Detailed Answer Key For Medical Surgical Exam, A+ Solutions-1. A nurse is reviewing the cause of gout with a group of nurses. Which of the following
... [Show More] statements should the nurse make?
A. "Uric acid levels drop and calcium forms precipitate."
Rationale: With gout, clients have hyperuricemia, rather than a reduction in uric acid.
B. "Tophi form in the kidneys and they impair the excretion of uric acid."
Rationale: Tophi, or deposits in tissues near a joint, develop in chronic, late-stage gout. They are not part of the primary disease process.
C. "The intra-articular deposition of urate crystals causes inflammation."
Rationale: Gout, or gouty arthritis, develops when urate crystals deposit in joints and tissues and cause inflammation and pain.
D. "Articular cartilage thins, leading to splitting and fragmentation."
Rationale: Gout does not thin and fragment cartilage.
2. A nurse is teaching a group of clients about osteoarthritis. Which of the following recommendations should the nurse include in the teaching?
A. Use Echinacea to manage joint pain.
Rationale: The nurse may include the use of complementary and alternative therapies in the teaching.
However, Echinacea is used for the treatment of the common cold, not osteoarthritis. Alternative therapies that are used for osteoarthritis include glucosamine, chondroitin, and topical capsaicin.
B. Apply ice to the joint before exercising.
Rationale: The nurse should recommend that the clients begin exercising immediately following the application of heat. This reduces pain and improves mobility, allowing for increased range-of-motion during exercises. Cold application may be applied following exercise to decrease discomfort and inflammation.
C. Maintain a recommended body weight.
Rationale: Obesity is a risk factor for the development of osteoarthritis. Maintenance of an ideal weight is one way a client can prevent added wear and tear on joints and promote overall joint health.
D. Reduce the amount of purine in the diet.
Rationale: The nurse should recognize that limiting purine in the diet, which is often found in organ meats, is recommended for clients who have gout.
3. A nurse is caring for a client who has had a myocardial infarction. Upon his first visit to cardiac rehabilitation, he tells the nurse that he doesn't understand why he needs to be there because there is nothing more to do, as the
damage is done. Which of the following is the correct nursing response?
A. "Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous level of activity safely."
Rationale: With this response, the nurse uses the therapeutic communication technique of presenting reality by indicating her perception of the situation for the client.
B. "It’s not unusual to feel that way at first, but once you learn the routine, you’ll enjoy it."
Rationale: With this response, the nurse illustrates the nontherapeutic communication technique of giving reassurance, thus discouraging the client from further communication.
C. "Exercise is good for you and good for your heart."
Rationale: With this response, the nurse illustrates the nontherapeutic communication techniques of disagreeing and giving advice.
D. "Your doctor is the expert here, and I’m sure he would only recommend what is best for you."
Rationale: With this response, the nurse illustrates the nontherapeutic communication technique of defending.
4. A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client’s low potassium level?
A. Furosemide
Rationale: Furosemide is a loop (high-ceiling) diuretic that inhibits the reabsorption of sodium and chloride and results in diuresis, which decreases potassium through excretion in the distal nephrons.
Hypokalemia is an adverse effect of furosemide.
B. Nitroglycerin
Rationale: A potassium level of 2.4 mEq/L is not an adverse effect of nitroglycerin. Nitroglycerin is a vasodilator medication to treat angina.
C. Metoprolol
Rationale: A potassium level of 2.4 mEq/L is not an adverse effect of metoprolol. Metoprolol is a beta-blocker that slows the heart rate and improves contractility of the heart muscle.
D. Spironolactone
Rationale: Spironolactone is a potassium-s [Show Less]