Nursing Elites

1. A 28-year-old woman presents with abdominal pain, diarrhea, and rectal bleeding. She has a history of similar episodes in the past. What is the most likely diagnosis?

• A. Ulcerative colitis
• B. Irritable bowel syndrome
• C. Celiac disease
• D. Diverticulitis

Correct answer: A

Rationale: The constellation of symptoms including abdominal pain, diarrhea, and rectal bleeding in a young woman with a history of similar episodes is highly suggestive of ulcerative colitis. This chronic inflammatory condition primarily affects the colon and rectum, leading to symptoms such as bloody diarrhea, abdominal pain, and urgency. The recurrent nature of her symptoms and the presence of rectal bleeding further support this diagnosis over other conditions listed, such as irritable bowel syndrome, celiac disease, or diverticulitis, which typically do not present with the same combination of symptoms and history.

2. A patient with tuberculosis is started on rifampin. What advice should the nurse provide?

• A. Limit intake of green leafy vegetables.
• B. Expect orange-red discoloration of body fluids.
• C. Avoid exposure to sunlight.
• D. Take the medication with antacids.

Correct answer: B

Rationale: The correct advice for a patient starting rifampin is to expect orange-red discoloration of body fluids. Rifampin can cause harmless orange-red discoloration of body fluids, which may include urine, sweat, saliva, and tears. It is important for the patient to be aware of this side effect as it can stain clothing and contact lenses. Limiting the intake of green leafy vegetables is not necessary with rifampin. Avoiding exposure to sunlight is more commonly associated with other medications like tetracyclines, not rifampin. Taking rifampin with antacids is not recommended as antacids can reduce the absorption of rifampin, decreasing its effectiveness in treating tuberculosis.

3. A 34-year-old woman presents with intermittent abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?

• A. Irritable bowel syndrome
• B. Celiac disease
• C. Lactose intolerance
• D. Crohn's disease

Correct answer: B

Rationale: The patient's symptoms of intermittent abdominal pain, bloating, and diarrhea that improve with fasting, along with a history of iron deficiency anemia, are highly suggestive of celiac disease. In celiac disease, gluten ingestion leads to mucosal damage in the small intestine, causing malabsorption of nutrients like iron, leading to anemia. The improvement of symptoms with fasting can be explained by the temporary avoidance of gluten-containing foods. Irritable bowel syndrome typically does not improve with fasting. Lactose intolerance usually presents with symptoms after dairy consumption, not with fasting. Crohn's disease typically presents with more chronic symptoms and is not commonly associated with improvement on fasting.

4. A client with liver cirrhosis and ascites is being treated with spironolactone. What is a key nursing consideration for this medication?

• A. Monitoring for signs of hyperkalemia
• B. Checking for signs of hypoglycemia
• C. Assessing for signs of dehydration
• D. Observing for symptoms of hyponatremia

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia as it helps retain potassium in the body. Therefore, monitoring for signs of hyperkalemia such as muscle weakness, arrhythmias, or ECG changes is crucial to prevent potential complications.

5. A 65-year-old woman presents with difficulty swallowing, weight loss, and a history of long-standing heartburn. She has been on proton-pump inhibitors for years, but her symptoms have worsened. What is the most likely diagnosis?

• A. Peptic stricture
• B. Esophageal cancer
• C. Achalasia
• D. Esophageal spasm

Correct answer: B

Rationale: The presentation of difficulty swallowing, weight loss, and worsening symptoms despite long-term use of proton-pump inhibitors raises suspicion for esophageal cancer, especially in a patient with a history of chronic heartburn. Esophageal cancer should be considered in this scenario due to the concerning symptoms and lack of improvement despite appropriate medical management.

Similar Questions