A nurse is teaching a client how to follow a low-purine diet as prescribed by the provider for the management of gout. What statement by the client indicates a correct understanding of the teaching?

Correct Answer: B

Rationale: In the context of managing gout through a low-purine diet, option B, "I should avoid eating liver and other organ meats," is the correct choice. Organ meats like liver are high in purines, which can lead to increased uric acid levels and worsen gout symptoms. By avoiding organ meats, the client can better control their purine intake, thereby reducing the risk of gout flare-ups. Option A, "I should choose red meat instead of poultry," is incorrect as both red meat and poultry can be high in purines. Red meat, in general, should be limited in a low-purine diet. Option C, "I can drink only white wine," is incorrect as alcohol, in general, should be consumed in moderation or avoided, particularly beer and spirits which are high in purines. White wine still contains purines and should not be the focus of dietary changes for gout management. Option D, "I will need to limit the number of fruit servings each day," is incorrect as most fruits are low in purines and are generally considered safe for individuals with gout. It is important to focus more on limiting high-purine foods like organ meats and certain seafood rather than fruits when following a low-purine diet for gout. Educationally, this question highlights the importance of understanding the specific dietary recommendations for managing conditions like gout. It emphasizes the need for clients to be aware of which foods to avoid or limit to effectively control their symptoms and improve their overall health.

Correct Answer: D

Rationale: In a client with rheumatoid arthritis one day after shoulder surgery, paresthesia in the fingers and intense increasing pain in the shoulder could indicate nerve compression or damage, which are serious post-operative complications. This situation requires immediate attention from the provider to prevent further complications and ensure appropriate management. The other options, such as refusing pain medication, reporting a minor headache, or experiencing minor abdominal discomfort, are important but not as urgent or indicative of potential serious complications as paresthesia in the fingers and intense increasing pain in the shoulder.

Correct Answer: C

Rationale: In the case of a client with systemic lupus erythematous (SLE) experiencing flank pain, the nurse would anticipate that a creatinine test will be ordered. This is because flank pain in a patient with SLE could be indicative of lupus nephritis, a common and serious complication where the kidneys are affected. Creatinine levels are a key indicator of kidney function, and an elevated creatinine level would suggest impaired kidney function, which is crucial information for managing a patient with lupus nephritis. Option A) Platelets: Platelet levels are not typically associated with flank pain in SLE. Platelets are more relevant in conditions like thrombocytopenia, which is a common hematologic manifestation of SLE. Option B) Skin biopsy: Skin biopsy is not directly related to flank pain in SLE. It is a diagnostic procedure used to evaluate skin conditions, not kidney involvement. Option D) Hemoglobin: Hemoglobin levels are important in assessing for anemia, which can be a complication of SLE, but they are not the primary concern when a patient presents with flank pain indicative of possible kidney involvement. Educationally, understanding the rationale behind ordering specific laboratory tests in the context of different symptoms and conditions is crucial for nurses to provide comprehensive care. Connecting clinical manifestations with appropriate diagnostic tests enhances nurses' ability to recognize and respond to potential complications promptly, thereby improving patient outcomes.

Correct Answer: C

Rationale: The most appropriate statement by the nurse in this scenario is option C: "How does this impact your role in your family?" This question addresses the psychosocial aspect of the client's condition, recognizing the holistic impact of rheumatoid arthritis beyond just physical symptoms. Choosing option A, "Tell me about what medication you are taking," focuses solely on the medical aspect of care and does not address the client's psychosocial needs. Option B, "What physical limitations are you experiencing?" while relevant to the client's condition, does not delve into the emotional or relational impact of the illness. Option D, "What therapies are you using to reduce swelling?" is more focused on the physical management of the condition rather than the client's emotional well-being and social interactions. In an educational context, it is crucial for nurses to understand the importance of holistic care and the impact of illness on a person's entire being. By addressing psychosocial aspects like family dynamics, nurses can provide more comprehensive care that considers the client's emotional and social needs alongside their physical symptoms. This approach enhances patient-centered care and promotes better overall outcomes for individuals facing chronic conditions like rheumatoid arthritis.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) The client's incision site has eviscerated. Evisceration refers to the protrusion of an organ through a wound or surgical incision. When a post-operative client with a sutured abdominal incision experiences sharp abdominal pain and bowel protrusion, it indicates evisceration, which is a surgical emergency requiring immediate intervention to prevent complications like infection and further tissue damage. Option B) The client's incision site has lacerated is incorrect because laceration refers to a tear in the tissue, while evisceration specifically involves an organ protruding through a wound. Option C) The client's incisional site is approximated is incorrect as it describes the alignment and closure of wound edges, not the protrusion of bowel. Option D) The client's incisional site has dehisced after is also incorrect as dehiscence refers to the separation of wound edges, not organ protrusion. Educationally, understanding the signs and implications of evisceration is crucial for nurses caring for post-operative patients. Prompt recognition and appropriate communication to the physician are vital to ensure timely intervention and prevent further complications in surgical patients. This knowledge is essential for providing safe and effective patient care in clinical settings.