Mr. K., aged 60 years, has a diagnosis of transient ischemic attack. An essential aspect of his history that needs to be documented is

Correct Answer: A

Rationale: The correct answer is A) sudden, brief loss of sensory, motor, or visual function. This is crucial to document because a transient ischemic attack (TIA) is characterized by temporary disruption of blood flow to the brain, leading to temporary neurologic deficits. Documenting the specific symptoms experienced during the TIA episode is essential for accurate diagnosis and appropriate management. Option B) determining if he has any allergies is incorrect as it is not directly related to the diagnosis of TIA. Allergies are important to document in a medical history but not specifically relevant to a TIA. Option C) any history of neurologic disease is incorrect because the focus here is on documenting the specific symptoms experienced during the TIA episode, not a general history of neurologic diseases. Option D) his medication history, both prescribed and over-the-counter, is important in a comprehensive assessment but is not as essential as documenting the specific symptoms experienced during the TIA episode. In an educational context, understanding the importance of accurate documentation in a patient's history is critical for healthcare professionals to provide effective care and treatment. This question highlights the significance of recognizing key information needed to assess and manage a patient presenting with a TIA, emphasizing the importance of thorough history-taking in neurological assessments.

Correct Answer: A

Rationale: The correct answer is A) needs to exercise involved joints periodically. Joint stiffness can result from prolonged, static postures, such as reading for extended periods. Encouraging the patient to periodically move and exercise the involved joints can help alleviate stiffness and improve circulation. This is supported by the concept of maintaining joint mobility and preventing stiffness through movement. Option B) needs to take long walks twice a day is incorrect as it does not directly address the issue of joint stiffness related to prolonged reading. While walking can be beneficial for overall health, it may not specifically target the stiffness caused by reading. Option C) is a chronic complainer is a distractor and not related to the patient's reported joint stiffness. This option lacks relevance to the scenario presented. Option D) needs to rest involved joints for one hour at a time is incorrect because prolonged rest can actually contribute to joint stiffness. While rest is important, in this case, gentle movement and exercises are more appropriate to address the stiffness issue. In an educational context, understanding the importance of movement and exercise in maintaining joint health is crucial for healthcare providers. Encouraging patients to engage in regular physical activity can help prevent and manage joint stiffness, promoting overall well-being. It is essential to tailor recommendations to each individual's specific situation and activities to optimize health outcomes.

Correct Answer: B

Rationale: The correct answer is B) have an eye examination every 4-6 months. This is essential because hydroxychloroquine can cause retinopathy, a serious eye condition that can lead to vision loss if not detected early. Regular eye examinations are crucial for monitoring any signs of retinal damage and ensuring prompt intervention if needed. Option A is incorrect because hydroxychloroquine may take several weeks to months to start showing its full effects in managing symptoms of rheumatoid arthritis, so immediate relief within 1-2 weeks is not typical. Option C is incorrect as there is no specific requirement to take hydroxychloroquine before bedtime. The key is to take the medication consistently as prescribed. Option D is also incorrect because while being alert for a skin rash is important when taking any medication, it is not the primary concern associated with hydroxychloroquine therapy in rheumatoid arthritis. In an educational context, it is crucial for healthcare providers to educate patients about the potential side effects of medications they are prescribed, like hydroxychloroquine. Emphasizing the need for regular eye examinations can help prevent serious complications and promote patient safety and well-being. Patients should be empowered with knowledge to actively participate in their treatment and monitoring processes for better health outcomes.

Correct Answer: A

Rationale: The correct answer is A) Nonsteroidal anti-inflammatory medications and colchicine. In the treatment of acute gout attacks, nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce inflammation and pain, while colchicine is specifically effective in treating gout by reducing inflammation and pain associated with crystal deposition in the joints. This combination targets the underlying cause of the acute gout attack and provides symptomatic relief. Option B) Allopurinol and aspirin is incorrect because allopurinol is a medication used for long-term management of gout by lowering uric acid levels and preventing future attacks, not for treating acute symptoms. Aspirin can actually worsen gout symptoms by interfering with uric acid excretion. Option C) Antibiotics and acetaminophen is also incorrect as antibiotics are not indicated for acute gout attacks unless there is an accompanying infection. Acetaminophen may provide some pain relief but does not address the underlying inflammatory process of gout. Option D) Bisphosphonates and calcium are used in the treatment of osteoporosis and have no role in managing acute gout attacks. Educationally, understanding the appropriate management of acute gout attacks is crucial for healthcare professionals to provide effective care and alleviate patient discomfort. This question highlights the importance of differentiating between long-term gout management and acute attack treatment, emphasizing the need for targeted therapies based on the underlying pathophysiology of the condition.

Correct Answer: A

Rationale: In this scenario, the nurse suspects that the client is experiencing problems with circulation, which is the correct answer (Option A). Weak pulses, dusky color in the ankles, and significant local edema are indicative of impaired blood flow to the lower extremities. This could be due to conditions such as peripheral vascular disease or deep vein thrombosis, which can lead to serious complications if not addressed promptly. Option B, problems with sensation, is incorrect in this case because the symptoms described are more closely related to circulatory issues rather than sensory deficits. Problems with sensation would typically involve issues such as numbness, tingling, or loss of feeling in the affected area. Option C, problems with mobility, is also incorrect as the symptoms presented do not directly point to issues with the client's ability to move. While impaired circulation can impact mobility in the long term if left untreated, it is not the primary concern based on the symptoms provided. Option D, problems with pain, is not the most likely issue as the symptoms described are more indicative of compromised blood flow rather than pain perception. While the client may eventually experience pain if circulation is severely compromised, the initial symptoms point more towards circulatory issues. From an educational perspective, understanding the signs and symptoms of circulatory problems in the lower extremities is crucial for nurses working in various clinical settings. Recognizing these indicators early can help prevent complications such as tissue damage, ulceration, and even amputation. Nurses should be able to differentiate between circulatory issues, sensory deficits, mobility problems, and pain to provide timely and appropriate care to their patients.