
Choice D rationale:
Fluid intake should be increased, not limited, in gout patients. This is because adequate hydration helps to flush uric acid out of the body and reduce the risk of gout attacks.