The nurse is teaching a class about Irritable Bowel Syndrome. Which statement should not be included?

It is an inflammatory disease

Symptoms can be triggered by stress

Treatment is focused on symptom relief

Symptoms may include constipation or diarrhea

Answer and Explanation

The Correct Answer is A

Choice A reason: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, not primarily an inflammatory disease. While low-grade inflammation may be present in some cases, IBS is characterized by altered gut motility and visceral hypersensitivity without significant inflammatory markers, unlike inflammatory bowel diseases like Crohn’s or ulcerative colitis. This statement is inaccurate.

Choice B reason: Stress is a well-documented trigger for IBS symptoms. The brain-gut axis, involving the hypothalamic-pituitary-adrenal axis, modulates gut motility and sensitivity. Psychological stress can exacerbate visceral pain, diarrhea, or constipation by altering neurotransmitter release and gut microbiome interactions, making this statement accurate for IBS pathophysiology.

Choice C reason: IBS treatment focuses on symptom relief, as there is no cure. Strategies include dietary modifications (e.g., low FODMAP diet), antispasmodics, laxatives, or antidiarrheals to manage pain, bloating, and bowel irregularities. This statement is accurate, reflecting the symptomatic approach to improving quality of life in IBS patients.

Choice D reason: IBS symptoms commonly include constipation, diarrhea, or alternating patterns, along with abdominal pain and bloating. These result from dysregulated gut motility and visceral hypersensitivity, affecting the enteric nervous system. This statement is accurate, as variable bowel habits are a hallmark of IBS diagnostic criteria.

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Correct Answer is A

Explanation

Choice A reason: Gout results from hyperuricemia, leading to urate crystal deposition in joints. A 45-year-old male with obesity (BMI 40) has increased purine turnover, elevating uric acid. Hydrochlorothiazide reduces urate excretion, and aspirin impairs renal uric acid clearance, significantly increasing gout risk, making this patient the most susceptible due to multiple risk factors.

Choice B reason: Bulimia may cause electrolyte imbalances, but it is not strongly linked to hyperuricemia or gout. A BMI of 24 is normal, reducing obesity-related purine production. This 39-year-old female has fewer gout risk factors compared to an obese male on medications that elevate uric acid, making her less likely to develop gout.

Choice C reason: Ulcerative colitis may cause systemic inflammation, but it is not a direct risk factor for gout. Hyperuricemia is not typically associated with inflammatory bowel diseases unless complicated by other factors like diuretic use. This 27-year-old female has a lower gout risk compared to the obese male with predisposing medications.

Choice D reason: Limiting purine-rich foods like smoked meat and cheeses reduces uric acid production, lowering gout risk. This 56-year-old male’s dietary habits mitigate hyperuricemia, making him the least likely to develop gout compared to the obese patient on medications that impair uric acid metabolism and excretion.

A. Today at 8:30 am B. Today at 7:45 am C. Today at 12:30 pm D. Tomorrow at 6:30 am

Correct Answer is A

Explanation

Choice A reason: Insulin lispro, a rapid-acting insulin, peaks 1-2 hours after administration (around 8:30-9:30 am for a 7:30 am dose). This peak coincides with maximum glucose-lowering effect, increasing hypoglycemia risk, especially if breakfast is inadequate or delayed. This time is the most likely for low blood sugar due to insulin’s pharmacodynamics.

Choice B reason: At 7:45 am, insulin lispro is just beginning to act (onset 15-30 minutes), and breakfast is likely being consumed, providing glucose to counter insulin’s effect. Hypoglycemia risk is lower than at peak action (1-2 hours), making this time less critical for hypoglycemia monitoring.

Choice C reason: By 12:30 pm, insulin lispro’s effect (duration 3-5 hours) is waning, and glucose from breakfast is metabolized. Hypoglycemia risk is lower unless additional insulin or activity occurs. This time is less likely for hypoglycemia compared to the peak action period around 8:30 am.

Choice D reason: Tomorrow at 6:30 am is beyond insulin lispro’s duration of action (3-5 hours). Hypoglycemia risk from the 7:30 am dose is negligible 23 hours later, as insulin is cleared. This time is irrelevant to the dose’s effect, making it the least likely for hypoglycemia.

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The nurse is teaching a class about Irritable Bowel Syndrome. Which statement should not be included?

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Naxlex Comprehensive Predictor Exams

Which patient below is at greatest risk for developing gout?

Correct Answer is A

Explanation

The client’s blood glucose level is 220 mg/dL. The client is about to eat breakfast. The prescribed sliding scale indicates that 4 units of insulin lispro (Humalog) be given subcutaneously at 7:30 am. At what time is the client most at risk for hypoglycemia?

Correct Answer is A

Explanation

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The nurse is teaching a class about Irritable Bowel Syndrome. Which statement should not be included?