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1. 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.
2. Which of the following statements is true about ischemic colitis?
- A. Typically requires colonic resection
- B. Affects the watershed areas of the colon, namely, the splenic flexure, right colon, and rectum
- C. Is only seen in the elderly
- D. Requires colonoscopic intervention
Correct answer: B
Rationale: Ischemic colitis most often results from low-flow states associated with hypotension or poor perfusion. As a result, the vascular watershed areas of the colon, including the splenic flexure, right colon, and rectum, are at highest risk of ischemic injury. Therefore, option B is correct as it accurately identifies the areas commonly affected by ischemic colitis.
3. What skin care instructions should the nurse give to a patient receiving external beam radiation therapy for cancer treatment?
- A. Use a heating pad to relieve any pain in the treated area.
- B. Apply alcohol-based lotions to the treated area daily.
- C. Avoid exposing the treated area to sunlight.
- D. Wash the treated area with hot water and strong soap.
Correct answer: C
Rationale: Patients undergoing external beam radiation therapy should be advised to avoid exposing the treated area to sunlight to prevent further skin damage. Heat sources like heating pads should be avoided to prevent burns and irritation to the skin. Alcohol-based lotions can be irritating to the skin and are not recommended. Washing the treated area with lukewarm water and mild soap is preferable to maintain skin integrity and prevent irritation. Therefore, the correct instruction for the patient is to avoid exposing the treated area to sunlight.
4. Which regimen is most effective for treating H. pylori infection?
- A. Metronidazole, bismuth subsalicylate, amoxicillin for 14 days
- B. Clarithromycin and omeprazole for 14 days
- C. Metronidazole, lansoprazole, and clarithromycin for 14 days
- D. Metronidazole, clarithromycin, and omeprazole for 7 days
Correct answer: C
Rationale: Regimen C, which consists of metronidazole, lansoprazole, and clarithromycin for 14 days, is recommended by the FDA as an effective treatment for H. pylori infection. This regimen has been shown to have a high eradication rate and is a standard recommendation in clinical practice guidelines for the management of H. pylori-related conditions.
5. A 60-year-old woman presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. What is the most likely diagnosis?
- A. Hepatitis C
- B. Primary biliary cirrhosis
- C. Hemochromatosis
- D. Wilson's disease
Correct answer: B
Rationale: The symptoms of fatigue, pruritus, jaundice, and elevated bilirubin and alkaline phosphatase levels are classic features of primary biliary cirrhosis, an autoimmune liver disease. Hepatitis C typically presents with different symptoms and findings, such as specific viral markers. Hemochromatosis and Wilson's disease involve iron overload and copper accumulation, respectively, leading to distinct clinical and laboratory findings, which do not match the presentation described in this case.
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