NSG121- FINAL EXAM (UNIT 1)

After an arthrogram you should stabilize joint for...

12 hours

You are providing a free clinic seminar to participants about gout. Which statement by a participant about the occurrence of gout is correct? A. "Gout attacks tend to awake the person out of their sleep in the middle of the night." B. "The pain felt with gout tend to be intense during the first 30 minutes." C. "It is best for a patient experiencing gout to tightly bandage the affected extremity." D. "Typically acute gout attacks are predictable and tend to occur once or twice a week."

A. "Gout attacks tend to awake the person out of their sleep in the middle of the night."

Which patients below are at risk for developing osteoarthritis? Select-all-that-apply: A. A 65 year old male with a BMI of 35. B. A 59 year old female with a history of taking long term doses of corticosteroids. C. A 55 year old male with a history of repeated right knee injuries. D. A 60 year old female with high uric acid levels.

A. A 65 year old male with a BMI of 35. C. A 55 year old male with a history of repeated right knee injuries.

Your patient is scheduled for a DEXA scan this morning. The patient is having heartburn and requests a PRN medication to help with relief. Which medications can the patient NOT have at this time? A. Calcium Carbonate B. Bismuth Salicylate C. Milk of Magnesia D. Famotidine

A. Calcium Carbonate

During an outpatient visit you are assessing the patient's understanding about the signs and symptoms associated with osteoporosis. Select all of the signs and symptoms stated by the patient that are correct: A. Dowager's Hump (kyphosis) B. Loss of 0.5 inches in height compared to young adult height C. Swelling and warmth at the bone site D. Some patients are asymptomatic E. Fractures most commonly in the hips, wrist, and spine

A. Dowager's Hump D. Some patients are asymptomatic E. Fractures most commonly in the hips, wrist, and spine (B. is incorrect bc there is normally a loss of 2-3 inches)

Which assessment finding found while assessing a patient with a fracture who has traction requires immediate intervention? A. The weights are freely hanging on the floor. B. Pin sites are free from drainage. C. Patient uses the overhead trapeze bar to move around in the bed. D. Patient's extremities have a capillary refill of less than 2 seconds.

A. The weights are freely hanging on the floor. (Weights used for traction should freely hang but NOT on the floor. All the other options are expected findings.)

Phosphorus is needed for....

Activating vitamin and enzymes, functions in acid base balance.,

The nurse admits an older adult client who sustained a left hip fracture and is in considerable pain. The nurse anticipates that the client will be placed in which type of traction? A) Balanced skin traction B) Buck's traction C) Overhead traction D) Plaster traction

B) Buck's traction (Buck's traction may be applied before surgery to help decrease pain associated with muscle spasm.)

An EKG shows a shortened QT interval. Which of the following lab values would be indicative of this change? A) Calcium level of 8.0 B) Calcium level of 12.0 C) Calcium level of 8.7 D) Calcium level of 9.2

B) Calcium level of 12.0

Stimulation of the facial nerve via the masseter muscle causes twitching of the nose/lips in hypocalcemia is known as? A) Trousseau's Sign B) Chvostek's Sign C) Homan's Sign D) Goodell's Sign

B) Chvostek's Sign

A patient has a calcium level of 7.2. What sign below is indicative of this lab value? A) None this is a normal calcium level B) Prolonged QT interval on the EKG C) Hypoactive bowel sounds D) Shortened ST segment

B) Prolonged QT interval on the EKG

An older adult client who has osteoporosis is discharged from the hospital. What does the nurse include in client teaching related to the client's home safety? A. "Use area rugs on tile floors" B. "Keep walkways free of clutter" C. "Walk slowly on wet floor areas after mopping." D. "Keep light low to prevent glare."

B. "Keep walkways free of clutter" (PREVENT FALLS)

A patient is taking Calcitonin for osteoporosis. The patient should be monitored for? A. Hyperkalemia B. Hypokalemia C. Hypocalcemia D. Hypercalcemia

C. Hypocalcemia (Calcitonin is made from salmon calcitonin and acts like the hormone calcitonin which is produced naturally by the thyroid gland. It decreases osteoclast activity, which can decrease calcium levels.)

During discharge teaching to a patient at risk for developing osteoporosis, you discuss the types of exercise the patient should perform. Which type of exercise is not the best to perform to prevent osteoporosis? A. Tennis B. Weight-lifting C. Walking D. Hiking

C. Walking (Low-impact exercises are not as beneficial in building bone mass as compared to weight-bearing exercises such as tennis, lifting weights, and hiking etc. The patient should perform exercises that put stress on the bones against gravity, which will help increase bone strength and build muscle.)

With fractures of the femoral neck, the leg is A. shortened, abducted, and internally rotated. B. abducted and externally rotated. C. shortened, adducted, and externally rotated D. adducted and internally rotated.

C. shortened, adducted, and externally rotated

If there is muscle issue or damage, what labs will be elevated? (4)

Creatine kinase LDH ALD AST

A client with a fracture asks the nurse about the difference between a compound fracture and a simple fracture. Which statement by the nurse is correct? A) "Simple fracture involves a break in the bone, with skin contusions." B) "Compound fracture does not extend through the skin." C) "Simple fracture is accompanied by damage to the blood vessels." D) "Compound fracture involves a break in the bone, with damage to the skin."

D) "Compound fracture involves a break in the bone, with damage to the skin."

Diagnostic tests for assessment of Musculoskeletal: Arthrogram

Detects tears in joint capsule; performed when a traumatic injury is suspected. Injects air in joint capsule/ air helps visualize the capsule

To help prevent osteoporosis, what should a nurse advise a young woman to do? a) Consume at least 1,000 mg of calcium daily. b) Keep the serum uric acid level within the normal range. c) Encourage the use of a firm mattress. d) Avoid trauma to the affected bone.

a) Consume at least 1,000 mg of calcium daily.

Musculoskeletal changes r/t Aging: INCREASED bone prominence Intervention?

(Due to loss of fat stores) Client is at risk for pressure ulcers Intervention: Provide client with pillows and help with reposiitoning

Musculoskeletal changes r/t Aging: Curvature of the spine Intervention?

(Kyphotic posture) Intervention: Have client sit in chair with back supported

Musculoskeletal changes r/t Aging: DECREASED muscle tone Intervention?

(Muscle atrophy) Encourage client to perform isometric exercises such as stretching and eating foods high in protein

Musculoskeletal changes r/t Aging: Cartilage degeneration. Intervention?

(Osteoarthritis) Intervention: Apply warm compress to increase blood flow

Function of Calcium (5)

1. Bone strength and density 2. Control nerve impulse transmission 3. Skeletal and cardiac muscle contraction 4. Necessary for activation of enzymes 5. Plays a role in blood coagulation

Diagnostic tests for assessment of Musculoskeletal: Bone Scan

A bone scan is used to detect.. Tumors, arthritis, osteoporosis, osteomyelitis, bone cancer, and vertebral compression fractures. It uses radioisotopes to see where isotope is metabolizing= problem

What is a bone densitometry?

A test like an x-ray that quickly and accurately measures the density of bone Detects: Osteopenia, osteoporosis, conditions where minerals and density are low.

A patient has a calcium level of 12.5. Which medication will most likely be ordered for this patient? A) Calcitonin B) 10% Calcium Gluconate C) Calcium Chloride D) Hydrochlorothiazide

A) Calcitonin

A patient is recovering from parathyroid surgery. Morning labs values are back. Which of the following lab values would correlate as a complication from this type of surgery? A) Calcium 6.9 B) Calcium 12.5 C) Calcium 8.7 D) Calcium 9.2

A) Calcium 6.9

A client with a compound fracture of the left femur is admitted to the emergency department after a motorcycle crash. Which action is most essential for the nurse to take first? A) Check the dorsalis pedis pulses. B) Immobilize the left leg with a splint. C) Administer the prescribed analgesic. D) Place a dressing on the affected area.

A) Check the dorsalis pedis pulses. (The first action should be to assess the circulatory status of the leg because the client is at risk for acute compartment syndrome, which can begin as early as 6 to 8 hours after an injury.)

A patient's lab work shows that they have a high parathyroid hormone level. Which of the following conditions is the patient at risk for? A) Hypercalcemia B) Hypocalcemia C) Hypokalemia D) Hyperkalemia

A) Hypercalcemia

The nurse is caring for a client with prostate cancer who has bone metastasis. The nurse anticipates that the health care provider will prescribe which medication? A. Calcitonin (Calcimar) B. Medroxyprogesterone (Prempo) C. Pamidronate (Aredia) D. Tamsulosin hydrochloride (Flomax)

A. Calcitonin (Calcimar)

Parathyroid hormone plays an important role in bone health. When the parathyroid gland secretes PTH (parathyroid hormone) it causes: A. the body to increase the calcium levels by stimulating the osteoclast activity. B. the body to decrease the calcium levels by inhibiting osteoclast activity. C. the body to increase the calcium levels by stimulating osteoblast activity. D. the body to decrease the calcium levels by inhibiting osteoblast activity.

A. the body to increase the calcium levels by stimulating the osteoclast activity.

Diagnostic tests for assessment of Musculoskeletal: CT Scan

Allows more views than basic x-ray (bone deformities) ASSESS for shellfish or iodine allergies.

Bone Scan: TEACHING

Assess for allergies Encourage fluids after to flush radioactive isotopes out (Gallium and Thallium scans)

Post Arthroscopy?

Assess neurovascular status and stabilize the joint

Which information about a client who was admitted with pelvic and bilateral femoral fractures after being crushed by a tractor is most important for the nurse to report to the health care provider? A) Thighs have multiple oozing abrasions. B) Serum potassium level is 7 mEq/L. C) The client is describing pain as level 4 (0-to-10 scale). D) Hemoglobin level is 12.0 g/dL.

B) Serum potassium level is 7 mEq/L. (The elevated potassium level may indicate that the client has rhabdomyolysis and acute tubular necrosis caused by the crush injury.)

A 85 year old patient has an accidental fall while going to the bathroom without assistance. It appears the patient has sustained a bone fracture to the left leg. The leg's shape is deformed and the patient is unable to move it. The patient is alert and oriented but in pain. What will you do FIRST after confirming the patient is safe and stable? A. Apply an ice pack covered with a towel to the site. B. Immobilize the fracture with a splint. C. Administer pain medication. D. Elevate the extremity above heart level.

B. Immobilize the fracture with a splint.

What should you monitor for post biopsy?

BLEEDING at site of the biopsy.

A client is in skeletal traction. Which nursing intervention ensures proper care of this client?A) Ensure that weights are attached to the bed frame or placed on the floor. B) Ensure that pins are not loose, and tighten as needed. C) Inspect the skin at least every 8 hours. D) Remove the traction weights only for bathing.

C) Inspect the skin at least every 8 hours.

Which patient below is NOT at risk for osteoporosis? A. A 50 year old female whose last menstrual period was 7 years ago. B. A 45 year old male patient who has been taking glucocorticoids for the last 6 months. C. A 30 year old male who drinks alcohol occasionally and has a BMI of 28. D. A 35 year old female who has a history of seizures and takes Dilantin regularly.

C. A 30 year old male who drinks alcohol occasionally and has a BMI of 28.

The patient is brought to the emergency department after a car accident and has a femur fracture. What nursing intervention should the nurse implement to prevent a fat embolus in this patient? A. Provide range-of-motion exercises. B. Administer enoxaparin C. Immobilize the fracture preoperatively. D. Apply sequential compression boots.

C. Immobilize the fracture preoperatively.

Which of these statements by the client indicates an understanding of how the parathyroid hormone (PTH) assists in the body's regulation of calcium? A. The parathyroid hormone works by increasing the release of PTH when the calcium in the blood is high B. The parathyroid hormone works by releasing PTH in response to the serum pH C. The parathyroid hormone pulls out calcium from the bones and promotes the transfer of calcium into the plasma D. The parathyroid hormones works by keeping the calcium in the bones and decreases the absorption

C. The parathyroid hormone pulls out calcium from the bones and promotes the transfer of calcium into the plasma

Which finding does the nurse expect to observe in a client with suspected common chronic osteomyelitis? A. Erythema of the affected area B. Fever; temperature usually above 101 C. Ulceration of the skin D. Constant, localized, and pulsating bone pain

C. Ulceration of the skin (This is a feature of CHRONIC osteomyelitis)

Calcitonin (______) and PTH (______) balances Ca++ levels by telling the kidneys to either reabsorb or excrete Ca++ levels

Calcitonin: LOWERS PTH: RAISES

MRI: TEACHING?

Check to see if there is any metal inside or outside, patient CANNOT have pacemaker or a pain pump. Tattoos could have lead. Check surgical history for any joint repairs. Instruct client to lie flat and still for 45 min-1 hr. May require sedation if client gets clasterphobic.

What is a late sign of compartment syndrome? A. Paralysis B. Pain C. Parethesia D. Pulselessness

D. Pulselessness

You're caring for a patient who has a health history of severe osteoporosis. On assessment you note the patient has severe kyphosis of the upper back. Which nursing diagnosis takes priority for this patient's care? A. Risk for skin breakdown B. Knowledge deficient regarding disease process C. Limited mobility D. Risk for falls

D. Risk for falls (This deformity of the spine limits mobility and increases the chances of falls In addition, it is important the nurse takes precautions in preventing falls because the patient will most likely experience a fracture due to severe osteoporosis.)

It is important a patient with gout avoid medications that can increase uric acid levels. Which medication below is NOT known to increase uric acid levels? A. Aspirin B. Niacin C. Cyclosporine D. Tylenol

D. Tylenol

How is calcium regulated?

Enters the body based on diet and absorbed by our intestines with the help of vitamin D and then stored in our bones. REGULATED by: PTH and Calcitonin

True or False: Osteoarthritis develops due to the deterioration of the synovium within the joint that can lead to complete bone fusion.

FALSE (Osteoarthritis is the most common type of arthritis that develops due to the deterioration of the HYALINE CARTILAGE)

True or False: Osteoporosis is a disease process that results in the thinning of the matrix of pore-like structures within the compact bone.

False

What is Alkaline phosphatase? If it is ______ this could indicate damage.

It is found in the bone and blood. Leaks out of bone, so if it is INCREASED this could indicate damage.

What is phosphorus? and what is it inversely proportional to?

It is found in the bone, major anion in the ICF compared to the ECF. Inversely proportional to Calcium

Diagnostic tests for assessment of Musculoskeletal: X-ray

No prep required Picks up on swelling, bone fractures and deformities

What do we assess for with calcium imbalances? (5)

Nutrition Medications PMH of kidney disease/thyroid/parathyroid GI issues (malabsorption) Vitamin D deficiency

Diagnostic tests for assessment of Musculoskeletal: Arthroscopy

Small incision and inserting fibrooptic tube into joint space- can fix problem while in there. Diagnostic or surgical

Diagnostic tests for assessment of Musculoskeletal: Ultrasound

Sound waves produce an image Picks up on fluid-filled abnormalities.

After an arthrogram... stabilize _____

Stabilize the joint=helps with swelling

True or False: When using the swing-to gait with crutches, the patient will move both crutches forward, and then will move both legs forward to the same point as the crutches.

TRUE

Diagnostic tests for assessment of Musculoskeletal: MRI

With or without contrast dye. Produces more detailed images and commonly used to diagnose musculoskeletal disorders.

During a routine physical examination on a 75-year-old female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best response by the nurse? a) "After menopause, the body's bone density declines, resulting in a gradual loss of height." b) "After age 40, height may show a gradual decrease as a result of spinal compression" c) "The posture begins to stoop after middle age." d) "There may be some slight discrepancy between the measuring tools used."

a) "After menopause, the body's bone density declines, resulting in a gradual loss of height."

Of the following, which is not a risk factor for osteoporosis? a) Being male b) Being postmenopausal c) Small-framed, thin White or Asian women d) Family history

a) Being male

What food can the nurse suggest to the client at risk for osteoporosis? a) Broccoli b) Bananas c) Carrots d) Chicken

a) Broccoli (Calcium is important for the prevention of osteoporosis. Broccoli is high in calcium)

1. Which of the following is not a risk for hypercalcemia? a. Bone fracture b. Cancer c. Hyperparathyroidism d. Thiazide diuretics

a. Bone fracture

1. A client comes into the ER with hypocalcemia. What clinical manifestations may this client display? (SATA) a. Facial twitch b. Drowsy c. Paresthesia d. Constipation e. Hyperactive tendon reflex

a. Facial twitch c. Paresthesia e. Hyperactive tendon reflex

1. When caring for a patient who has sustained a fracture, what should be the nurse's priority when caring for this patient? a. Prevention of NV dysfunction b. Taking vitals c. Maintain bone alignment d. Preventing tissue damage

a. Prevention of NV dysfunction

1. An arthrogram is prescribed to a patient to indicate... a. Tear in joint capsule b. Nerve and muscle damage c. Fluid filled type of abnormalities d. Infection of bone

a. Tear in joint capsule

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for? a) Needle aspiration b) Arthroscopy c) Arthroplasty d) Open reduction

b) Arthroscopy

Which of the following clinical manifestations would the nurse expect to find in a client who has had osteoporosis for several years? a) Diarrhea b) Decreased height c) Bone spurs d) Increased heel pain

b) Decreased height

Treatment of metastatic bone cancer includes which of the following? a) Radiation b) Palliation c) Chemotherapy d) Combination chemotherapy and radiation

b) Palliation

Which is a risk-lowering strategy for osteoporosis? a) Increased age b) Smoking cessation c) Diet low in calcium and vitamin D d) Low initial bone mass

b) Smoking cessation

1. Which client is more likely to be most at risk for a calcium deficiency? a. A 67-year-old male who is retired from being an athletic sports coordinator b. A 62-year-old women who was a stay at home mom c. A 47-year old women who works currently as a night shift nurse d. A 55-year-old man who is a middle school teacher

b. A 62-year-old women who was a stay at home mom (Post-menopausal women are especially at risk for calcium deficiency and musculoskeletal complications.)

1. Which of the following patient's is most at risk for enduring a fracture? a. A patient who was a former athlete b. A patient who currently takes corticosteroids c. A patient who is a teacher and a coach d. A patient who is vegan

b. A patient who currently takes corticosteroids

1. A 59-year-old female is admitted to the oncology floor and was recently diagnosed with bone cancer. She received what diagnostic test? a. X-ray b. Bone scan c. MRI d. Electromyography

b. Bone scan

1. What is primarily responsible for regulating Calcium? a. PTH b. Calcitonin c. Intestines d. Estrogen

b. Calcitonin

1. Which laboratory assessments indicate muscle damage has occurred (SATA) a. Serum Calcium b. Lactic Dehydrogenase (LDH) c. ALD/AST d. Alkaline phosphatase (ALP) e. Creatine Kinase

b. Lactic Dehydrogenase (LDH) c. ALD/AST e. Creatine Kinase

1. A patient is brought in on an ambulance and has sustained multiple fractures to the extremities and ribs. Which of the following is NOT best practice? a. Assess airway b. Remove shoes c. Remove jewelry d. Immobilize area

b. Remove shoes (we want to keep shoes on to reduce the amount of swelling)

1. A nurse is treating a client for hypocalcemia. Which of the following examples would require an intervention? a. The nurse applies padding to the bed b. The nurse quickly administers IV calcium c. The nurse orders a lunch tray with instant oatmeal and leafy greens d. The nurse is careful when moving the client up in bed

b. The nurse quickly administers IV calcium (IV calcium must be administered slowly as it is a severe tissue irritant.)

A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure? a) Withholding all oral intake b) Instructing the client to ambulate twice daily c) Administering large doses of I.V. antibiotics as ordered d) Administering large doses of oral antibiotics as ordered

c) Administering large doses of I.V. antibiotics as ordered

A patient with a leg cast denies pain; toes are pink; capillary refill is brisk and toes move freely; the leg is elevated with an ice pack. Six hours later, the patient reports worsening pain unrelieved by medication. The patient's toes are cool and capillary refill is sluggish. What does the nurse suspect is occurring with this patient? a. Crush syndrome b. Fat embolism syndrome c. Acute compartment syndrome d. Fasciitis

c. Acute compartment syndrome

1. A 6-year-old boy is admitted to the ER with a bone visibly protruding. After an x-ray is taking, the provider identifies it to be a clean break across the radial bone. The two classifications include... a. Incomplete and Open b. Incomplete and Closed c. Complete and Open d. Complete and Closed

c. Complete and Open

1. A client comes in with hypocalcemia, the nurse's main intervention should be... a. Assess medication use b. Monitor intake and output c. Maintain a patent IV access d. Monitor electrolyte values

c. Maintain a patent IV acces

1. A 76-year-old male is admitted to the hospital with a heart rate of 56bpm, confused, and a decreased deep tendon reflex. Which of the following would NOT be in his plan of care? a. IV saline b. Administer calcitonin c. Oral calcium supplement d. Dialysis

c. Oral calcium supplement

When performing a physical assessment of a client, the client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. The nurse recognizes that this finding is consistent with: a) Dupuytren's contracture b) Impingement syndrome c) Morton's neuroma d) Carpal tunnel syndrome

d) Carpal tunnel syndrome

Which group is at the greatest risk for osteoporosis? a) Men b) African American women c) Asian women d) Caucasian women

d) Caucasian women

The nurse is caring for a client following foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan? a) Administer pain medication per client request. b) Monitor vital signs every 4 hours. c) Examine surgical dressing every hour. d) Perform neuromuscular assessment every hour.

d) Perform neuromuscular assessment every hour.

1. A male client who is 76-years-old comes to the clinic for a check-up. A nurse practices promoting client education by emphasizing... a. Sitting in a reclined chair to increase comfort b. Increase the amount of carbs in his diet c. Promoting cardio d. Apply moist heat to joints

d. Apply moist heat to joints

1. After the female patient was admitted to the oncology floor, her surgeon decided he wanted to perform a bone biopsy. Post-surgical procedure, the nurse's main priority should be... a. Assess for allergic reaction b. Encourage patient to increase fluid intake c. Lie flat and still d. Monitor bleeding at site

d. Monitor bleeding at site

1. A patient has been given a skin traction as a form of treatment. You know which option to be true? a. Surgical insertion of wires are pins are applied to affected bone b. 15-25lb weight is used c. Patient has an increased risk for bone infection d. The main purpose is to decrease painful spasms

d. The main purpose is to decrease painful spasms

Diagnostic tests for assessment of Musculoskeletal: EMG

detects nerve/muscle damage. Needle like electros: apply to any extremity they're examining. Measures muscle activity/nerves

A patient's calcium level is 6.9. Which of the following is a nursing priority? A) Initiate seizure precautions B) Educate patient about foods rich in calcium C) Administer Calcitonin D) Administer Vitamin D supplements as ordered

A) Initiate seizure precautions

Lithium is known to affect the parathyroid by increasing ______ levels and decreasing _____ levels? A) calcium, phosphate B) phosphate, calcium C) calcium, sodium D) sodium, calcium

A) calcium, phosphate

A rock climber has sustained an open fracture of the right tibia after a 20-foot fall. The nurse plans to assess the client for which potential complications? Select all that apply. A. Fat embolism syndrome (FES) B. Congestive heart failure C. Urinary tract infection D. Osteomyelitis E. Acute compartment syndrome (ACS)

A. Fat embolism syndrome (FES) D. Osteomyelitis E. Acute compartment syndrome (ACS)

The nurse is teaching a client newly diagnosed with osteoporosis about dietary and lifestyle interventions to decrease risk factors for osteoporosis. Which is the best way to decrease the risk for osteoporosis? A. walk for 30 minutes 3 times a week B. increase nutritional intake of calcium C. increased nutritional intake of phosphorus D. engage in high impact exercise, such as running

A. walk for 30 minutes 3 times a week

A patient's calcium level is 11.2. Which options below could be the cause? A) None, 11.2 is a normal calcium level B) Hydrochlorothiazide C) Cushing's Syndrome D) Hypoparathyroidism

B) Hydrochlorothiazide

A patient with Celiac's disease is at risk for which of the following? A) Hypokalemia B) Hypocalcemia c) Hypomagnesemia D) Hypercalcemia

B) Hypocalcemia (Celiac's disease involves inflammation and destruction of the inner lining of the small intestine and can lead to the malabsorption of minerals and nutrients)

A patient is post-op from surgery. The patient has a history of gout. While performing a head-to-toe assessment, you assess the patient for signs and symptoms of gout. As the nurse, you know that gout tends to start at what site? A. Elbow B. Big toe C. Thumb or index finger D. Knees

B. Big toe (Most patients tend to have an acute attack of gout that begins in the big toe.)

A 5 year old has a fracture of the right upper arm. The x-ray showed that one side of the bone is bent while the other is broken. This known as a __________ fracture? A. Spiral B. Greenstick C. Oblique D. Transverse

B. Greenstick (These types of fractures are more common in the pediatric population because their bones tend to be more flexible and the periosteum is stronger than an adult.)

Select all the signs and symptoms that will present in compartment syndrome? A. Capillary refill less than 2 seconds B. Pallor C. Pain relief with medication D. Feeling of tingling in the extremity E. Affected extremity feels cooler to the touch than the unaffected extremity

B. Pallor D. Feeling of tingling in the extremity E. Affected extremity feels cooler to the touch than the unaffected extremity (THINK OF THE 6 P's)

A patient needs to go up the stairs while using crutches. What finding by the nurse demonstrates the patient understands how to ambulate upstairs with crutches? A. The patient moves the crutches forward up the step, then the injured and non-injured leg. B. The patient moves the non-injured leg forward onto the step and then the moves the injured leg and crutches up. C. The patient moves the injured leg forward onto the steps, then moves the crutches, and then moves the non-injured leg. D. The patient moves the crutches and non-injured leg forward to the step together, and then the non-injured leg.

B. The patient moves the non-injured leg forward onto the step and then the moves the injured leg and crutches up.

While your patient is ambulating with crutches he moves both crutches forward along with the injured leg and then moves the non-injured forward. When you document you will note that the patient used what type of gait while ambulating with crutches? A. Two-point gait B. Three-point gait C. Four-point gait D. Swing-to-gait

B. Three-point gait

Which client would be highest risk for the development of a DVT? A. A middle-aged client who is post-op for hernia repair B. An elderly client who has osteoarthritis C. An older adult client in traction for fractured hip D. An elderly client who is post bronchoscopy

C. An older adult client in traction for fractured hip

A client underwent amputation below the knee on the left leg after a recent heavy farm machinery accident. Which intervention should the nurse include in the plan of care? A. Elevate the residual limb on a pillow for 4 to 5 days after surgery B. Sit in a chair for 1 to 2 hours three times each day C. Lie prone with hip extended for 30 minutes four times per day C. Dangle the residual limb for 20 to 30 minutes every 6 hours

C. Lie prone with hip extended for 30 minutes four times per day

The nurse is admitting a client who is scheduled for knee arthroscopy related to osteoarthritis. Which finding should the nurse expect when examining the client's knee? A. Stiffness that increases with movement B. Ulnar drift C. Pain with movement D. Reddened, swollen affected joints

C. Pain with movement

The client diagnosed with Osteoarthritis is a resident in a long term care facility. The resident is refusing to bathe because she is hurting. Which instruction should the nurse give the unlicensed nursing assistant? A. Tell the assistant to give the client a bed bath this morning B. Allow the client to stay in bed until the pain becomes bearable C. Try to encourage the client to get up and go to the shower D. Notify the family that the client is refusing to b bathed

C. Try to encourage the client to get up and go to the shower

A patient is being discharged home after hospitalization for hypocalcemia. Which statement by the patient indicates she understood the dietary instructions? A) "I will avoid sardines." B) "I'll avoid salt and Vitamin-D supplements." C) "I will tell my husband to only purchase skim milk." D) "I will be sure to eat lots of cheese, tofu and spinach."

D) "I will be sure to eat lots of cheese, tofu and spinach."

The nurse is providing discharge instruction to a client who is going home after a knee replacement. Which information regarding symptoms of DVT should the nurse include? A)"If you develop a DVT, you will know it." B) "Watch for paleness or coolness in your toes." C) "Report any swelling in your knee." D) "Look for increased tenderness in your lower legs."

D) "Look for increased tenderness in your lower legs."

A client is brought to the emergency department via ambulance after a motor vehicle crash. What condition does the nurse assess for first? A) Bleeding B) Head injury C) Pain D) Respiratory distress

D) Respiratory distress

Which is the correct gait when a client is ascending stairs on crutches? A. A modified two-point gait (the affected leg is advanced between the crutches to the stairs) B. A modified four-point gait (both legs advance between the crutches to the stairs) C. A swing through gait D. A modified three-point gait (the unaffected leg is advanced between the crutches to the stairs)

D. A modified three-point gait (the unaffected leg is advanced between the crutches to the stairs)

The nurse is conducting a health screening for osteoporosis. Which client is at greatest risk for developing this problem? A. A 25-year old woman who runs B. A 36-year old man who has asthma C. A 70-year old man who consumes excess alcohol D. A sedentary 65-year old woman who smokes cigarettes

D. A sedentary 65-year old woman who smokes cigarettes

1. Calcium is the main mineral found in the body's system. Identify the function of calcium. (SATA) a. Bone strength and density b. Smooth and skeletal muscle contraction c. Necessary to deactivate enzymes d. Controls nerve impulse transmission e. Helps with blood coagulation

a. Bone strength and density d. Controls nerve impulse transmission e. Helps with blood coagulation (calcium's main function is bone strength and density. It also controls nerve impulses and contracts skeletal and cardiac muscle, not smooth muscle. It also plays a role in clotting and activates enzymes.)

1. There was a motor-vehicle accident and a patient is admitted with a broken back. This is considered a.... a. Pathologic fracture b. Stress fracture c. Compressed fracture d. Closed fracture

c. Compressed fracture

1. A patient is admitted to the ER c/o of pain in the forearm. During the assessment, the nurse hears grating around the area. This can indicate... a. A dislocated wrist b. An abnormal mass c. Degeneration of cartilage d. Nothing abnormal

c. Degeneration of cartilage (Crepitus can occur with degeneration of cartilage)

Musculoskeletal changes r/t Aging: DECREASED bone mass

(Osteoporosis) Client is at risk for falls

A client will be receiving Dabigatran. Which of the following is true regarding this drug therapy? SATA A) Ginger, garlic, and green tea may increase the risk of bleeding. B) Vitamin B12 is used to augment this drug's response. C) Dabigatran is used in treatment of DVT. D) Activated partial thromboplastin time must be monitored to determine effectiveness. E) This drug is contraindicated for clients with gastritis.

A) Ginger, garlic, and green tea may increase the risk of bleeding. C) Dabigatran is used in treatment of DVT. D) Activated partial thromboplastin time must be monitored to determine effectiveness. E) This drug is contraindicated for clients with gastritis.

A client has undergone an elective below-the-knee amputation of the right leg as a result of severe peripheral vascular disease. In postoperative care teaching, the nurse instructs the client to notify the health care provider if which change occurs? A) Observation of a large amount of serosanguineous or bloody drainage B) Mild to moderate pain controlled with prescribed analgesics C) Absence of erythema and tenderness at the surgical site D) Ability to flex and extend the right knee

A) Observation of a large amount of serosanguineous or bloody drainage

A patient is ordered by the physician to take Allopurinol (Zyloprim) for treatment of gout. You've provided education to the patient about this medication. Which statement by the patient requires you to re-educate them about this medication? A. "This medication will help relieve the inflammation and pain during an acute attack." B. "It is important I have regular eye exams while taking this medication." C. "I will not take large doses of vitamin C supplements while taking this medication." D. "Allopurinol decreases the production of uric acid."

A. "This medication will help relieve the inflammation and pain during an acute attack." (Allopurinol is used to PREVENT gout attacks....not treat an acute attack.)

You're caring for a patient who has experienced an open fracture to the right arm. What nursing intervention will you take with this type of fracture? A. Cover the fracture with a sterile dressing B. Place the arm below the heart level. C. Attempt bone reduction by manually readjusting the bone. D. Place a tight compression bandage over the fracture.

A. Cover the fracture with a sterile dressing

You're developing a nursing care plan for a patient with gout present in the right foot. What specific nursing interventions will you include in this patient's plan of care? Select all that apply: A. Encourage fluid intake of 2-3 liter per day. B. Provide patient with foods high in purine with each meal daily. C. Place patient's right foot in a foot board while patient is in bed. D. Administer PRN dose of Aspirin for a pain rating greater than 5 on 1-10 scale. E. Apply alternating cold and warm compresses to right foot as tolerated by the patient daily.

A. Encourage fluid intake of 2-3 liter per day. C. Place patient's right foot in a foot board while patient is in bed. E. Apply alternating cold and warm compresses to right foot as tolerated by the patient daily.

The nurse is reinforcing health teaching about osteoporosis with a client admitted to the hospital. What should the nurse explain to the client? A. Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise B. Estrogen therapy must be maintained to prevent rapid progression of the osteoporosis C. Continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis D. With a family history of osteoporosis, you cannot prevent or slow bone resorption

A. Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise

A client is in skeletal traction. Which nursing intervention ensures proper care of this client? A. Inspect the skin at least every 8 hours B. Ensure that weights are attached to the bed frame or placed on the floor. C. Ensure that pins are not loose, and tighten as needed. D. Remove the traction weights only for bathing.

A. Inspect the skin at least every 8 hours

Which assessment findings would the nurse expect in a client diagnosed with osteomyelitis? A. Leukocytosis and localized bone pain B. Pruritus and uremic frost C. Petechiae over the chest and abnormal ABGs D. Thrombocytopenia and ecchymosis

A. Leukocytosis and localized bone pain

An injured soldier underwent left leg amputation on yesterday, and is complaining of pain and heaviness in the left foot. Which action by the nurse is supported by research findings? A. Massage therapy B. Administer the prescribed opioid analgesic q 4hr prn C. Rebandage the residual limb D. Show the client the leg is gone

A. Massage therapy

The nurse is caring for several patients on an orthopedic trauma unit. Which conditions have a high risk for development of acute compartment syndrome? Select all that apply A. Massive infiltration of IV fluid into forearm B. Lower legs caught between the bumpers of two cars C. Multiple insects bites to lower legs D Severe burns to the upper extremities E. Bivalve cast on the lower leg F. Daily use of oral contraceptives

A. Massive infiltration of IV fluid into forearm B. Lower legs caught between the bumpers of two cars C. Multiple insects bites to lower legs D Severe burns to the upper extremities

A patient with osteoarthritis is describing their signs and symptoms. Which signs and symptoms below are NOT associated with osteoarthritis? Select-all-that-apply: A. Morning stiffness greater than 30 minutes B. Experiencing grating during joint movement C. Fever and Anemia D. Symmetrical joint involvement E. Pain and stiffness tends to be worst at the end of the day

A. Morning stiffness greater than 30 minutes C. Fever and Anemia D. Symmetrical joint involvement

Which is a priority problem for the older adult client diagnosed with bone cancer? A. Potential for injury related to weakness and drug therapy B. Altered self-esteem related to fear of death and dying C. Reduce mobility related to weakness and fatigue D. Pain of a chronic nature related to tumor invasion of other organs.

A. Potential for injury related to weakness and drug therapy (The priority problem for the older adult client with bone cancer is potential for injury related to weakness and prescribed medications, especially analgesics)

During a home health visit you are helping a patient with gout identify foods in their pantry they should avoid eating. Select all the foods below the patient should avoid: A. Sardines B. Whole wheat bread C. Sweetbreads D. Crackers E. Craft beer F. Bananas

A. Sardines C. Sweetbreads E. Craft beer (A patient with gout should avoid foods high in PURINES. These include most red meats, organ meats (liver, kidneys, sweetbreads), alcohol) Purines= increase uric acid production

A patient is prescribed Alendronate (Fosamax) at 0800 for the treatment of osteoporosis. As the nurse you know you must administer this medication: A. on an empty stomach with a full glass of water and keep the patient upright for 30 minutes. B. right after breakfast and to lay the patient flat (as tolerated) for 30 minutes. C. with food but to avoid giving this medication with dairy products. D. on an empty stomach with a full glass of juice or milk.

A. on an empty stomach with a full glass of water and keep the patient upright for 30 minutes (Alendronate (Fosamax) is a bisphosphonate which is known for causing GI upset, especially inflammation of the esophagus.)

Which statement by a patient, who just received a cast on the right arm for a fracture, requires you to notify the physician immediately? A. "It is really itchy inside my cast!" B. "My pain is so severe that it hurts to stretch or elevate my arm." C. "I can feel my fingers and move them." D. "I've been using ice packs to reduce swelling.""

B. "My pain is so severe that it hurts to stretch or elevate my arm." (This statement is very concerning and may represent a condition called compartment syndrome. Compartment syndrome is where the nerves and blood vessels are becoming compromised due to increasing pressure in the compartments within the fascia (remember fascia doesn't expand, so if there is building pressure within the compartments of muscle from bleeding etc. it will compromise circulation and nerve function)

Identify which patient below is at MOST risk for developing gout: A. A 56 year old male who reports consuming foods low in purines. B. A 45 year old male with a BMI of 40 who reports taking hydrochlorothiazide and aspirin. C. A 39 year old female hospitalized with bulimia that has a BMI of 24. D. A 27 year old female with ulcerative colitis.

B. A 45 year old male with a BMI of 40 who reports taking hydrochlorothiazide and aspirin. (Gout is due to high levels of uric acid in the blood. This can either be due to the kidney's inability to excrete uric acid out of the body or the body is producing too much uric acid)

Which of these clinical findings would be reported for a client with a diagnosis of parathyroid disease and presenting with a low calcium level of 6.0 mg/dl? A. Depressed patellar reflex B. Carpopedal spasm after BP cuff is inflated above systolic pressure C. Paresthesia in hand is produced when tapping over the median nerve at the wrist crease D. Foot extension of the big toe while fanning the other toes when stimulating the outside of the sole of the foot

B. Carpopedal spasm after BP cuff is inflated above systolic pressure

Which nursing action does the nurse on the orthopedic unit plan to delegate to unlicensed assistive personnel (UAP)? A. Remove the wound drain for a client who had an open reduction of a hip fracture 3 days ago. B. Check the vital signs for a client who was admitted after a total knee replacement 3 hours ago. C. Teach a client with a right ankle fracture how to use crutches when transferring and ambulating. D. Assess for bruising on a client who is receiving warfarin to prevent deep vein thrombosis.

B. Check the vital signs for a client who was admitted after a total knee replacement 3 hours ago.

You receive your patient back from radiology. The patient had an x-ray of the hips and knees for the evaluation of possible osteoarthritis. What findings would appear on the x-ray if osteoarthritis was present? Select-all-that-apply: A. Increased joint space B. Osteophytes C. Sclerosis of the bone D. Abnormal sites of hyaline cartilage

B. Osteophytes C. Sclerosis of the bone (The joint space would be DECREASED and an x-ray cannot assess cartilage)

Which clinical assessment findings would be an early indication of hypovolemia in a client? A. BP was 147/70 now is 160/90, RR was 18/min now is 24/min B. RR was 18/min now 28/min, HR was 78 BPM now is 99 BPM C. Urine output 40 now 30 ml/hr, HR was 96 BPM now is 88 BPM D. HR was 70 BPM, now 52 BPM; RR was 20/min, now is 16/min

B. RR was 18/min now 28/min, HR was 78 BPM now is 99 BPM

A patient with osteoarthritis has finished their first physical therapy session. As the nurse you want to evaluate the patient's understanding of the type of exercises they should be performing regularly at home as self-management. Select all the appropriate types of exercise stated by the patient: A. Jogging B. Water aerobics C. Weight Lifting D. Tennis E. Walking

B. Water aerobics C. Weight Lifting E. Walking (The patient needs to perform exercises that are low impact)

Your patient will be using crutches for mobility. After educating the patient on how to adjust the crutches to fit correctly, you assess how well the patient understood the instructions. What findings demonstrate that the crutches were adjusted correctly by the patient? Select all that apply: A. The hand grips of the crutches are even with the mid-forearm B. When the patient grips the hand grips of the crutches the elbow bends at about 30 degrees. C. The patient has a 2-3 finger width distance between the axillae and crutch rest pad. D. The patient places weight on the axillae rather than the hands while ambulating.

B. When the patient grips the hand grips of the crutches the elbow bends at about 30 degrees. C. The patient has a 2-3 finger width distance between the axillae and crutch rest pad.

While going down the stairs with crutches the patient will move the crutches down onto the step followed by? A. moving the non-injured leg down onto the step. B. moving the injured leg down onto the step. C. moving both legs down onto the step.

B. moving the injured leg down onto the step. (When going down the stairs with crutches, the patient will move the crutches down first onto the step followed by moving the INJURED leg and then the patient will move the non-injured leg down.)

The nurse is caring for a postoperative client with total joint arthroplasty. What actions does the nurse take to prevent venous thromboembolism (VTE) postoperatively? Select all that apply. A. Use the knee gatch on the bed. B. Massage the legs. C. Apply elastic stockings D. Keep the legs slightly abducted. E. Administer anticoagulants

C. Apply elastic stockings E. Administer anticoagulants

During the 1000 medication pass, your patient reports to you that he is having muscle pain and tingling in his fingers and toes. You note that the patient also has a grayish color to his lips. You immediately notify the doctor. In addition, you would hold which medication that is scheduled to be administered at 1000? A. Ibuprofen B. Prednisone C. Colchicine D. Aspirin

C. Colchicine (The signs and symptoms presenting in this patient are classic signs of Colchicine toxicity.)

A nurse is working with a client who has osteoarthritis.. Which description of the disorder should be included in the teaching plan? A. Overproduction of synovial fluid resulting in joint destruction B. Joint destruction caused by an autoimmune process C. Degeneration of articular cartilage in synovial joints D. Breakdown of tissue in non-weight bearing joints by enzymes

C. Degeneration of articular cartilage in synovial joints

A patient sustained a fracture to the femur. The patient has suddenly become confused, restless, and has a respiratory rate of 30 breaths per minute. Based on the location of fracture and the presenting symptoms, this patient may be experiencing what type of complication? A. Compartment Syndrome B. Osteomyelitis C. Fat embolism D. Hypovolemia

C. Fat embolism (Patients who experience a fracture of the long bones (such as the femur) are at risk for a fat embolism. The patient will become confused and restless along with an abnormal respiratory status.)

What is the priority action for a client with a long leg cast on the right leg whose assessment reveals right foot is pale and cool to touch and the right leg pain is still severe with no relief from the pain medication administered 45 minutes ago? A. Repeat the dose of analgesic stat B. Apply a heating pad to the right toes C. Notify the HCP immediately D. Remove the case immediately

C. Notify the HCP immediately

A client with a fracture of the proximal left tibia in a long leg cast complains of sever pain and a prickling sensation in the left foot. The toes on the left foot are pale and cool. Which nursing action is a priority? A. Elevate the left leg above the level of the heart B. Apply ice packs to the left proximal tibia over the cast C. Notify the healthcare provider immediately D. Administer prescribed Morphine sulfate intravenously for pain

C. Notify the healthcare provider immediately

A patient newly diagnosed with osteoarthritis asks about the medication treatments for their condition. Which medication is NOT typically prescribed for OA? A. NSAIDs B. Topical Creams C. Oral corticosteroids D. Acetaminophen (Tylenol)

C. Oral corticosteroids (Intra-articular corticosteroids (an injection in the joint) are commonly prescribed rather than oral corticosteroids. Remember OA in within the joint...not systemic so oral corticosteroids are not as effective.)

A nurse is assessing the recent health history of a 63-year-old client with osteoarthritis Which activity pattern will the nurse recommend? A. Bed rest with bathroom privileges B. Frequent rest periods with minimal exercise C. Regular exercise program of walking D. Daily high-impact aerobic exercise

C. Regular exercise program of walking

Bones play an important role in the body. Which of the following in NOT a function performed by the bones? A. Provide protection and support for the organs. B. Give the body shape. C. Secrete the hormone calcitonin and store blood cells. D. Store calcium and phosphorus.

C. Secrete the hormone calcitonin and store blood cells.

While using crutches the patient moves both crutches forward and then moves both legs forward past the placement of the crutches. This is known as the: A. Two-point gait B. Swing-to-gait C. Swing-through-gait D. Three-point gait

C. Swing-through-gait

The nurse is caring for the following clients. After receiving the shift report, which client should the nurse assess first? A. The client who is status post left below the knee amputation who is experiencing left foot pain 10/10. B. The client who needs to receive a scheduled intravenous antibiotic C. The client with a total knee replacement who is complaining of a cold foot D. The client diagnosed with osteoarthritis who is complaining of stiff joints

C. The client with a total knee replacement who is complaining of a cold foot

Your patient is prescribed to use crutches for ambulation. The patient can bear partial weight and needs to be taught how to use the two-point gait while using crutches. Which description below best describes this type of gait with crutches? A. The patient moves both crutches forward and then moves both legs forward to the same point as the crutches. B. The patient moves the right crutch (injured side), then moves the left foot (non-injured side), then moves the left crutch (non-injured side), and then moves the right foot (injured side). C. The patient moves both the right crutch (injured side) and left foot (non-injured side) forward together, and then moves the left crutch (non-injured side) and right foot (injured side) forward together. D. The patient moves both crutches and injured leg forward together, and then moves the non-injured leg forward.

C. The patient moves both the right crutch (injured side) and left foot (non-injured side) forward together, and then moves the left crutch (non-injured side) and right foot (injured side) forward together. (The two-point gait is where the patient moves both the right crutch (injured side) and left foot (non-injured side) forward TOGETHER, and then moves the left crutch (non-injured side) and right foot (injured side) forward TOGETHER.)

Gout is a type of arthritis that occurs due to the accumulation of ____________ in the blood that causes needle-like crystals to form around the joints. A. purines B. creatinine C. uric acid D. amino acids

C. uric acid

Which of the following is not a cause of hypocalcemia? A) Low parathyroid hormone B) Crohn's Disease C) Acute Pancreatitis D) Thiazide Diuretics

D) Thiazide Diuretics

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication? a) Negative calcium balance b) Loss of estrogen c) Dowager's hump d) Bone fracture

D. Bone Fracture (Bone fracture is a major complication of osteoporosis; it results when loss of calcium and phosphate increases the fragility of bones.)

A client has had a sequestrectomy of the right fibula for osteomyelitis 1 day ago. Which assessment finding requires the nurse to immediately contact the surgeon? A. Swelling of the right lower extremity B. 1+ or 2+ bilateral palpable pedal pulses C. Pain of right lower extremity on movement D. Decreased sensation of right lower extremity

D. Decreased sensation of right lower extremity (Decreased sensation of the right lower extremity indicates a neurovascular compromise that must be reported immediately to the surgeon)

The nurse is completing discharge teaching with a male patient who is recovering from a right total hip arthroplasty by posterior approach. Which patient action indicates further instruction is needed? A. Verifies need to notify future caregivers about the prosthesis B. Uses an elevated toilet seat C. Sits with feet flat on the floor D. Maintains hip in adduction and internal rotation

D. Maintains hip in adduction and internal rotation

________ are found within the spongy bone and are responsible for building up the bone matrix. While ________, which are also found in the spongy bone, breakdown the bone matrix. A. Osteocytes, osteoclasts B. Osteoclasts, osteoblasts C. Osteocytes, osteoblasts D. Osteoblasts, osteoclasts

D. Osteoblasts, osteoclasts (OsteoBLASTS are found within the spongy bone and are responsible for building up the bone matrix, while osteoCLASTS, which are also found in the spongy bone as well, breakdown the bone matrix.)

A client with a recent thyroidectomy complains of numbness and tingling around the mouth. Which of the following assessment findings would the nurse expect to find? A. Nausea B. Negative Trousseau's sign C. Depressed deep tendon reflexes D. Positive Chvostek's sign

D. Positive Chvostek's sign

You're demonstrating how to ambulate while using crutches to a group of pre-op patients, who will need to use crutches after surgery. You ask one of the group participants to demonstrate the four-point gait using the crutches. Which demonstration by the participant demonstrates they understood the demonstration you provided earlier? A. The participant moves both crutches forward and then moves both legs past the placement of the crutches. B. The participant moves both crutches and injured leg forward together, and then moves the non-injured leg forward. C. The participant moves both the right crutch and left foot forward together, and then moves the left crutch and right foot forward together. D. The participant moves the right crutch, then moves the left foot, then moves the left crutch, and then moves the right foot.

D. The participant moves the right crutch, then moves the left foot, then moves the left crutch, and then moves the right foot.

Which is the best way to decrease the risk for osteoporosis in a client who has just been determined to be at high risk for the disease? A. Increase nutritional intake of calcium B. Engage in high-impact exercise, such as running C. Increase nutritional intake of phosphorus D. Walk for 30 minutes three times a week.

D. Walk for 30 minutes three times a week.

The nurse determines that colchicine has been effective for a patient with an acute attack of gout upon finding A. increased urine output B. increased white blood cells C. elevated serum uric acid level D. reduced joint pain

D. reduced joint pain (Colchicine decreases inflammation, therefore helping to reduce pain)