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A 40-year-old man presents with abdominal pain, diarrhea, and weight loss. He has a history of Crohn's disease. Laboratory tests reveal low hemoglobin and elevated ESR. What is the most likely diagnosis?
- A. Ulcerative colitis
- B. Irritable bowel syndrome
- C. Celiac disease
- D. Crohn's disease flare
Correct Answer: D
Rationale: The correct answer is D: Crohn's disease flare. Given the patient's history of Crohn's disease, symptoms of abdominal pain, diarrhea, weight loss, and abnormal lab findings (low hemoglobin, elevated ESR) are indicative of a flare-up of Crohn's disease. This is supported by the clinical presentation and the lab results. Ulcerative colitis (A) presents differently with rectal bleeding and mucous diarrhea. Irritable bowel syndrome (B) does not typically cause weight loss or abnormal lab findings. Celiac disease (C) would present with malabsorption symptoms and specific antibodies, not consistent with this patient's presentation. Crohn's disease flare (D) is the most likely diagnosis based on the information provided.
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A 60-year-old man 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 60-year-old man with fatigue, polyuria, polydipsia, hyperglycemia, and ketonuria is Type 1 diabetes mellitus. The key clues are the presence of ketonuria, which indicates the body is breaking down fats for energy due to lack of insulin in Type 1 diabetes. Additionally, the acute onset of symptoms in an older individual suggests an autoimmune destruction of pancreatic beta cells seen in Type 1 diabetes. Type 2 diabetes is less likely due to the acute presentation and ketonuria. Diabetes insipidus presents with polyuria but not hyperglycemia or ketonuria. Hyperthyroidism typically presents with symptoms such as weight loss, tremors, and heat intolerance, not the classic symptoms seen in this case.
After a client's neck dissection surgery resulted in damage to the superior laryngeal nerve, what area of assessment should the nurse prioritize?
- A. The client's swallowing ability
- B. The client's ability to speak
- C. The client's management of secretions
- D. The client's airway patency
Correct Answer: A
Rationale: The correct answer is A: The client's swallowing ability. Damage to the superior laryngeal nerve can lead to swallowing difficulties, as it innervates the muscles involved in swallowing. Prioritizing assessment of swallowing ability is crucial to prevent aspiration and ensure adequate nutrition intake.
Incorrect choices:
B: The client's ability to speak - Damage to the superior laryngeal nerve mainly affects swallowing, not speech.
C: The client's management of secretions - While important, it is secondary to swallowing assessment in this context.
D: The client's airway patency - Although important, focusing on swallowing ability is more directly related to the nerve damage.
A client with a cold is taking the antitussive benzonatate (Tessalon). Which assessment data indicates to the nurse that the medication is effective?
- A. Reports reduced nasal discharge.
- B. Denies having coughing spells.
- C. Able to sleep through the night.
- D. Expectorating bronchial secretions.
Correct Answer: B
Rationale: The correct answer is B: Denies having coughing spells. Benzonatate is an antitussive medication that suppresses cough reflex. If the client denies having coughing spells, it indicates that the medication is effectively suppressing the cough. This is the most direct indicator of the medication's effectiveness.
A: Reports reduced nasal discharge - This is not directly related to the effectiveness of benzonatate in suppressing cough.
C: Able to sleep through the night - While improved sleep may result from reduced coughing, it is not as specific an indicator of antitussive effectiveness as denying coughing spells.
D: Expectorating bronchial secretions - This indicates productive coughing, which is not the intended effect of benzonatate.
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 most likely diagnosis is Celiac disease (Choice B) due to the patient's symptoms of abdominal pain, bloating, diarrhea, and improvement with fasting, which are consistent with malabsorption seen in Celiac disease. The history of iron deficiency anemia also supports this, as it is a common complication of Celiac disease due to impaired absorption of nutrients. Irritable bowel syndrome (Choice A) typically does not improve with fasting, lactose intolerance (Choice C) does not usually cause iron deficiency anemia, and Crohn's disease (Choice D) typically presents with more severe symptoms and different patterns of improvement.
The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that cannot. What risk factors should the nurse list that can be controlled or modified?
- A. Gender, obesity, family history, and smoking
- B. Inactivity, stress, gender, and smoking
- C. Cholesterol levels, hypertension, and smoking
- D. Stress, family history, and obesity
Correct Answer: C
Rationale: The correct answer is C because cholesterol levels, hypertension, and smoking are modifiable risk factors for CAD. High cholesterol levels can be controlled through diet and medication. Hypertension can be managed through lifestyle changes and medication. Smoking is a behavior that can be modified.
A is incorrect because gender and family history are non-modifiable risk factors. Obesity can be controlled but is not listed in the correct answer.
B is incorrect because inactivity and stress are modifiable risk factors, but gender is not modifiable.
D is incorrect because stress and family history are non-modifiable risk factors, and obesity is not listed in the correct answer.