Page 2148 - Saunders Comprehensive Review For NCLEX-RN

Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Musculoskeletal
Health Problem: Adult Health: Musculoskeletal: Skeletal Injury
Priority Concepts: Clinical Judgment; Infection
Reference: Ignatavicius, Workman, Rebar (2018), pp. 906-908.

752. Answer: 2

Rationale: In addition to the presence of clinical manifestations, gout is diagnosed
by the presence of persistent hyperuricemia, with a uric acid level higher than 8
mg/dL (480 mcmol/L); a normal value for a male ranges from 4.0 to 8.5 mg/dL (240–
501 mcmol/L) and for a female, from 2.7 to 7.3 mg/dL (160–430 mcmol/L). Options 1,
3, and 4 indicate normal laboratory values. In addition, the presence of uric acid in
an aspirated sample of synovial fluid confirms the diagnosis.
Test-Taking Strategy: Focus on the subject, manifestation of gout. Use knowledge
of normal laboratory values. Recalling that increased uric acid levels occur in gout
and noting that the correct option has the only abnormal value will assist you in
answering the question.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Musculoskeletal
Health Problem: Adult Health: Musculoskeletal: Gout
Priority Concepts: Cellular Regulation; Clinical Judgment
Reference: Lewis et al. (2017), pp. 1026, 1532-1534.

753. Answer: 4

Rationale: Buck’s (extension) traction is a type of skin traction often applied after
hip fracture before the fracture is reduced in surgery. Traction reduces muscle
spasms and helps immobilize the fracture. Traction does not allow for bony healing
to begin or provide rigid immobilization. Traction does not lengthen the leg for the
purpose of preventing blood vessel severance. This type of traction involves pulleys
and wheels, not pins and screws.
Test-Taking Strategy: Focus on the subject, use of traction following a hip
fracture. Read each option carefully and note that each option has more than one
part. All parts of the option need to be correct in order for the answer to be correct.
Noting the words provides comfort and fracture immobilization will direct you to the
correct option.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Adult Health: Musculoskeletal
Health Problem: Adult Health: Musculoskeletal: Skeletal Injury
Priority Concepts: Clinical Judgment; Mobility
Reference: Lewis et al. (2017), p. 1470.

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