A client with gouty arthritis reports tenderness and swelling of the right ankle and great toe. The nurse observes the area of inflammation extends above the ankle area. What should the nurse do?

Correct Answer: C

Rationale: For a client with gouty arthritis experiencing tenderness and swelling, the nurse should administer prescribed anti-inflammatory medication. Gout results from uric acid crystal deposition, causing acute inflammation and severe pain. Medications like NSAIDs or colchicine reduce inflammation and provide relief, addressing the root cause. Massaging joints could worsen pain and crystal movement, cold packs and elevation help symptomatically but aren't primary, making medication the most effective initial action per standard care.

Correct Answer: B

Rationale: Sodium (Na⁺) is mostly reabsorbed via primary active transport, driven by the Na⁺/K⁺-ATPase pump on the basolateral membrane of tubular cells, especially in the proximal convoluted tubule (PCT). This pump uses ATP to move Na⁺ out into the peritubular capillaries against its gradient, creating a low intracellular Na⁺ concentration. This facilitates Na⁺ entry from the lumen via secondary mechanisms, but the primary energy-dependent step defines the process, making B correct.

Correct Answer: A

Rationale: Glomerular hydrostatic pressure (GHP), typically around 55 mmHg, is the force exerted by blood pressure within glomerular capillaries, pushing fluid out into the Bowman's capsule during filtration. It's the primary driving force of GFR, opposed by oncotic and capsular pressures. It doesn't push fluid back (B), affect filtration neutrally (C), or alter oncotic pressure (D), making A correct.

Correct Answer: C

Rationale: Potassium secretion in the cortical collecting tubule by principal cells is driven by aldosterone, which increases Na⁺ reabsorption and K⁺ secretion. Spironolactone, an aldosterone antagonist, inhibits this, reducing K⁺ secretion. High plasma K⁺ (A) and alkalosis (D) increase secretion, and diuretics like furosemide (B) indirectly enhance it, making C the correct inhibitor.

Correct Answer: B

Rationale: The fastest system controlling [H⁺] is CO₂ excretion by the lungs, acting within seconds to minutes via increased ventilation, reducing PCO₂ and thus H₂CO₃ (H⁺ source). Buffers (C) act instantly but don't eliminate H⁺, kidney H⁺ excretion (A) takes hours, and carbonic anhydrase (D) is a mechanism, not a system, making B correct.