Nursing Elites

1. A 30-year-old woman presents with fatigue, polyuria, and polydipsia. Laboratory tests reveal hyperglycemia and ketonuria. What is the most likely diagnosis?

• A. Type 1 diabetes mellitus
• B. Type 2 diabetes mellitus
• C. Diabetes insipidus
• D. Hyperthyroidism

Correct answer: A

Rationale: The clinical presentation of a 30-year-old woman with fatigue, polyuria, polydipsia, hyperglycemia, and ketonuria is highly suggestive of type 1 diabetes mellitus. Type 1 diabetes mellitus is characterized by autoimmune destruction of pancreatic beta cells, leading to insulin deficiency and subsequent hyperglycemia. The presence of ketonuria indicates the breakdown of fats for energy due to the lack of insulin. In contrast, type 2 diabetes mellitus typically presents with gradual onset and is often associated with insulin resistance rather than absolute insulin deficiency. Diabetes insipidus is characterized by polyuria and polydipsia but is not associated with hyperglycemia or ketonuria. Hyperthyroidism may present with symptoms like fatigue but does not typically cause hyperglycemia or ketonuria.

2. A client with cirrhosis is at risk for bleeding. Which laboratory test is most important to monitor?

• A. Blood glucose
• B. Serum creatinine
• C. Prothrombin time (PT)
• D. Electrolytes

Correct answer: C

Rationale: In clients with cirrhosis, monitoring the Prothrombin time (PT) is crucial as it assesses the blood's ability to clot. Cirrhosis can lead to impaired liver function, affecting the synthesis of clotting factors, hence increasing the risk of bleeding. Maintaining a close watch on PT levels helps in timely intervention to prevent excessive bleeding episodes. Blood glucose (Choice A) is not directly related to the clotting function; serum creatinine (Choice B) and electrolytes (Choice D) are important, but in cirrhosis, monitoring PT takes precedence due to the increased bleeding risk.

3. A client with liver cirrhosis is prescribed lactulose. What is the purpose of this medication?

• A. To lower blood sugar levels
• B. To reduce ammonia levels
• C. To treat liver inflammation
• D. To improve bile flow

Correct answer: B

Rationale: Lactulose is prescribed to reduce ammonia levels in clients with liver cirrhosis. Elevated ammonia levels can lead to hepatic encephalopathy, a serious complication of liver cirrhosis. Lactulose works by acidifying the colon, which in turn traps ammonia in the colon and helps its elimination from the body through stool, thereby reducing the risk of hepatic encephalopathy. Choice A is incorrect because lactulose does not lower blood sugar levels. Choice C is incorrect as lactulose is not used to treat liver inflammation. Choice D is incorrect as lactulose does not improve bile flow.

4. A 50-year-old man presents with severe epigastric pain radiating to his back, nausea, and vomiting. He has a history of heavy alcohol use. Laboratory tests reveal elevated serum amylase and lipase. What is the most likely diagnosis?

• A. Acute cholecystitis
• B. Peptic ulcer disease
• C. Acute pancreatitis
• D. Gastroesophageal reflux disease

Correct answer: C

Rationale: The patient's history of heavy alcohol use, severe epigastric pain radiating to the back, nausea, vomiting, and elevated serum amylase and lipase levels are classic signs of acute pancreatitis. Alcohol consumption is a common predisposing factor for pancreatitis, leading to inflammation of the pancreas. The clinical presentation, along with the laboratory findings, strongly support the diagnosis of acute pancreatitis in this patient.

5. A client with peptic ulcer disease is prescribed ranitidine (Zantac). Which statement by the client indicates the need for further teaching?

• A. I will take this medication at bedtime.
• B. I need to avoid smoking while taking this medication.
• C. I should take this medication with meals.
• D. This medication will help reduce stomach acid.

Correct answer: C

Rationale: The client's statement that they should take ranitidine with meals indicates a need for further teaching. Ranitidine is typically taken at bedtime or before meals to be most effective in reducing stomach acid. Taking it with meals may not provide the optimal therapeutic effect.

Similar Questions