Nursing Elites

1. A client who has Type 1 diabetes and is at 10-weeks gestation comes to the prenatal clinic complaining of a headache, nausea, sweating, feeling shaky, and being tired all the time. What action should the nurse take first?

• A. Check the blood glucose level.
• B. Draw blood for a Hemoglobin A1C.
• C. Assess urine for ketone levels.
• D. Provide the client with a protein snack.

Correct answer: A

Rationale: The correct action for the nurse to take first is to check the client's blood glucose level. This is crucial to determine if the symptoms are a result of hypoglycemia or hyperglycemia, which requires immediate attention to maintain the client's health and the health of the developing fetus.

2. A patient with bipolar disorder is prescribed valproic acid. What is an important side effect for the nurse to monitor?

• A. Hypertension
• B. Liver toxicity
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Liver toxicity. Valproic acid is known to potentially cause liver toxicity. Monitoring liver function tests regularly in patients taking valproic acid is crucial to detect any signs of liver damage early and prevent serious complications.

3. A 55-year-old man presents with jaundice, pruritus, and dark urine. Laboratory tests reveal elevated bilirubin and alkaline phosphatase. Imaging shows dilated intrahepatic bile ducts and a normal common bile duct. What is the most likely diagnosis?

• A. Primary biliary cirrhosis
• B. Primary sclerosing cholangitis
• C. Gallstones
• D. Pancreatic cancer

Correct answer: A

Rationale: The clinical presentation of jaundice, pruritus, dark urine, elevated bilirubin and alkaline phosphatase, along with imaging findings of dilated intrahepatic bile ducts and a normal common bile duct, are characteristic of primary biliary cirrhosis. Primary biliary cirrhosis is an autoimmune liver disease that leads to destruction of intrahepatic bile ducts, causing cholestasis and liver damage. This condition typically presents in middle-aged women but can also affect men, as seen in this case.

4. The nurse is planning care for a client with cirrhosis of the liver. Which intervention should the nurse include to reduce the risk of bleeding?

• A. Monitor for signs of infection.
• B. Limit the client's dietary protein intake.
• C. Administer vitamin K as prescribed.
• D. Encourage the client to increase fluid intake.

Correct answer: C

Rationale: Administering vitamin K as prescribed can help reduce the risk of bleeding in clients with cirrhosis by promoting clotting factor production. Cirrhosis often leads to impaired liver function, affecting the synthesis of clotting factors. Vitamin K supplementation helps in the production of these essential clotting factors, thus reducing the risk of bleeding in clients with cirrhosis. Monitoring for signs of infection (Choice A) is important for overall care but not directly related to reducing the risk of bleeding in cirrhosis. Limiting dietary protein intake (Choice B) may be necessary in some cases of cirrhosis but does not directly address the risk of bleeding. Encouraging increased fluid intake (Choice D) is beneficial for various aspects of health but does not specifically target the risk of bleeding in cirrhosis.

5. A 45-year-old woman presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. Imaging shows a normal common bile duct but dilated intrahepatic bile ducts. What is the most likely diagnosis?

• A. Primary biliary cirrhosis
• B. Primary sclerosing cholangitis
• C. Gallstones
• D. Pancreatic cancer

Correct answer: A

Rationale: Based on the symptoms of fatigue, pruritus, and jaundice, along with elevated bilirubin and alkaline phosphatase levels, and imaging findings of a normal common bile duct but dilated intrahepatic bile ducts, the most likely diagnosis is primary biliary cirrhosis. Primary sclerosing cholangitis presents with different imaging findings, often showing strictures and beading of the bile ducts. Gallstones typically cause obstruction in the biliary system, leading to different symptoms and imaging findings. Pancreatic cancer would present with different clinical features and imaging characteristics.

Similar Questions