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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 client with a diagnosis of schizophrenia is being treated with risperidone (Risperdal). Which finding should the nurse report to the healthcare provider immediately?
- A. Weight gain.
- B. Dry mouth.
- C. Muscle rigidity.
- D. Drowsiness.
Correct answer: C
Rationale: Muscle rigidity is a crucial finding to report immediately as it can indicate neuroleptic malignant syndrome (NMS), a rare but potentially life-threatening reaction to antipsychotic medications. NMS is characterized by muscle rigidity, high fever, autonomic dysfunction, and altered mental status. Prompt recognition and intervention are essential to prevent serious complications or death.
3. The healthcare provider is planning care for a non-potty-trained child with nephrotic syndrome. Which intervention provides the best means of determining fluid retention?
- A. Weigh the child daily.
- B. Observe the lower extremities for pitting edema.
- C. Measure the child's abdominal girth weekly.
- D. Weigh the child's wet diapers.
Correct answer: A
Rationale: Daily weighing is the most accurate method to monitor fluid retention in a child with nephrotic syndrome. Changes in weight can indicate fluid retention or loss, which is crucial in managing nephrotic syndrome. Observing for pitting edema and measuring abdominal girth are also important assessments, but daily weighing provides more immediate and precise information about fluid status.
4. A client is being educated about type 2 diabetes. The educator can confirm that the client understands the primary treatment for type 2 diabetes when the client states what?
- A. I read that a pancreas transplant will provide a cure for my diabetes.
- B. I will take my oral antidiabetic agents when my morning blood sugar is high.
- C. I will make sure to follow the weight loss plan designed by the dietitian.
- D. I will make sure I call the diabetes educator when I have questions about my insulin.
Correct answer: C
Rationale: The primary treatment approach for managing type 2 diabetes includes following a weight loss plan. Weight loss can improve insulin sensitivity and glycemic control in individuals with type 2 diabetes. Making dietary changes and maintaining a healthy weight are crucial components of managing this condition.
5. What is the primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT)?
- A. No need for regular INR monitoring
- B. Lower risk of bleeding
- C. Fewer dietary restrictions
- D. Longer half-life
Correct answer: A
Rationale: The primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT) is that rivaroxaban does not require regular INR monitoring. This eliminates the need for frequent blood tests to adjust the dosage, making it more convenient for patients to manage their anticoagulant therapy.
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