Chapter 13-Agents used to treat hyperuricemia

Question 1

The nurse understands the most common joint to be affected by hyperuricemia is the:

Answer 1

metatarsophalangeal joint.

The metatarsophalangeal joint in the great toe is the most common site.

Question 2

Allopurinol is an agent used to treat hyperuricemia. Which of the following statements by the nurse recruit will show that she understands the action of allopurinol?

Answer 2

“It prevents the formation of uric acid in the body.”

Question 3

An agent that increases uric acid excretion and prevents blood clot formation is:

Answer 3

sulfinpyrazone.

Sulfinpyrazone alters platelet function, preventing blood clot formation.

Question 4

An agent used to treat gout that can inhibit the excretion of penicillin is:

Answer 4

probenecid.

Probenecid inhibits penicillin excretion, so it raises the level of penicillin in the body.

Question 5

The client is experiencing an acute attack of gout. The nurse would expect an order from the health care provider for which of the following agents?

Answer 5

colchicine.

Question 6

When treating a client during an acute attack of gout, the nurse would monitor for which of the following to determine when to terminate the administration of colchicine?

Answer 6

nausea or diarrhea occurs.

Question 7

The nurse is providing instructions for the client who is experiencing an acute attack of gout. All of the following information is true about an acute attack of gout, EXCEPT:

Answer 7

opioids are the drugs of choice for pain relief.

Question 8

The client would be advised to take acetaminophen, rather than aspirin, with which of the following medications?

Answer 8

probenecid.

Question 9

During an acute attack of gout, the nurse should advise the client to avoid:

Answer 9

beer- is a purine-rich beverage and should be avoided.

Question 10

A common nursing diagnosis during an acute attack of gout is acute pain related to:

Answer 10

deposition of urate crystals in body tissues.

Question 11

A client with insulin-dependent diabetes is being treated with probenecid for hyperuricemia and gout. For this client the nurse should:

Answer 11

provide client teaching about the increased risk for hypoglycemia.

Question 12

The nurse caring for clients taking allopurinol (Zyloprim) for long-term therapy understands that which of the following will maximize the benefits of allopurinol?

Answer 12

alkalinization of the urine.

Question 13

The nurse understanding the pathophysiology of hyperuricemia monitors the client with gouty arthritis for:

Answer 13

deposits of tophi in subcutaneous tissues.

Question 14

The nurse monitors the client for colchicine therapy for:

Answer 14

nausea, vomiting, and diarrhea.

Question 15

A client with hyperuricemia has a nursing diagnosis of acute pain. The nurse evaluates the plan of care and determines that a successful resolution of this nursing diagnosis has been achieved when:

Answer 15

the client states pain level of 0 on a 1-to-10 scale.

Question 16

The nurse knows the client needs further teaching regarding a low-purine diet when the client makes which of the following statements?

Answer 16

“I can have red wine with my meals.”

Question 17

When caring for a client being treated with allopurinol, the nurse notes the client has developed a skin rash. The nurse should:

Answer 17

notify the health care provider promptly.

Question 18

The nurse is teaching a client about gout medication treatment. Teaching should include:

Answer 18

begin taking the medications for gout at the first sign of an attack.

Question 19

A hospitalized client is experiencing the pain of an acute gout attack. Which action of the nurse will most help this client?

Answer 19

Place a bed cradle on the foot of the bed.

Question 20

When assessing a client’s ability to perform self-care and increase activities, the nurse is addressing which nursing diagnosis?

Answer 20

activity intolerance

Question 21

A client is experiencing the pain of an acute gout attack. The first nursing action is to:

Answer 21

administer naproxen as prescribed.

Naproxen is one of the NSAIDs (nonsteroidal anti-inflammatory drugs) most commonly used to treat acute attacks.

Question 22

A client is to receive a 1.2 mg loading dose of colchicine by mouth for an acute attack of gout. The pharmacy sends 600 mcg tablets. The nurse should administer:

Answer 22

Correct: 600 mcg = 0.6 mg; 1.2 mg divided by 0.6 mg = 2 tablets.

Question 23

A client is prescribed sulfinpyrazone 400 mg by mouth in two divided doses. The pharmacy sends 0.1 gram tablets. How many tablets should the client receive for each dose?

Answer 23

2 tablets

Question 24

A client with renal insufficiency is being treated with allopurinol and asks the nurse why the health care provider decided on allopurinol instead of probenecid, which his friend is on. The nurse’s best reply is:

Answer 24

“Allopurinol is less likely to make your kidney problems worse.”

Question 25

An elderly client taking a nonsteroidal anti-inflammatory drug (NSAID) for gout pain is admitted to the hospital with altered mental status. As the nurse reviews drug use, the client’s condition is anticipated because of:

Answer 25

indomethacin.

Question 26

The nurse should include which of the following information to the client who has hyperuricemia and is experiencing an acute attack of gout? Select all that apply

Answer 26

a. Consuming a high-fat diet can provoke an acute attack of gout.
b. Taking thiazide diuretics can provoke an acute attack of gout.
e. During an acute attack of gout, increase fluid intake unless there is an underlying condition that would require restriction of fluids.
f. The use of a bed cradle will keep linens off the tender areas affected by gout.

Question 27

The client receives a prescription for Uloric. Which of the following instructions would be appropriate information for the nurse to provide to the client? Select all that apply.

Answer 27

a. Liver function tests will be done at 2 months, 4 months, and again periodically during therapy.
c. The medication may be taken without regard to food intake.
d. Notify the health care provider if you experience chest pain or any neurologic changes.
e. NSAIDs may be taken for a gout attack.
f. You may have a gout flare after beginning the medication regimen.

Question 28

The client is taking the NSAID Motrin. The nurse would monitor for:

Answer 28

a. gastric irritation
b. vertigo
c. rash
d. visual changes
e. bleeding, if used concurrently with oral anticoagulants
f. intracerebral mass bleeding if used concurrently with ginkgo biloba

Question 29

Of the following, which are high-purine foods?

Answer 29

a. mushrooms
c. anchovies
d. meat gravy