Nursing Elites

1. 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.

2. What is the primary cause of jaundice in a client with liver cirrhosis?

• A. Decreased bile production
• B. Increased bilirubin levels
• C. Hepatic inflammation
• D. Portal hypertension

Correct answer: B

Rationale: Jaundice in a client with liver cirrhosis is primarily caused by increased bilirubin levels. In liver cirrhosis, impaired liver function leads to the accumulation of bilirubin in the blood, resulting in jaundice. Bilirubin is a yellow pigment produced from the breakdown of red blood cells, and its elevation is a common manifestation of liver dysfunction. Choices A, C, and D are incorrect. While decreased bile production can contribute to jaundice, in liver cirrhosis, the key factor is the buildup of bilirubin due to liver dysfunction, not a decrease in bile production. Hepatic inflammation and portal hypertension are associated with liver cirrhosis but are not the primary causes of jaundice in this context.

3. A client is undergoing chemotherapy and is at risk for developing thrombocytopenia. What precaution should the nurse teach the client to minimize the risk of bleeding?

• A. Use a soft-bristled toothbrush.
• B. Engage in daily aerobic exercise.
• C. Take aspirin for headaches.
• D. Use an electric razor for shaving.

Correct answer: A

Rationale: Using a soft-bristled toothbrush is essential for clients at risk of thrombocytopenia to prevent gum bleeding, as their platelet counts may be low. Vigorous brushing with a hard-bristled toothbrush can injure the gums, leading to bleeding, which can be exacerbated in clients with low platelets. Therefore, advising the client to use a soft-bristled toothbrush is a crucial precaution to minimize the risk of bleeding.

4. A patient with diabetes insipidus is prescribed desmopressin. What is the primary purpose of this medication?

• A. Increase urine output
• B. Reduce blood sugar levels
• C. Decrease urine output
• D. Lower blood pressure

Correct answer: C

Rationale: Desmopressin is prescribed to decrease urine output in patients with diabetes insipidus. It works by increasing water reabsorption in the kidneys, helping to control fluid balance in the body.

5. A 48-year-old woman presents with fatigue, pruritus, and jaundice. She has a history of ulcerative colitis. Laboratory tests reveal elevated bilirubin and alkaline phosphatase. What is the most likely diagnosis?

• A. Hepatitis B
• B. Primary biliary cirrhosis
• C. Primary sclerosing cholangitis
• D. Autoimmune hepatitis

Correct answer: C

Rationale: The combination of symptoms (fatigue, pruritus, jaundice) along with a history of ulcerative colitis and elevated bilirubin and alkaline phosphatase levels suggests primary sclerosing cholangitis. Primary sclerosing cholangitis is commonly associated with inflammatory bowel disease, such as ulcerative colitis. It is characterized by inflammation and fibrosis of the bile ducts, leading to cholestasis and elevated alkaline phosphatase and bilirubin levels.

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