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A 34-year-old woman presents with intermittent 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 correct answer is B: Celiac disease. The patient's symptoms of abdominal pain, bloating, diarrhea, and improvement with fasting are classic for celiac disease, an autoimmune condition triggered by gluten ingestion. Her iron deficiency anemia can be attributed to malabsorption common in celiac disease. Irritable bowel syndrome (A) typically presents with abdominal pain relieved by defecation, not fasting. Lactose intolerance (C) results in symptoms after consuming dairy, not necessarily improved by fasting. Crohn's disease (D) may present similarly, but the improvement with fasting and iron deficiency anemia point more towards celiac disease in this case.
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A 28-year-old woman presents with abdominal pain, diarrhea, and rectal bleeding. She has a history of similar episodes in the past. What is the most likely diagnosis?
- A. Ulcerative colitis
- B. Irritable bowel syndrome
- C. Celiac disease
- D. Diverticulitis
Correct Answer: A
Rationale: The correct answer is A: Ulcerative colitis. This chronic inflammatory condition affects the colon and rectum, leading to symptoms like abdominal pain, diarrhea, and rectal bleeding. The patient's recurrent episodes and history of similar symptoms point towards ulcerative colitis. Irritable bowel syndrome (choice B) typically presents with abdominal pain, bloating, and changes in bowel habits but not rectal bleeding. Celiac disease (choice C) presents with gastrointestinal symptoms after consuming gluten. Diverticulitis (choice D) presents with localized abdominal pain and fever due to inflammation or infection of the diverticula, not typically with rectal bleeding.
A client is receiving chemotherapy and is at risk for neutropenia. Which precaution should the nurse implement?
- A. Encourage regular visitors to boost morale.
- B. Ensure the client receives live vaccines.
- C. Place the client in a private room.
- D. Provide a diet high in fresh fruits and vegetables.
Correct Answer: C
Rationale: The correct answer is C: Place the client in a private room. This is important to reduce the risk of infection for the client with neutropenia, as being in a private room minimizes exposure to pathogens from other individuals. Neutropenia is a condition where there is a low level of neutrophils, a type of white blood cell that helps fight infections. By placing the client in a private room, the nurse can control the environment and limit the client's exposure to potential sources of infection.
Choice A is incorrect because regular visitors may introduce pathogens that could increase the client's risk of infection. Choice B is incorrect as live vaccines are contraindicated in clients receiving chemotherapy due to their weakened immune system. Choice D is incorrect because while fresh fruits and vegetables are important for overall health, in this case, the risk of infection outweighs the benefits of a diet high in these foods.
A 40-year-old woman presents with fatigue, polyuria, and polydipsia. Laboratory tests reveal hyperglycemia and ketonuria. What is the most likely diagnosis?
- A. Type 1 diabetes mellitus
- B. Type 2 diabetes mellitus
- C. Diabetes insipidus
- D. Hyperthyroidism
Correct Answer: A
Rationale: The most likely diagnosis for a 40-year-old woman presenting with fatigue, polyuria, polydipsia, hyperglycemia, and ketonuria is Type 1 diabetes mellitus.
1. Age: Type 1 diabetes commonly presents at a younger age.
2. Symptoms: Polyuria, polydipsia, fatigue are classic symptoms of uncontrolled diabetes.
3. Laboratory tests: Hyperglycemia and ketonuria indicate insulin deficiency.
4. Clinical presentation: Presence of ketonuria suggests metabolic derangement due to lack of insulin.
In summary, Type 1 diabetes is the correct choice due to the age of the patient, symptoms, laboratory findings, and clinical presentation. Diabetes insipidus (choice C) presents with polyuria and polydipsia but lacks hyperglycemia and ketonuria. Type 2 diabetes (choice B) typically presents at an older age and rarely with ketonuria. Hyperthyroidism (choice D)
An 89-year-old male client complains to the nurse that people are whispering behind his back and mumbling when they talk to him. What age-related condition is likely to be occurring with this client?
- A. Delirium
- B. Presbyopia
- C. Presbycusis
- D. Cerebral dysfunction
Correct Answer: C
Rationale: The correct answer is C: Presbycusis. This age-related condition refers to gradual hearing loss typically seen in older adults. In this case, the client's complaint of people whispering and mumbling suggests difficulty hearing clearly, which aligns with symptoms of presbycusis. Delirium (choice A) is characterized by acute confusion and disorientation, not specifically related to hearing loss. Presbyopia (choice B) is a condition of aging that affects near vision, not hearing. Cerebral dysfunction (choice D) refers to broader cognitive impairment, not specifically related to hearing loss as in presbycusis. Therefore, choice C is the most likely age-related condition in this scenario.
The nurse is caring for a client with a history of deep vein thrombosis (DVT) who is receiving warfarin (Coumadin). Which laboratory value should the nurse monitor closely?
- A. Platelet count.
- B. Prothrombin time (PT).
- C. Hemoglobin level.
- D. White blood cell count.
Correct Answer: B
Rationale: The correct answer is B: Prothrombin time (PT). Warfarin affects the clotting process by inhibiting vitamin K-dependent clotting factors. Monitoring PT helps assess the effectiveness of warfarin therapy and prevent complications like bleeding. Platelet count (A) is important but not directly affected by warfarin. Hemoglobin level (C) and white blood cell count (D) are not typically affected by warfarin therapy.