Exam 2 Nurs 623- Questions and Answers
A metabolic disease that produces an inflammatory arthritis? Correct Ans-gout
What are the two primary factors of gout? Correct Ans-*enzyme defects and decreased
renal clearance
What are secondary risk factors for gout? Correct Ans-excessive daily intake of purine,
starvation, obesity, alcohol, medications(thiazide diuretics, ethambutol, nicotinic acid,
pyrazinamide, low dose salicylates, cyclosporine), pagets disease, chronic hemolytic anemis,
psoriasis, cytoxic drugs, carcinoma and sarcome, CRD, hypothyroidism, lead poisoning, DI
DKA, hyperparathyroidism
What uric acid level would be indicative of gout? Correct Ans->7 in men and >6 in women
Explain the pathophysiology of a gout flare? Correct Ans-Urate deposits in the joints and
the crystallization of urate triggers the inflammatory response
What is the most common trigger of an acute gout attack? Correct Ans-trauma or surgery
What is the typical presentation of gout? Correct Ans-excruciating pain that often awakens
the person at night, joint is usually warm or hot to touch, pain with palpation and ROM
maybe limited
, Exam 2 Nurs 623- Questions and Answers
What drugs should you ask about if there is a gout flare? Correct Ans-ASA, cyclosporine
When there is large joint involvement with gout what symptoms might you see? Correct
Ans-elevated temp, tachycardia, malaise, headache and chills
Acute management of gout includes Correct Ans-generalized rest elevation, and
immobilization of affected joint
What is the pharmacological management of gout? Correct Ans-NSAIDs (indomethacin or
naproxen), colchicine (if less than 36 hours) and corticosteroids
If administering colchicine to a patient for an acute gout flare what time frame must it be
given in? Correct Ans-administered within 36 hours of initial onset of symptoms
When are corticosteroids contraindicated in gout? Correct Ans-in septic conditions, must
draw a synovial aspirate to test fluid
What are the 3 agents you can use to lower the uric acid ? These are prescribed for individuals
with chronic gout attacks Correct Ans-Probenecid, allpurinol, febuxostat
What are the long term effects of hyperthyroidism? Correct Ans-heart disease,
osteoporosis, mental illness, infertility
, Exam 2 Nurs 623- Questions and Answers
What tests should be performed when diagnosis hyperthyroidism? Correct Ans-TSH, Free
T4 (free thyroxine immunoassay)
What will the lab values show with hyperthyroidism? Correct Ans-low TSH <0.35 and an
elevated FT4 >12.5
Brittle, coarse hair might be a sign of what thyroid disorder Correct Ans-hypothyroidism
A thyroid bruit, gynomastia, fine hair, warm, smoot, moist skin are all associated with what
thyroid disorder Correct Ans-hyperthyroidism
Hirsutism, Purple striae over the abdomen is seen with what condition and
hyperpigmentation are seen with what disease? Correct Ans-Cushings syndrome
ACE inhibitors are given to patients who have diabetes with persistent? Correct Ans-
proteinuria
Addison crisis can be precipitated by? Correct Ans-abruptly stopping glucocorticoid
medications
Signs and symptoms of DKA Correct Ans-Kussmaul respirations (very deep),
hypergylcemia, glucosuria, polyuria, polydipsia, anorexia and headache, keytonuria,
decreased blood pH