Nursing Elites

1. A 28-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?

• A. Ulcerative colitis
• B. Irritable bowel syndrome
• C. Crohn's disease
• D. Diverticulitis

Correct answer: C

Rationale: The combination of symptoms including recurrent mouth ulcers, perianal fistula, abdominal pain, diarrhea, and weight loss is characteristic of Crohn's disease. These extra-intestinal manifestations, along with the gastrointestinal symptoms, point towards Crohn's disease rather than ulcerative colitis, irritable bowel syndrome, or diverticulitis.

2. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy. Which intervention should the nurse implement to ensure the client's safety?

• A. Increase the oxygen flow rate to 6 liters/minute if the client is short of breath.
• B. Instruct the client to breathe deeply and cough frequently.
• C. Use a nasal cannula to deliver oxygen at a low flow rate.
• D. Encourage the client to remove the oxygen when eating or drinking.

Correct answer: C

Rationale: Using a nasal cannula to deliver oxygen at a low flow rate is the appropriate intervention for clients with COPD receiving oxygen therapy. High flow rates can lead to respiratory depression in COPD patients. This intervention helps maintain a safe and controlled oxygen delivery to prevent potential complications associated with high oxygen flow rates.

3. A patient with type 2 diabetes is prescribed metformin. What instruction should the nurse provide regarding this medication?

• A. Take the medication on an empty stomach.
• B. Monitor for signs of hypoglycemia.
• C. Take the medication with meals.
• D. Increase intake of simple carbohydrates.

Correct answer: C

Rationale: The correct instruction for a patient prescribed metformin is to take the medication with meals. This helps reduce gastrointestinal side effects commonly associated with metformin. Patients should also be educated about the signs of lactic acidosis, a rare but serious side effect associated with metformin use.

4. The client is prescribed clozapine (Clozaril), and the nurse plans to educate them about its purpose. Which statement should the nurse provide?

• A. It will help you function better in the community.
• B. The medication will help you think more clearly.
• C. You will be able to cope with your symptoms.
• D. It will improve your grooming and hygiene.

Correct answer: B

Rationale: Clozapine (Clozaril) is an antipsychotic medication that is known to improve cognitive function and thought clarity in individuals with schizophrenia. It primarily helps in managing symptoms related to thought processes rather than focusing on community function, coping with symptoms, or grooming and hygiene.

5. A client is admitted with a diagnosis of acute pancreatitis. Which laboratory value should the nurse monitor closely?

• A. Serum amylase.
• B. Serum sodium.
• C. Serum calcium.
• D. Serum potassium.

Correct answer: A

Rationale: In acute pancreatitis, serum amylase is a crucial laboratory value to monitor closely. Elevated levels of serum amylase are a key indicator of pancreatic inflammation and can help confirm the diagnosis of acute pancreatitis. Therefore, monitoring serum amylase levels is essential for assessing the progression and severity of the condition in a client with acute pancreatitis.

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