a 35 year old woman presents with abdominal pain diarrhea and weight loss she has a history of recurrent mouth ulcers and a perianal fistula what is t
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1. A 35-year-old woman presents with abdominal pain, diarrhea, and weight loss. She has a history of recurrent mouth ulcers and a perianal fistula. What is the most likely diagnosis?

Correct answer: C

Rationale: The combination of symptoms including recurrent mouth ulcers, perianal fistula, abdominal pain, diarrhea, and weight loss strongly suggests Crohn's disease. These extra-intestinal manifestations are characteristic of Crohn's disease, a chronic inflammatory condition that can affect any part of the gastrointestinal tract. Ulcerative colitis primarily involves the colon, while irritable bowel syndrome is a functional disorder without the inflammatory component seen in Crohn's disease. Diverticulitis typically presents with localized left lower quadrant pain and is less likely to cause mouth ulcers and perianal fistulas.

2. A client with a history of chronic alcohol use is admitted with confusion and an unsteady gait. Which deficiency should the nurse suspect?

Correct answer: A

Rationale: The correct answer is Thiamine (Vitamin B1). Chronic alcohol use can lead to thiamine deficiency, which can result in neurological symptoms such as confusion and an unsteady gait. Thiamine is essential for proper brain function and nerve conduction, and its deficiency is common in individuals with alcohol use disorder. Cyanocobalamin (Vitamin B12) deficiency can also present with neurological symptoms, but in this case, the patient's history of chronic alcohol use points more towards thiamine deficiency. Folic acid deficiency typically presents with symptoms like fatigue and megaloblastic anemia. Vitamin D deficiency is associated with bone health issues rather than neurological symptoms.

3. A client with a newly created ileostomy has not had ostomy output for the past 12 hours and reports worsening nausea. What is the nurse's priority action?

Correct answer: B

Rationale: The nurse's priority action in this situation is to report signs and symptoms of possible obstruction to the healthcare provider. Lack of ostomy output and worsening nausea can indicate a potential obstruction, which requires immediate attention and intervention to prevent complications.

4. What is the most likely diagnosis in a 30-year-old woman with right upper quadrant pain, fever, and jaundice, along with elevated white blood cell count and bilirubin levels?

Correct answer: C

Rationale: The combination of right upper quadrant pain, fever, jaundice, elevated white blood cell count, and bilirubin levels is classic for acute cholangitis, which is an infection of the bile ducts. Acute hepatitis typically presents with other liver function abnormalities, while acute cholecystitis is characterized by gallbladder inflammation. Pancreatic cancer would not typically present with these specific symptoms and lab findings.

5. In acute pancreatitis, a client experiencing severe abdominal pain should have which enzyme level closely monitored?

Correct answer: A

Rationale: In acute pancreatitis, serum amylase levels should be closely monitored. Elevated serum amylase levels are a key diagnostic marker for acute pancreatitis, aiding in the assessment and management of the patient's condition. Monitoring serum sodium, calcium, or potassium levels is not typically associated with acute pancreatitis and would not provide relevant information for this specific condition.

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