Nursing Elites

1. A client's telemetry monitor indicates the sudden onset of ventricular fibrillation. Which assessment finding should the nurse anticipate?

• A. Bounding erratic pulse.
• B. Regularly irregular pulse.
• C. Thready irregular pulse.
• D. No palpable pulse.

Correct answer: D

Rationale: Ventricular fibrillation is a life-threatening arrhythmia characterized by chaotic, asynchronous contractions of the ventricles, resulting in ineffective cardiac output. This leads to the absence of a palpable pulse. Nurses should be prepared to initiate immediate interventions such as defibrillation to restore normal cardiac rhythm in a client experiencing ventricular fibrillation.

2. A patient with Parkinson's disease is prescribed levodopa. What dietary modification should the nurse suggest to the patient?

• A. Increase intake of vitamin C.
• B. Limit foods high in protein.
• C. Avoid foods rich in fiber.
• D. Increase sodium intake.

Correct answer: B

Rationale: The correct answer is to limit foods high in protein. Patients taking levodopa should restrict their intake of protein-rich foods because protein can interfere with the absorption of the medication. Levodopa competes with dietary proteins for absorption in the small intestine, potentially reducing the effectiveness of the medication. Therefore, by reducing protein intake, the patient can enhance the absorption and therapeutic effects of levodopa. Increasing vitamin C intake is not necessary for patients prescribed with levodopa. Avoiding foods rich in fiber or increasing sodium intake are not directly related to optimizing levodopa therapy and might not benefit the patient's condition.

3. A 28-year-old woman presents with abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?

• A. Irritable bowel syndrome
• B. Celiac disease
• C. Lactose intolerance
• D. Crohn's disease

Correct answer: B

Rationale: The symptoms of abdominal pain, bloating, diarrhea improving with fasting, and a history of iron deficiency anemia are characteristic of celiac disease. Celiac disease is an autoimmune disorder triggered by gluten consumption, leading to damage in the small intestine. The improvement with fasting may be due to the temporary avoidance of gluten-containing foods. Irritable bowel syndrome, lactose intolerance, and Crohn's disease do not typically present with improvement of symptoms with fasting or have a clear association with iron deficiency anemia.

4. 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.

5. A 50-year-old man presents with progressive jaundice, dark urine, and pruritus. Imaging reveals a mass in the head of the pancreas. What is the most likely diagnosis?

• A. Pancreatic cancer
• B. Chronic pancreatitis
• C. Gallstones
• D. Primary sclerosing cholangitis

Correct answer: A

Rationale: The presentation of progressive jaundice, dark urine, and pruritus along with a pancreatic mass, particularly in the head of the pancreas, strongly suggests pancreatic cancer as the most likely diagnosis. These symptoms are classic for obstructive jaundice caused by a mass in the head of the pancreas, making pancreatic cancer the most fitting choice.

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