Marichu is admitted to the hospital because of hepatic failure and was prescribed with lactulose (Duphalac). The primary action of this drug is:

Correct Answer: B

Rationale: The correct answer is B: decrease resident intestinal flora. Lactulose is a synthetic sugar that is not absorbed in the intestine and is used to decrease ammonia levels in patients with hepatic encephalopathy by promoting the growth of beneficial gut bacteria that help metabolize ammonia. This action helps reduce the toxic effects of ammonia on the brain. A: prevent constipation - Lactulose may help with constipation, but its primary action in this scenario is to decrease resident intestinal flora. C: increase intestinal peristalsis - Lactulose does not directly increase peristalsis. D: prevent portal hypertension - Lactulose does not have a direct effect on preventing portal hypertension.

Correct Answer: B

Rationale: The correct answer is B: Arm and leg trembling. With a blood glucose level of 470 mg/dl in a client with type I diabetes mellitus, the most likely finding is arm and leg trembling, which is a common symptom of hypoglycemia. This occurs due to the body's response to low blood sugar levels, causing tremors as a compensatory mechanism to increase glucose utilization. The other choices are incorrect because cool, moist skin is a sign of hypoglycemia, rapid thready pulse is a sign of shock or hypovolemia, and slow shallow respirations are not typically associated with high blood glucose levels in this scenario.

Correct Answer: D

Rationale: Step 1: Define nonmodifiable risk factors - these are factors that cannot be changed or controlled by the individual. Step 2: Advanced age is a nonmodifiable risk factor as it is determined by genetics and time. Step 3: Poor control of blood glucose levels, foot trauma, and inappropriate foot care are modifiable risk factors that can be managed through lifestyle changes or medical interventions. Summary: Choice D is correct because advanced age is a nonmodifiable risk factor for diabetes mellitus, while the other choices involve factors that can be modified through appropriate actions.

Correct Answer: C

Rationale: The correct answer is C: By suggesting daily food choices. The food pyramid helps guide a client's diet by recommending the types and proportions of food to consume daily, such as fruits, vegetables, grains, protein, and dairy. It does not specify exact servings (A), calculate calories (B), or divide food into only four basic groups (D). The pyramid is a visual representation of a balanced diet, emphasizing variety and moderation.

Correct Answer: C

Rationale: The correct answer is C: Increased risk of respiratory complications. Clients with myasthenia gravis, Guillain-Barre Syndrome, or amyotrophic lateral sclerosis may experience respiratory muscle weakness, leading to difficulty breathing and an increased risk of respiratory complications such as pneumonia or respiratory failure. This is due to the involvement of the muscles responsible for breathing in these conditions. Progressive deterioration until death (A) is not always the case and varies depending on the condition and individual. Deficiencies of essential neurotransmitters (B) is not a common symptom in these conditions. Involuntary twitching of small muscle groups (D) is not a characteristic symptom of these neurological disorders.