The nurse is reviewing the results of the testing for a 68-year-old male client newly diagnosed with an acute gout attack. Which laboratory/specimen finding should the nurse expect for a client with gout? Reference Ranges: Uric Acid: 2.4-7.0 mg/dL C-Reactive Protein (CRP):< 10 mg/L Erythrocyte Sedimentation Rate (ESR): 0-20 mm/hr

A. Uric acid of 6.5 mg/dL: Although hyperuricemia is a common risk factor for gout, a level of 6.5 mg/dL falls within the reference range and may not always indicate an acute attack. Some patients experience gout flares even with uric acid in the normal range. B. Erythrocyte sedimentation rate (ESR) of 5 mm/hr: An ESR of 5 mm/hr is within the normal range and does not suggest active inflammation. During an acute gout flare, inflammatory markers like ESR are often elevated due to the intense joint inflammation. C. Decreased C-Reactive Protein (CRP): A decreased CRP is not expected in acute gout. CRP usually rises as part of the systemic inflammatory response, reflecting the acute inflammatory process occurring in the affected joint. D. Urate crystals in the synovial fluid: The presence of monosodium urate crystals in joint aspirate is the hallmark diagnostic finding in gout. This confirms the diagnosis during an acute attack, as the crystals precipitate in the joint space, causing pain and inflammation.