Pathophysiology of the Musculoskeletal System > Pathophysiology
Exam Review
Gout
Total Questions : 15
Showing 15 questions, Sign in for moreWhich statement by the nurse accurately describes the pathophysiology of gout?
Explanation
"Gout is caused by a bacterial infection in the joints." This statement is not accurate.
Gout is not caused by a bacterial infection.
Gout results from the accumulation of uric acid crystals in the joints, leading to inflammation and pain.
Choice C rationale:
"Gout occurs when there is too much calcium buildup in the joint spaces." This statement is incorrect.
Gout is primarily associated with the buildup of uric acid crystals, not calcium.
Calcium deposits in joints are more commonly seen in conditions like calcium pyrophosphate deposition disease (CPPD) or pseudogout.
Choice D rationale:
"Gout is primarily due to an autoimmune response targeting joint tissues." This statement is inaccurate.
Gout is not primarily an autoimmune disorder.
It is a metabolic disorder characterized by the deposition of uric acid crystals in joints, which triggers an inflammatory response.
Autoimmune disorders involve the immune system mistakenly attacking the body's own tissues, which is not the case in gout.
What statement by the nurse correctly identifies a risk factor associated with gout?
Explanation
"Excessive alcohol consumption is unrelated to gout development." This statement is not entirely accurate.
Excessive alcohol consumption, especially of beer and spirits, has been associated with an increased risk of gout.
Alcohol can raise uric acid levels and contribute to gout development, although it is not the sole cause.
Choice B rationale:
"Low-purine diets are a significant risk factor for gout." This statement is incorrect.
Low-purine diets are actually recommended for individuals with gout because foods high in purines can lead to higher uric acid levels, which can trigger gout attacks.
Low-purine diets help reduce the risk of gout flares.
Choice C rationale:
"Obesity and hypertension have no association with gout." This statement is inaccurate.
Obesity and hypertension are indeed risk factors associated with gout.
Obesity can lead to increased uric acid production, and hypertension is associated with higher uric acid levels as well.
A nurse is assessing a patient with gout.
Which clinical findings may be indicative of gout? Select all that apply:
Explanation
Swelling and redness in the affected joint.
E. Increased urinary frequency and urgency.
Choice B rationale:
"Elevated levels of cholesterol in the blood." Elevated cholesterol levels are not indicative of gout.
Gout is primarily related to uric acid metabolism, and its clinical presentation includes joint symptoms like swelling and redness.
Choice C rationale:
"Severe abdominal pain and diarrhea." Severe abdominal pain and diarrhea are not typical signs of gout.
These symptoms are more suggestive of gastrointestinal issues rather than gout.
Choice D rationale:
"History of heart disease." While gout and heart disease can coexist, a history of heart disease is not a direct clinical finding indicative of gout.
Gout primarily affects the joints and is characterized by symptoms such as joint pain and swelling.
What should the nurse include in the response regarding gout treatment?
Explanation
"Gout is typically treated with antibiotics." This statement is incorrect.
Gout is not caused by bacteria, so antibiotics are not the primary treatment.
Antibiotics are used to treat bacterial infections, not gout.
Choice B rationale:
"Surgical intervention is necessary to remove uric acid crystals." Surgical intervention is not the primary treatment for gout.
Medications and lifestyle modifications are the mainstays of gout management.
Surgery may be considered in rare cases with severe joint damage or when other treatments are ineffective, but it is not the first-line approach.
Choice D rationale:
"Physical therapy is the primary treatment for g gout." Physical therapy can be a helpful adjunctive therapy for gout patients, especially in managing joint function and mobility, but it is not the primary treatment.
Medications to lower uric acid levels and manage pain are the cornerstone of gout treatment.
What nursing intervention should be included in the plan of care for this patient?
Explanation
Choice A rationale:
"Encourage the patient to consume a diet high in purines." Encouraging a high-purine diet is not appropriate for a patient with gout.
High-purine foods can lead to increased uric acid levels, exacerbating gout symptoms.
The goal is to reduce purine intake.
Choice B rationale:
"Administer diuretics to help eliminate excess uric acid." While diuretics can increase uric acid levels in some cases, they are not typically administered as a primary treatment for gout.
In fact, certain diuretics can exacerbate gout symptoms by raising uric acid levels.
They are usually avoided or used cautiously in gout management.
Choice D rationale:
"Instruct the patient to avoid hydration to prevent uric acid buildup." Instructing the patient to avoid hydration is not appropriate and can be harmful.
Proper hydration is essential for gout management because it helps flush excess uric acid from the body.
Dehydration can lead to increased uric acid concentration in the blood and may worsen gout symptoms.
Questions
Which clinical manifestations should the nurse expect to find in this patient? .
Explanation
Choice A rationale:
The statement, "My joint pain has been gradually increasing over the past few months," is indicative of gout, but it is not a specific clinical manifestation.
Gout typically presents with sudden and severe joint pain during acute attacks.
Choice B rationale:
"I have noticed that my joint is swollen, red, and warm" is the correct choice.
These are classic clinical manifestations of gout during an acute attack.
The accumulation of uric acid crystals in the joint causes inflammation, leading to redness, warmth, and swelling.
Choice C rationale:
"I can move my affected joint without any limitations" is not consistent with gout.
Gout attacks often limit joint mobility due to pain and inflammation.
Choice D rationale:
"I have been experiencing hard lumps of uric acid crystals under my skin" describes tophi, which are a more advanced manifestation of gout.
While tophi can occur in some cases, they are not one of the initial clinical manifestations of gout.
What statement by the client indicates the need for further education about gout management?
Explanation
Choice A rationale:
"I will take the nonsteroidal anti-inflammatory drugs (NSAIDs) as needed for pain" is a reasonable statement, as NSAIDs are often prescribed for pain relief during gout attacks.
However, it's important to note that NSAIDs should be taken as directed by the healthcare provider, and their use should be monitored due to potential side effects.
Choice B rationale:
"I'll make sure to use colchicine during acute attacks to reduce inflammation" is the correct choice.
Colchicine is an anti-inflammatory medication commonly used to treat gout during acute attacks.
Choice C rationale:
"I should avoid corticosteroids unless my doctor says they are necessary" is a reasonable statement.
Corticosteroids are typically reserved for cases of gout where other treatments are ineffective, and their use should be under medical supervision.
Choice D rationale:
"I will take allopurinol regularly to lower my uric acid levels" is a correct statement.
Allopurinol is a medication used to lower uric acid levels in individuals with gout, helping to prevent future attacks.
It is a part of long-term gout management.
What is the primary purpose of allopurinol in the treatment of gout?
Explanation
Choice A rationale:
"To relieve acute pain during gout attacks" is not the primary purpose of allopurinol.
Allopurinol is used to lower uric acid levels over the long term and prevent future gout attacks, but it does not provide immediate pain relief during acute attacks.
Choice B rationale:
"To reduce inflammation and swelling in the joints" is not the primary purpose of allopurinol.
Allopurinol primarily works by inhibiting the production of uric acid, not by directly reducing inflammation.
Choice C rationale:
"To lower uric acid levels in the body" is the correct choice.
Allopurinol is a xanthine oxidase inhibitor that reduces the production of uric acid in the body, helping to maintain uric acid levels within a normal range and prevent gout attacks.
Choice D rationale:
"To improve joint mobility and range of motion" is not the primary purpose of allopurinol.
While effective management of gout can lead to improved joint function over time, allopurinol primarily addresses the underlying cause by lowering uric acid levels.
The client is allergic to NSAIDs and corticosteroids are contraindicated.
Which medication would be an appropriate alternative for pain relief in this client?
Explanation
Choice A rationale:
"Acetaminophen" is the appropriate alternative for pain relief in a client with gout who is allergic to NSAIDs and cannot take corticosteroids.
Acetaminophen is a non-prescription pain reliever that can be used for pain management in gout and is not known to exacerbate gout symptoms.
Choice B rationale:
"Aspirin" is generally not recommended for gout pain relief because it may interfere with uric acid excretion and potentially worsen gout symptoms.
Choice C rationale:
"Ibuprofen" is an NSAID and may not be suitable for a client allergic to NSAIDs.
Choice D rationale:
"Naproxen" is also an NSAID and is not suitable for a client allergic to NSAIDs.
Questions
The nurse asks the patient about their current medications.
Which statement by the nurse is most appropriate in this situation?
Explanation
Choice A rationale:
"Are you taking any medications for pain relief?" This choice is not the most appropriate in this situation.
While it is important to address the patient's pain, understanding the medications aimed at treating the underlying cause, which is high uric acid levels, is more crucial.
Pain relief medications may provide symptomatic relief but do not address the root cause of gout.
Choice B rationale:
"Are you taking any medications to lower your uric acid levels?" This is the correct choice.
Gout is primarily caused by elevated uric acid levels in the blood, leading to the formation of urate crystals in the joints.
Lowering uric acid levels is a key component of managing and preventing gout attacks.
Asking about medications that target this aspect of the condition is essential for the patient's care.
Choice C rationale:
"Are you taking any medications to treat kidney stones?" This choice is not the most appropriate in this context.
While kidney stones can be associated with gout due to the deposition of urate crystals in the kidneys, the primary concern in gout management is to control uric acid levels and prevent joint inflammation.
Kidney stone treatment may be relevant but is not the immediate focus of care.
Choice D rationale:
"Are you taking any medications to promote weight loss?" This choice is not relevant to gout management.
While weight loss can be beneficial for some patients with gout, especially if they are overweight, it is not a primary medication-based treatment for the condition.
Lowering uric acid levels and managing pain are more critical aspects of gout care.
The client asks the nurse for examples of foods to avoid.
What should the nurse respond?
Explanation
Choice A rationale:
"Avoid foods high in calcium." This choice is not directly related to gout management.
Calcium is not a significant factor in the development or exacerbation of gout.
Therefore, there is no need to instruct the patient to avoid foods high in calcium as a primary dietary modification for gout.
Choice B rationale:
"Avoid foods high in vitamin C." While vitamin C can be associated with gout prevention due to its potential to lower uric acid levels, it is not a primary dietary modification for reducing purine intake.
Purines are the compounds primarily responsible for uric acid production, and avoiding foods high in purines is a more effective dietary strategy.
Choice C rationale:
"Avoid foods high in purines." This is the correct choice.
Purines are broken down into uric acid, and excess uric acid can lead to gout attacks.
Therefore, advising the patient to avoid foods high in purines is a key dietary recommendation for gout management.
Choice D rationale:
"Avoid foods high in fiber." Fiber is generally considered a healthy component of the diet and is not specifically related to gout management.
There is no need to instruct the patient to avoid foods high in fiber as part of dietary modifications for gout.
Which nursing interventions are appropriate for managing gout? Select all that apply.
Explanation
Choice A rationale:
"Administering prescribed medications." This is a correct choice.
Gout management often involves the use of medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and urate-lowering drugs, to alleviate symptoms and reduce uric acid levels.
Choice B rationale:
"Encouraging the patient to elevate the affected joint and apply ice packs." This is a correct choice.
Elevating the affected joint and applying ice packs can help reduce pain and inflammation during a gout attack.
These measures are part of symptomatic relief strategies for gout.
Choice C rationale:
"Promoting weight gain and sedentary lifestyle." This choice is incorrect.
Promoting weight gain and a sedentary lifestyle are not appropriate interventions for managing gout.
Gout is often associated with obesity and sedentary lifestyles, and the focus should be on weight management and encouraging physical activity rather than promoting weight gain and inactivity.
Choice D rationale:
"Assisting with joint immobilization if necessary." This choice is not generally recommended for managing gout.
While immobilization may be necessary in cases of severe pain or joint damage, it is not a primary nursing intervention for gout management.
Choice E rationale:
"Providing education on increasing purine intake." This choice is incorrect.
Increasing purine intake is not a suitable strategy for managing gout.
In fact, gout management typically involves reducing purine intake to lower uric acid levels and prevent gout attacks.
Which complication should the nurse prioritize when discussing potential risks with the client?
Explanation
Choice A rationale:
"Chronic gouty arthritis." Chronic gouty arthritis is a potential complication of gout, but it is not the highest priority when discussing potential risks with the client.
Kidney stones and kidney damage (nephrolithiasis) are more concerning complications due to their impact on overall health.
Choice B rationale:
"Tophi formation in joints and soft tissues." Tophi formation is a complication of gout and can lead to joint deformities and limited mobility.
While it is important to address, kidney stones and kidney damage pose a more immediate and severe threat to the client's well-being.
Choice C rationale:
"Joint deformities and limited mobility." This is a valid concern, but kidney stones and kidney damage (nephrolithiasis) should be prioritized when discussing potential complications of gout because they can have more serious systemic consequences.
Choice D rationale:
"Kidney stones or kidney damage (nephrolithiasis)." This is the correct choice.
Kidney stones and kidney damage can result from the deposition of urate crystals in the kidneys, which is a complication of gout.
These complications can lead to significant health issues and should be prioritized in discussions with the client.
Which nursing action is appropriate to promote prevention?
Explanation
Choice A rationale:
"Advising the patient to limit alcohol consumption." This is the correct choice.
Alcohol consumption, particularly excessive consumption of beer and spirits, is associated with an increased risk of gout attacks.
Advising the patient to limit alcohol intake is an appropriate nursing action for gout prevention.
Choice B rationale:
"Encouraging a diet high in purine-rich foods." This choice is incorrect.
Encouraging a diet high in purine-rich foods is not appropriate for gout prevention.
High purine intake can lead to elevated uric acid levels, increasing the risk of gout attacks.
Choice C rationale:
"Recommending a sedentary lifestyle." This choice is incorrect.
Recommending a sedentary lifestyle is not appropriate for gout prevention.
Physical activity and maintaining a healthy weight are essential components of gout management and prevention.
Choice D rationale:
"Discouraging medication adherence for uric acid control." This choice is incorrect.
Discouraging medication adherence for uric acid control is counterproductive to gout prevention and management.
Medications prescribed to lower uric acid levels are a critical part of preventing gout attacks and complications.
Questions
(Select all that apply): A nurse is providing education to a client with gout about lifestyle modifications.
Which recommendations should the nurse include?
Explanation
Choice A rationale:
"Reduce your intake of red meat and seafood" is a correct recommendation.
These foods are high in purines, which can contribute to elevated uric acid levels and increase the risk of gout attacks.
Choice B rationale:
"Increase your consumption of alcohol to stay hydrated" is an incorrect recommendation.
Alcohol can contribute to dehydration and may exacerbate gout symptoms.
It is generally advisable for individuals with gout to limit or avoid alcohol consumption.
Choice C rationale:
"Maintain a high-protein diet to support muscle health" is an incorrect recommendation.
While protein is important for muscle health, high-protein diets, especially those rich in red meat, can be associated with increased purine intake, which may worsen gout symptoms.
Choice D rationale:
"Consider losing weight if you are overweight" is a correct recommendation.
Weight loss can help reduce the risk of gout and improve gout management, as obesity is a risk factor for gout.
Choice E rationale:
"Avoid fruits and vegetables rich in antioxidants" is an incorrect recommendation.
Fruits and vegetables rich in antioxidants are generally considered healthy and can be part of a balanced diet.
They are not associated with gout risk and can even have protective effects.
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