Gout is a systemic disease in which urate crystals deposit
in joints and other body tissues. Gout results from abnormal amounts of uric acid
in the body. Primary gout results from a disorder of purine metabolism. Secondary
gout involves excessive uric acid in the blood caused by another disease.
NCLEX Examination.
Practice Question # 689.
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1. Question
The nurse is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client?
Correct
Answer: Option 2 is the correct answer.
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 (0.48 mmol/ L); a normal value for a male ranges from 4.0 to 8.5 mg/dL (0.24 to 0.51 mmol/L) and for a female, from 2.7 to 7.3 mg/ dL(0.16 to 0.43 mmol/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.
Review: The manifestations of gout and the normal uric acid level
Incorrect
Answer: Option 2 is the correct answer.
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 (0.48 mmol/ L); a normal value for a male ranges from 4.0 to 8.5 mg/dL (0.24 to 0.51 mmol/L) and for a female, from 2.7 to 7.3 mg/ dL(0.16 to 0.43 mmol/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.
Review: The manifestations of gout and the normal uric acid level
Phases of Gout:
Asymptomatic: Client has no symptoms but serum uric acid
level is elevated.
Acute: Client has excruciating pain and inflammation of 1 or
more small joints, especially the great toe.
Intermittent: Client has intermittent periods without
symptoms between acute attacks.
Chronic: Results from repeated episodes of acute gout.
Results in deposits of urate crystals under the
skin.
Results in deposits of urate crystals within major
organs, such as the kidneys, leading to organ dysfunction.
