Nursing Elites

1. A 40-year-old man presents with abdominal pain, diarrhea, and weight loss. He has a history of Crohn's disease. Laboratory tests reveal low hemoglobin and elevated ESR. What is the most likely diagnosis?

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

Correct answer: D

Rationale: The symptoms of abdominal pain, diarrhea, weight loss, along with the history of Crohn's disease, and the laboratory findings of low hemoglobin and elevated ESR, strongly suggest a Crohn's disease flare. These clinical manifestations are classic features of a flare-up in a patient with a known history of Crohn's disease.

2. A client with a diagnosis of rheumatoid arthritis is experiencing severe pain. Which medication is likely to be prescribed?

• A. Acetaminophen (Tylenol)
• B. Ibuprofen (Advil)
• C. Methotrexate (Rheumatrex)
• D. Prednisone (Deltasone)

Correct answer: C

Rationale: Methotrexate is commonly prescribed for rheumatoid arthritis to reduce inflammation and slow disease progression. It is a disease-modifying antirheumatic drug (DMARD) that helps control symptoms and prevent joint damage in individuals with rheumatoid arthritis. While acetaminophen and ibuprofen are used for pain relief, they are not typically prescribed to address the underlying inflammation and disease progression associated with rheumatoid arthritis. Prednisone may be used for short-term symptom relief or during disease flares, but it is not a first-line treatment for rheumatoid arthritis.

3. A client with a history of peptic ulcer disease is admitted with severe abdominal pain. Which assessment finding should the nurse report to the healthcare provider immediately?

• A. Bowel sounds active in all quadrants.
• B. Blood pressure of 110/70 mm Hg.
• C. Rigid, board-like abdomen.
• D. Heart rate of 90 beats per minute.

Correct answer: C

Rationale: A rigid, board-like abdomen is a sign of peritonitis, a serious complication of peptic ulcer disease that can lead to sepsis and requires immediate intervention. This finding indicates a potential emergency situation that needs urgent medical attention to prevent further complications.

4. The mother of a 9-month-old who was diagnosed with respiratory syncytial virus (RSV) yesterday calls the clinic to inquire if it will be all right to take her infant to the first birthday party of a friend's child the following day. What response should the nurse provide this mother?

• A. The child can be around other children but should wear a mask at all times.
• B. The child will no longer be contagious, no need to take any further precautions.
• C. Make sure there are no children under the age of 6 months around the infected child.
• D. Do not expose other children. RSV is very contagious even without direct oral contact.

Correct answer: D

Rationale: The correct response is to advise the mother not to expose other children to the infected child. RSV is highly contagious, and transmission can occur even without direct oral contact. It is crucial to prevent the spread of the virus to protect other children from getting infected.

5. A patient with chronic kidney disease (CKD) is prescribed calcium acetate. What is the primary purpose of this medication?

• A. Treat hyperkalemia
• B. Reduce phosphate levels
• C. Lower blood pressure
• D. Increase hemoglobin levels

Correct answer: B

Rationale: The primary purpose of prescribing calcium acetate to a patient with chronic kidney disease (CKD) is to reduce phosphate levels. Calcium acetate binds to dietary phosphate, preventing its absorption and helping to manage hyperphosphatemia commonly seen in CKD patients.

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