Nursing Elites

1. A 55-year-old man presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. Imaging shows dilated intrahepatic bile ducts and a normal common bile duct. What is the most likely diagnosis?

• A. Primary biliary cirrhosis
• B. Primary sclerosing cholangitis
• C. Gallstones
• D. Pancreatic cancer

Correct answer: A

Rationale: The constellation of symptoms including fatigue, pruritus, and jaundice, along with elevated bilirubin and alkaline phosphatase levels, and imaging findings of dilated intrahepatic bile ducts and a normal common bile duct, are classical features of primary biliary cirrhosis.

2. The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?

• A. Prevents indigestion associated with the ingestion of spicy foods.
• B. Binds with phosphorus in foods and prevents absorption.
• C. Promotes stomach emptying and prevents gastric reflux.
• D. Buffers hydrochloric acid and prevents gastric erosion.

Correct answer: B

Rationale: Sevelamer (RenaGel) binds with phosphorus in foods and prevents its absorption. By taking RenaGel with meals, the binding of phosphorus helps to reduce the phosphorus load absorbed from food, thus aiding in the management of hyperphosphatemia in clients with ESRD.

3. A 60-year-old male client is admitted to the hospital with the complaint of right knee pain for the past week. His right knee and calf are warm and edematous. He has a history of diabetes and arthritis. Which neurological assessment action should the nurse perform for this client?

• A. Glasgow Coma Scale
• B. Assess pulses, paresthesia, and paralysis distal to the right knee
• C. Assess pulses, paresthesia, and paralysis proximal to the right knee
• D. Optic nerve using an ophthalmoscope

Correct answer: B

Rationale: In this scenario, the nurse should assess pulses, paresthesia, and paralysis distal to the right knee to evaluate for neurovascular compromise. This assessment helps determine the perfusion and sensation of the lower extremity, which is crucial in identifying potential vascular or nerve damage that may be causing the client's symptoms.

4. A client with hyperthyroidism is prescribed propylthiouracil (PTU). Which instruction should the nurse include in the client's discharge teaching?

• A. Report any signs of infection, such as sore throat or fever, to your healthcare provider.'
• B. Increase your intake of iodine-rich foods, such as seafood and dairy products.'
• C. Take the medication on an empty stomach for better absorption.'
• D. You may experience weight gain and fatigue as side effects of the medication.'

Correct answer: A

Rationale: Propylthiouracil (PTU) can suppress bone marrow function, increasing the risk of infection, so it is important to report signs of infection promptly.

5. In a client with liver cirrhosis experiencing confusion and disorientation, what condition is most likely causing these symptoms?

• A. Hepatic encephalopathy
• B. Hypoglycemia
• C. Electrolyte imbalance
• D. Dehydration

Correct answer: A

Rationale: Hepatic encephalopathy is the most likely condition causing confusion and disorientation in a client with liver cirrhosis. This condition is a common complication of liver cirrhosis and is characterized by cognitive impairment due to elevated ammonia levels in the blood. The build-up of ammonia affects brain function, leading to symptoms such as confusion, disorientation, and altered consciousness. Hypoglycemia (choice B) may present with confusion but is less likely in a client with liver cirrhosis without a history of diabetes or insulin use. Electrolyte imbalance (choice C) and dehydration (choice D) can contribute to confusion but are not the primary causes in a client with liver cirrhosis experiencing these symptoms.

Similar Questions