a 60 year old woman presents with pruritus jaundice and xanthomas laboratory tests reveal elevated cholesterol and alkaline phosphatase levels what is
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1. A 60-year-old woman presents with pruritus, jaundice, and xanthomas. Laboratory tests reveal elevated cholesterol and alkaline phosphatase levels. What is the most likely diagnosis?

Correct answer: A

Rationale: The combination of pruritus, jaundice, and xanthomas, along with elevated cholesterol and alkaline phosphatase levels, is classic for primary biliary cirrhosis. Pruritus is often the initial symptom, followed by jaundice due to cholestasis. Xanthomas, elevated cholesterol, and alkaline phosphatase levels are also common findings in primary biliary cirrhosis. Primary sclerosing cholangitis and pancreatic cancer may present with similar symptoms but are less likely in this clinical context.

2. A 56-year-old woman presents to discuss the results of her recent upper endoscopy. She was having some mild abdominal pain, so she underwent the procedure, which revealed an ulcer in the antrum of the stomach. Biopsy of the lesion revealed the presence of H. pylori. All of the following statements regarding her condition are correct except

Correct answer: B

Rationale: H. pylori is associated with a majority of peptic ulcer disease cases and has links to gastric MALT and adenocarcinoma. Triple drug therapy is more effective than dual therapy. Reinfection after adequate treatment is rare. While urea breath testing is a better diagnostic tool, quantitative serology can monitor treatment efficacy. A 30% decrease in IgG titer should occur post-therapy, indicating effectiveness.

3. A patient with chronic pain is prescribed gabapentin. What is the primary purpose of this medication?

Correct answer: A

Rationale: Gabapentin is primarily prescribed to relieve neuropathic pain. It works by stabilizing electrical activity in the nerves, making it effective in managing conditions such as diabetic neuropathy, postherpetic neuralgia, and other forms of chronic pain originating from nerve damage.

4. A client with a history of asthma is prescribed salmeterol (Serevent). Which instruction should the nurse provide?

Correct answer: C

Rationale: The correct instruction for a client prescribed salmeterol (Serevent) is to use it twice daily for long-term control. Salmeterol is a long-acting bronchodilator that is not intended for acute asthma attacks or as-needed use for wheezing. Choice A is incorrect because salmeterol is not used for acute asthma attacks. Choice B is incorrect as salmeterol is not meant to replace the albuterol inhaler but rather used for long-term control. Choice D is incorrect because salmeterol should not be used as needed; it is a maintenance medication for asthma.

5. A client has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging. When taking the health history, the nurse should expect the client to describe what sign or symptom?

Correct answer: B

Rationale: Regurgitation of undigested food is a typical symptom of esophageal diverticulum. This condition forms a pouch in the esophagus that can trap food, leading to regurgitation of undigested food. The other options are not typically associated with esophageal diverticulum.

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