A client hospitalized with ulcerative colitis reports 10-20 small diarrhea stools per day, with abdominal pain prior to defecation. The client appears depressed and underweight and is uninterested in self-care or suggested therapies. What is the priority nursing diagnosis?

Correct Answer: B

Rationale: The correct answer is B: Imbalanced Nutrition: Less Than Body Requirements related to nutrient loss. This is the priority nursing diagnosis because the client is underweight and experiencing significant nutrient loss due to the high frequency of diarrhea stools. Addressing the nutritional needs is crucial to prevent further weight loss and malnutrition. Choice A is incorrect because the issue is not just irritated bowel causing diarrhea but also nutrient loss leading to weight loss. Choice C is incorrect as the abdominal pain is not the primary concern in this case. Choice D is incorrect because the client's main issue is related to physical symptoms (nutrient loss and weight loss) rather than coping with the chronic illness.

Correct Answer: D

Rationale: The correct answer is D, Older adults. In pancreatitis, older adults may have diminished pain perception due to age-related changes in nerve function. This can lead to mild or absent pain sensation despite the presence of significant inflammation in the pancreas. Women nearing menopause (choice A) may still experience significant pain. Children (choice B) and young adults (choice C) are more likely to experience severe pain due to their higher pain perception and sensitivity.

Correct Answer: C

Rationale: The correct answer is C because after stomach surgery, particularly gastrectomy, the production of intrinsic factor, necessary for vitamin B12 absorption, is significantly reduced. Therefore, lifelong supplementation of cobalamin (vitamin B12) is crucial to prevent pernicious anemia. Iron supplementation (Choice A) may be necessary due to reduced iron absorption but is not the priority. Avoiding lactose-containing foods (Choice B) may be helpful, but it is not the most critical teaching. The absence of digestive enzymes (Choice D) might require enzyme replacement therapy, but the primary concern is vitamin B12 deficiency due to reduced intrinsic factor production.

Correct Answer: B

Rationale: The correct answer is B because as individuals age, their metabolism slows down, leading to a decreased need for calories. However, the need for protein remains the same or slightly increases to support muscle mass maintenance and repair. Option A is incorrect because nutrient needs do not decrease with aging. Option C is incorrect as reducing carbohydrates and protein while increasing vitamins and minerals is not recommended. Option D is incorrect as high-calorie supplements are not necessary for all older adults and should not be used as a general recommendation.

Correct Answer: C

Rationale: The main underlying risk factor for metabolic syndrome is insulin resistance (Choice C). Insulin resistance is a condition where the cells in the body do not respond effectively to insulin, leading to high blood sugar levels. This is a key feature of metabolic syndrome, which includes a cluster of conditions such as high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. Insulin resistance plays a central role in the development of metabolic syndrome by promoting inflammation, dyslipidemia, and cardiovascular complications. The other choices, Age (A), Heart disease (B), and High cholesterol levels (D), while they may be associated with metabolic syndrome, are not the main underlying risk factor. Age is a risk factor for many health conditions, heart disease is a potential consequence of metabolic syndrome, and high cholesterol levels are a component of metabolic syndrome but not the primary underlying risk factor.