Question 1

The nurse is caring for an African-American client with nephritis.For which long-term complication should the nurse include interventions to prevent when planning this client's care?
A) Congestive heart failure
B) Diabetes mellitus
C) End-stage renal disease
D) Hypertension

Accepted Answer

A) African-Americans are more likely than Caucasians to progress to end-stage renal disease after nephritis. The nurse should plan interventions to prevent the development of this long-term complication. African-Americans are not more likely to develop congestive heart failure, diabetes mellitus, or hypertension after nephritis.
B) African-Americans are more likely than Caucasians to progress to end-stage renal disease after nephritis. The nurse should plan interventions to prevent the development of this long-term complication. African-Americans are not more likely to develop congestive heart failure, diabetes mellitus, or hypertension after nephritis.
C) African-Americans are more likely than Caucasians to progress to end-stage renal disease after nephritis. The nurse should plan interventions to prevent the development of this long-term complication. African-Americans are not more likely to develop congestive heart failure, diabetes mellitus, or hypertension after nephritis.
D) African-Americans are more likely than Caucasians to progress to end-stage renal disease after nephritis. The nurse should plan interventions to prevent the development of this long-term complication. African-Americans are not more likely to develop congestive heart failure, diabetes mellitus, or hypertension after nephritis.

Question 2

A nurse caring for a pediatric client with inflammatory bowel disease (IBD)understands that there are variances in the presentation of IBD between children and adults.Which variances does the nurse anticipate for this pediatric client? Select all that apply.
A) Children suffer from Crohn disease more frequently than ulcerative colitis
B) Pediatric clients often present with fistulizing or stricturing disease.
C) Pediatric clients usually have colonic involvement.
D) Pediatric clients more often present with left-sided colitis.
E) IBD is more common in females than males in the pediatric population

Accepted Answer

A) The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement; the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.
B) The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement; the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.
C) The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement; the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.
D) The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement; the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.
E) The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement; the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.

Question 3

A client is being scheduled for diagnostic tests to determine the presence of ulcerative colitis.For which diagnostic tests should the nurse plan to provide teaching? Select all that apply.
A) Barium enema
B) Intravenous pyelogram
C) Colonoscopy
D) Upper endoscopy
E) Barium swallow

Accepted Answer

A) Tests to diagnose irritable bowel syndrome include upper and lower barium studies and a colonoscopy. An intravenous pyelogram is used to diagnose kidney disorders. An upper endoscopy is used to diagnose disorders of the esophagus and stomach.
B) Tests to diagnose irritable bowel syndrome include upper and lower barium studies and a colonoscopy. An intravenous pyelogram is used to diagnose kidney disorders. An upper endoscopy is used to diagnose disorders of the esophagus and stomach.
C) Tests to diagnose irritable bowel syndrome include upper and lower barium studies and a colonoscopy. An intravenous pyelogram is used to diagnose kidney disorders. An upper endoscopy is used to diagnose disorders of the esophagus and stomach.
D) Tests to diagnose irritable bowel syndrome include upper and lower barium studies and a colonoscopy. An intravenous pyelogram is used to diagnose kidney disorders. An upper endoscopy is used to diagnose disorders of the esophagus and stomach.
E) Tests to diagnose irritable bowel syndrome include upper and lower barium studies and a colonoscopy. An intravenous pyelogram is used to diagnose kidney disorders. An upper endoscopy is used to diagnose disorders of the esophagus and stomach.

Question 4

The nurse is caring for an adolescent client who has been non-adherent with the medical plan of care to treat Crohn disease.In order to increase adherent behavior,which complication associated with Crohn disease will the nurse include in the client's teaching plan?
A) Vomiting
B) Bowel perforation
C) Intestinal obstruction
D) Diarrhea

Accepted Answer

A) Bowel perforation is rare but may be a consequence of noncompliance with the treatment, because the disease would continue to progress. Diarrhea, vomiting, and intestinal obstructions are common symptoms of Crohn and may occur even if the client is compliant with medical care.
B) Bowel perforation is rare but may be a consequence of noncompliance with the treatment, because the disease would continue to progress. Diarrhea, vomiting, and intestinal obstructions are common symptoms of Crohn and may occur even if the client is compliant with medical care.
C) Bowel perforation is rare but may be a consequence of noncompliance with the treatment, because the disease would continue to progress. Diarrhea, vomiting, and intestinal obstructions are common symptoms of Crohn and may occur even if the client is compliant with medical care.
D) Bowel perforation is rare but may be a consequence of noncompliance with the treatment, because the disease would continue to progress. Diarrhea, vomiting, and intestinal obstructions are common symptoms of Crohn and may occur even if the client is compliant with medical care.

Question 5

A client who is 4 days post-cholecystectomy has T-tube drainage totaling 600 mL in 24 hours.Which actions by the nurse are appropriate based on this data? Select all that apply.
A) Notify the healthcare provider.
B) Place the client in a supine position.
C) Assess drainage characteristics.
D) Clamp the tube q 2 hours for 30 minutes.
E) Encourage an increased fluid intake.

Accepted Answer

A) The T-tube may drain 500 mL in the first 24 hours and is expected to decrease steadily thereafter. If there is excessive drainage, the nurse should further assess the drainage to be able to describe it accurately and notify the healthcare provider immediately. Clamping the tube would be contraindicated. Placing the client in a supine position and encouraging fluid intake are of no help.
B) The T-tube may drain 500 mL in the first 24 hours and is expected to decrease steadily thereafter. If there is excessive drainage, the nurse should further assess the drainage to be able to describe it accurately and notify the healthcare provider immediately. Clamping the tube would be contraindicated. Placing the client in a supine position and encouraging fluid intake are of no help.
C) The T-tube may drain 500 mL in the first 24 hours and is expected to decrease steadily thereafter. If there is excessive drainage, the nurse should further assess the drainage to be able to describe it accurately and notify the healthcare provider immediately. Clamping the tube would be contraindicated. Placing the client in a supine position and encouraging fluid intake are of no help.
D) The T-tube may drain 500 mL in the first 24 hours and is expected to decrease steadily thereafter. If there is excessive drainage, the nurse should further assess the drainage to be able to describe it accurately and notify the healthcare provider immediately. Clamping the tube would be contraindicated. Placing the client in a supine position and encouraging fluid intake are of no help.
E) The T-tube may drain 500 mL in the first 24 hours and is expected to decrease steadily thereafter. If there is excessive drainage, the nurse should further assess the drainage to be able to describe it accurately and notify the healthcare provider immediately. Clamping the tube would be contraindicated. Placing the client in a supine position and encouraging fluid intake are of no help.

Question 6

A nurse is receiving a client from the emergency department diagnosed with an acute exacerbation of ulcerative colitis (UC).The nurse anticipates the client may present with which clinical characteristics? Select all that apply.
A) 5-30 diarrhea stools per day with blood and mucus
B) Steady right lower quadrant or periumbilical pain
C) Cramping in left lower quadrant; relieved by defecation
D) Tenderness and mass noted in right lower quadrant
E) Fever, malaise, fatigue

Accepted Answer

A) With both ulcerative colitis (UC) and Crohn disease, the client experiences periods of symptom-free remissions with sporadic periods of active disease (flares). However, each condition has differences in clinical characteristics. With UC, the client may have 5-30 diarrhea stools per day with blood and mucus. Pain associated with UC presents with cramping in the left lower quadrant which is relieved by defecation. All other clinical manifestations are unique to Crohn disease.
B) With both ulcerative colitis (UC) and Crohn disease, the client experiences periods of symptom-free remissions with sporadic periods of active disease (flares). However, each condition has differences in clinical characteristics. With UC, the client may have 5-30 diarrhea stools per day with blood and mucus. Pain associated with UC presents with cramping in the left lower quadrant which is relieved by defecation. All other clinical manifestations are unique to Crohn disease.
C) With both ulcerative colitis (UC) and Crohn disease, the client experiences periods of symptom-free remissions with sporadic periods of active disease (flares). However, each condition has differences in clinical characteristics. With UC, the client may have 5-30 diarrhea stools per day with blood and mucus. Pain associated with UC presents with cramping in the left lower quadrant which is relieved by defecation. All other clinical manifestations are unique to Crohn disease.
D) With both ulcerative colitis (UC) and Crohn disease, the client experiences periods of symptom-free remissions with sporadic periods of active disease (flares). However, each condition has differences in clinical characteristics. With UC, the client may have 5-30 diarrhea stools per day with blood and mucus. Pain associated with UC presents with cramping in the left lower quadrant which is relieved by defecation. All other clinical manifestations are unique to Crohn disease.
E) With both ulcerative colitis (UC) and Crohn disease, the client experiences periods of symptom-free remissions with sporadic periods of active disease (flares). However, each condition has differences in clinical characteristics. With UC, the client may have 5-30 diarrhea stools per day with blood and mucus. Pain associated with UC presents with cramping in the left lower quadrant which is relieved by defecation. All other clinical manifestations are unique to Crohn disease.

Question 7

The nurse is evaluating care provided to an older adult client with a history of cholecystitis 5 months ago.Which statement indicates the client met a goal in the plan of care?
A) "I have increased my intake of fat."
B) "I have been eating out often."
C) "I have been walking 1 mile every day."
D) "I have been able to gain 5 pounds on the new diet."

Accepted Answer

A) The older adult client with cholecystitis is at risk for infection. A goal would be to stabilize or increase weight through the appropriate diet to support the immune system and resist infection. Exercise is excellent but does not meet this client's goal. Eating out would not be a goal for a client being treated for cholecystitis. The client would want to decrease fat intake.
B) The older adult client with cholecystitis is at risk for infection. A goal would be to stabilize or increase weight through the appropriate diet to support the immune system and resist infection. Exercise is excellent but does not meet this client's goal. Eating out would not be a goal for a client being treated for cholecystitis. The client would want to decrease fat intake.
C) The older adult client with cholecystitis is at risk for infection. A goal would be to stabilize or increase weight through the appropriate diet to support the immune system and resist infection. Exercise is excellent but does not meet this client's goal. Eating out would not be a goal for a client being treated for cholecystitis. The client would want to decrease fat intake.
D) The older adult client with cholecystitis is at risk for infection. A goal would be to stabilize or increase weight through the appropriate diet to support the immune system and resist infection. Exercise is excellent but does not meet this client's goal. Eating out would not be a goal for a client being treated for cholecystitis. The client would want to decrease fat intake.

Question 8

The nurse conducts an evaluation after completing a training session for community members on ways to prevent nephritis.When evaluating the success of this session,what responses should the members provide as evidence that learning has been successful? Select all that apply.
A) Practicing good hygiene
B) Not smoking
C) Maintaining a healthy body weight
D) Limiting alcohol intake
E) Controlling high blood pressure

Accepted Answer

A) The exact cause of nephritis is unknown, but preventing viral infections through practicing good hygiene habits, not smoking, maintaining a healthy body weight, and controlling high blood pressure reduces the risk of developing this disease. Limiting alcohol intake will not affect the development of nephritis.
B) The exact cause of nephritis is unknown, but preventing viral infections through practicing good hygiene habits, not smoking, maintaining a healthy body weight, and controlling high blood pressure reduces the risk of developing this disease. Limiting alcohol intake will not affect the development of nephritis.
C) The exact cause of nephritis is unknown, but preventing viral infections through practicing good hygiene habits, not smoking, maintaining a healthy body weight, and controlling high blood pressure reduces the risk of developing this disease. Limiting alcohol intake will not affect the development of nephritis.
D) The exact cause of nephritis is unknown, but preventing viral infections through practicing good hygiene habits, not smoking, maintaining a healthy body weight, and controlling high blood pressure reduces the risk of developing this disease. Limiting alcohol intake will not affect the development of nephritis.
E) The exact cause of nephritis is unknown, but preventing viral infections through practicing good hygiene habits, not smoking, maintaining a healthy body weight, and controlling high blood pressure reduces the risk of developing this disease. Limiting alcohol intake will not affect the development of nephritis.

Question 9

A nurse is caring for a client with severe acute abdominal pain secondary to cholelithiasis.Which nursing actions promote effective pain management? Select all that apply.
A) Withhold oral food and fluids.
B) Insert nasogastric tube and connect to high wall suction.
C) Educate the client about decreasing protein in the diet, as protein increases gallbladder contractions.
D) Administer morphine, meperidine, or another opioid analgesic as ordered.
E) Place the patient in supine position to relieve abdominal pain.

Accepted Answer

A) The pain associated with cholelithiasis can be severe. Nursing interventions that help to promote effective pain management include withholding oral food and fluids and inserting a nasogastric tube connected to low wall suction. The nurse should educate the client about decreasing fat in the diet, as fat entering the duodenum initiates gallbladder contractions, causing pain when gallstones are in the ducts. Administering morphine, meperidine, or another opioid analgesic as ordered aids in pain management. The nurse should place the patient in Fowler position, not supine, to decrease pressure on the inflamed gallbladder.
B) The pain associated with cholelithiasis can be severe. Nursing interventions that help to promote effective pain management include withholding oral food and fluids and inserting a nasogastric tube connected to low wall suction. The nurse should educate the client about decreasing fat in the diet, as fat entering the duodenum initiates gallbladder contractions, causing pain when gallstones are in the ducts. Administering morphine, meperidine, or another opioid analgesic as ordered aids in pain management. The nurse should place the patient in Fowler position, not supine, to decrease pressure on the inflamed gallbladder.
C) The pain associated with cholelithiasis can be severe. Nursing interventions that help to promote effective pain management include withholding oral food and fluids and inserting a nasogastric tube connected to low wall suction. The nurse should educate the client about decreasing fat in the diet, as fat entering the duodenum initiates gallbladder contractions, causing pain when gallstones are in the ducts. Administering morphine, meperidine, or another opioid analgesic as ordered aids in pain management. The nurse should place the patient in Fowler position, not supine, to decrease pressure on the inflamed gallbladder.
D) The pain associated with cholelithiasis can be severe. Nursing interventions that help to promote effective pain management include withholding oral food and fluids and inserting a nasogastric tube connected to low wall suction. The nurse should educate the client about decreasing fat in the diet, as fat entering the duodenum initiates gallbladder contractions, causing pain when gallstones are in the ducts. Administering morphine, meperidine, or another opioid analgesic as ordered aids in pain management. The nurse should place the patient in Fowler position, not supine, to decrease pressure on the inflamed gallbladder.
E) The pain associated with cholelithiasis can be severe. Nursing interventions that help to promote effective pain management include withholding oral food and fluids and inserting a nasogastric tube connected to low wall suction. The nurse should educate the client about decreasing fat in the diet, as fat entering the duodenum initiates gallbladder contractions, causing pain when gallstones are in the ducts. Administering morphine, meperidine, or another opioid analgesic as ordered aids in pain management. The nurse should place the patient in Fowler position, not supine, to decrease pressure on the inflamed gallbladder.

Question 10

An adolescent client with complications related to ulcerative colitis is scheduled for an ileostomy.The client is concerned about the social effects of this surgery and asks the nurse what to expect related to bowel function and care after surgery.Which responses from the nurse to the client are appropriate? Select all that apply.
A) "The stoma will require that you wear a collection device all the time."
B) "The drainage tends to be liquid but certain foods can cause it to be paste-like."
C) "The drainage will gradually become semi-solid and formed."
D) "After the stoma heals, you can irrigate your bowel so you won't have to wear a pouch."
E) "You will be able to have some control over your bowel movements."

Accepted Answer

A) A client with an ileostomy has no control over bowel movements and must always wear a collection device. The drainage tends to be liquid but becomes paste-like with the intake of certain foods.
B) A client with an ileostomy has no control over bowel movements and must always wear a collection device. The drainage tends to be liquid but becomes paste-like with the intake of certain foods.
C) A client with an ileostomy has no control over bowel movements and must always wear a collection device. The drainage tends to be liquid but becomes paste-like with the intake of certain foods.
D) A client with an ileostomy has no control over bowel movements and must always wear a collection device. The drainage tends to be liquid but becomes paste-like with the intake of certain foods.
E) A client with an ileostomy has no control over bowel movements and must always wear a collection device. The drainage tends to be liquid but becomes paste-like with the intake of certain foods.

Question 11

The nurse educator in a gastrostomy clinic is teaching a group of clients about how nutrition plays a role in the formation of gallstones.Which client would the nurse expect to benefit the most from this teaching session?
A) The Native American client
B) The African-American client
C) The Asian client
D) The Norwegian client

Accepted Answer

A) Native Americans have a higher incidence of gallstones than Asians, Caucasians, and African-Americans. This is believed to result from genes that promote inefficient calorie use and fat storage.
B) Native Americans have a higher incidence of gallstones than Asians, Caucasians, and African-Americans. This is believed to result from genes that promote inefficient calorie use and fat storage.
C) Native Americans have a higher incidence of gallstones than Asians, Caucasians, and African-Americans. This is believed to result from genes that promote inefficient calorie use and fat storage.
D) Native Americans have a higher incidence of gallstones than Asians, Caucasians, and African-Americans. This is believed to result from genes that promote inefficient calorie use and fat storage.

Question 12

A home health nurse is evaluating a client who had a colostomy placed 6 weeks ago for the treatment of ulcerative colitis.Which assessment will cause the nurse to conclude that teaching goals for this client have been met?
A) A colostomy pouch that is clean and dry
B) Vital signs that reveal a normal temperature
C) A stoma that is pink and intact
D) The client experiences pain with certain types of food.

Accepted Answer

A) Stoma care is taught to the client after surgery, and the goal is for the stoma to be pink with intact skin. It is not as critical that the ostomy pouch be clean and dry, particularly if the client has had a stool. A normal temperature would not be a particular goal for a client 6 weeks postoperatively. Patients with ulcerative colitis are going to have pain when they eat foods that irritate the bowel, but this is not a goal.
B) Stoma care is taught to the client after surgery, and the goal is for the stoma to be pink with intact skin. It is not as critical that the ostomy pouch be clean and dry, particularly if the client has had a stool. A normal temperature would not be a particular goal for a client 6 weeks postoperatively. Patients with ulcerative colitis are going to have pain when they eat foods that irritate the bowel, but this is not a goal.
C) Stoma care is taught to the client after surgery, and the goal is for the stoma to be pink with intact skin. It is not as critical that the ostomy pouch be clean and dry, particularly if the client has had a stool. A normal temperature would not be a particular goal for a client 6 weeks postoperatively. Patients with ulcerative colitis are going to have pain when they eat foods that irritate the bowel, but this is not a goal.
D) Stoma care is taught to the client after surgery, and the goal is for the stoma to be pink with intact skin. It is not as critical that the ostomy pouch be clean and dry, particularly if the client has had a stool. A normal temperature would not be a particular goal for a client 6 weeks postoperatively. Patients with ulcerative colitis are going to have pain when they eat foods that irritate the bowel, but this is not a goal.

Question 13

The nurse is caring for a client newly admitted to the hospital with uncomplicated cholelithiasis.Based on this data,which laboratory value does the nurse anticipate to be elevated?
A) Mean corpuscular hemoglobin concentration (MCHC)
B) Indirect bilirubin
C) Serum amylase
D) Alkaline phosphatase

Accepted Answer

A) Obstructive biliary disease causes a significant elevation in alkaline phosphatase. Obstruction in the biliary tract causes an elevation in direct bilirubin, not indirect bilirubin. The client's serum amylase and MCHC are unrelated.
B) Obstructive biliary disease causes a significant elevation in alkaline phosphatase. Obstruction in the biliary tract causes an elevation in direct bilirubin, not indirect bilirubin. The client's serum amylase and MCHC are unrelated.
C) Obstructive biliary disease causes a significant elevation in alkaline phosphatase. Obstruction in the biliary tract causes an elevation in direct bilirubin, not indirect bilirubin. The client's serum amylase and MCHC are unrelated.
D) Obstructive biliary disease causes a significant elevation in alkaline phosphatase. Obstruction in the biliary tract causes an elevation in direct bilirubin, not indirect bilirubin. The client's serum amylase and MCHC are unrelated.

Question 14

The nurse has identified the diagnosis Excess Fluid Volume as appropriate for a client with acute glomerulonephritis.What should the nurse assess to learn the most accurate indication of this client's fluid balance?
A) Vital signs
B) Intake and output records
C) Daily weight
D) Serum sodium levels

Accepted Answer

A) Daily weight provides the most accurate indication of fluid balance because of the pathophysiology of acute glomerulonephritis. Albumin is lost, causing decreased osmotic pressure and fluid shifting into the interstitial spaces. Accurate weights will provide data to indicate that treatments are effective in pulling fluids from interstitial spaces into the vascular system and then out via kidneys. Intake and output records, serum sodium levels, and vital signs will all provide data indicating fluid balance; however, they are not as accurate as daily weight for determining fluid balance.
B) Daily weight provides the most accurate indication of fluid balance because of the pathophysiology of acute glomerulonephritis. Albumin is lost, causing decreased osmotic pressure and fluid shifting into the interstitial spaces. Accurate weights will provide data to indicate that treatments are effective in pulling fluids from interstitial spaces into the vascular system and then out via kidneys. Intake and output records, serum sodium levels, and vital signs will all provide data indicating fluid balance; however, they are not as accurate as daily weight for determining fluid balance.
C) Daily weight provides the most accurate indication of fluid balance because of the pathophysiology of acute glomerulonephritis. Albumin is lost, causing decreased osmotic pressure and fluid shifting into the interstitial spaces. Accurate weights will provide data to indicate that treatments are effective in pulling fluids from interstitial spaces into the vascular system and then out via kidneys. Intake and output records, serum sodium levels, and vital signs will all provide data indicating fluid balance; however, they are not as accurate as daily weight for determining fluid balance.
D) Daily weight provides the most accurate indication of fluid balance because of the pathophysiology of acute glomerulonephritis. Albumin is lost, causing decreased osmotic pressure and fluid shifting into the interstitial spaces. Accurate weights will provide data to indicate that treatments are effective in pulling fluids from interstitial spaces into the vascular system and then out via kidneys. Intake and output records, serum sodium levels, and vital signs will all provide data indicating fluid balance; however, they are not as accurate as daily weight for determining fluid balance.

Question 15

An adolescent client is experiencing abdominal pain with diarrhea and bloody stools.Based on this data,which specific type of inflammatory bowel disease does the nurse suspect the client is experiencing?
A) Appendicitis
B) Ulcerative colitis
C) Crohn's disease
D) Necrotizing enterocolitis

Accepted Answer

A) Diarrhea and bloody stools are typical symptoms of ulcerative colitis. Appendicitis is not associated with bloody stools, and usually not with diarrhea. The teen with Crohn disease might have abdominal pain and diarrhea, but stools usually do not have blood in them. Necrotizing enterocolitis is usually seen in premature infants and not generally in an adolescent client.
B) Diarrhea and bloody stools are typical symptoms of ulcerative colitis. Appendicitis is not associated with bloody stools, and usually not with diarrhea. The teen with Crohn disease might have abdominal pain and diarrhea, but stools usually do not have blood in them. Necrotizing enterocolitis is usually seen in premature infants and not generally in an adolescent client.
C) Diarrhea and bloody stools are typical symptoms of ulcerative colitis. Appendicitis is not associated with bloody stools, and usually not with diarrhea. The teen with Crohn disease might have abdominal pain and diarrhea, but stools usually do not have blood in them. Necrotizing enterocolitis is usually seen in premature infants and not generally in an adolescent client.
D) Diarrhea and bloody stools are typical symptoms of ulcerative colitis. Appendicitis is not associated with bloody stools, and usually not with diarrhea. The teen with Crohn disease might have abdominal pain and diarrhea, but stools usually do not have blood in them. Necrotizing enterocolitis is usually seen in premature infants and not generally in an adolescent client.

Question 16

The nurse is teaching the family of a school-age client diagnosed with inflammatory bowel disease on the administration of prednisone at home.At which time should the nurse instruct the parents to provide the medication to the client?
A) 1 hour before meals
B) At bedtime
C) With meals
D) Between meals

Accepted Answer

A) Prednisone, a corticosteroid, can cause gastric irritation. It should be administered with meals to reduce the gastric irritation. It should not be given on an empty stomach.
B) Prednisone, a corticosteroid, can cause gastric irritation. It should be administered with meals to reduce the gastric irritation. It should not be given on an empty stomach.
C) Prednisone, a corticosteroid, can cause gastric irritation. It should be administered with meals to reduce the gastric irritation. It should not be given on an empty stomach.
D) Prednisone, a corticosteroid, can cause gastric irritation. It should be administered with meals to reduce the gastric irritation. It should not be given on an empty stomach.

Question 17

The nurse is caring for a client newly admitted to the medical-surgical unit with glomerulonephritis.Which classic manifestations of this disorder should the nurse expect to assess in this client? Select all that apply.
A) Edema
B) Weight loss
C) Hematuria
D) Acute flank pain
E) Proteinuria

Accepted Answer

A) Hematuria, proteinuria, and edema are the classic signs of glomerular disease because this disorder affects the structure and function of the glomerulus, disrupting glomerular filtration. This increased permeability in the glomeruli leads to plasma proteins being lost in the urine as well as red blood cells. Edema occurs because of the loss of plasma proteins, namely albumin. Acute flank pain is often more characteristic of renal calculi. Weight loss is a nonspecific symptom that can occur with many disorders, but not typically with glomerulonephritis.
B) Hematuria, proteinuria, and edema are the classic signs of glomerular disease because this disorder affects the structure and function of the glomerulus, disrupting glomerular filtration. This increased permeability in the glomeruli leads to plasma proteins being lost in the urine as well as red blood cells. Edema occurs because of the loss of plasma proteins, namely albumin. Acute flank pain is often more characteristic of renal calculi. Weight loss is a nonspecific symptom that can occur with many disorders, but not typically with glomerulonephritis.
C) Hematuria, proteinuria, and edema are the classic signs of glomerular disease because this disorder affects the structure and function of the glomerulus, disrupting glomerular filtration. This increased permeability in the glomeruli leads to plasma proteins being lost in the urine as well as red blood cells. Edema occurs because of the loss of plasma proteins, namely albumin. Acute flank pain is often more characteristic of renal calculi. Weight loss is a nonspecific symptom that can occur with many disorders, but not typically with glomerulonephritis.
D) Hematuria, proteinuria, and edema are the classic signs of glomerular disease because this disorder affects the structure and function of the glomerulus, disrupting glomerular filtration. This increased permeability in the glomeruli leads to plasma proteins being lost in the urine as well as red blood cells. Edema occurs because of the loss of plasma proteins, namely albumin. Acute flank pain is often more characteristic of renal calculi. Weight loss is a nonspecific symptom that can occur with many disorders, but not typically with glomerulonephritis.
E) Hematuria, proteinuria, and edema are the classic signs of glomerular disease because this disorder affects the structure and function of the glomerulus, disrupting glomerular filtration. This increased permeability in the glomeruli leads to plasma proteins being lost in the urine as well as red blood cells. Edema occurs because of the loss of plasma proteins, namely albumin. Acute flank pain is often more characteristic of renal calculi. Weight loss is a nonspecific symptom that can occur with many disorders, but not typically with glomerulonephritis.

Question 18

The nurse is caring for an older adult client with cholecystitis.The client has been admitted to the hospital for diagnostic testing and pain control.Which nursing diagnosis would be a priority for this client?
A) Anxiety
B) Risk for Infection
C) Impaired Comfort
D) Imbalanced Nutrition: Less than Body Requirements

Accepted Answer

A) All of these diagnoses are appropriate for the client with gallbladder disease. However, because the elderly client does not have as effective an immune system as younger clients, the nurse should prioritize care around preventing infection in this client.
B) All of these diagnoses are appropriate for the client with gallbladder disease. However, because the elderly client does not have as effective an immune system as younger clients, the nurse should prioritize care around preventing infection in this client.
C) All of these diagnoses are appropriate for the client with gallbladder disease. However, because the elderly client does not have as effective an immune system as younger clients, the nurse should prioritize care around preventing infection in this client.
D) All of these diagnoses are appropriate for the client with gallbladder disease. However, because the elderly client does not have as effective an immune system as younger clients, the nurse should prioritize care around preventing infection in this client.

Question 19

A client with cholelithiasis is in the clinic for a follow-up assessment following hospitalization.What lifestyle modification should the nurse teach the client to decrease the pain associated with the disease process?
A) Reduce sodium intake
B) Decrease fat consumption
C) Increase fluids
D) Decrease smoking

Accepted Answer

A) The client who is experiencing cholelithiasis should be instructed on the relationship between increased fat consumption and the severity of pain associated with cholelithiasis. While all clients should be instructed to reduce sodium intake, decreasing sodium will not assist in reducing cholelithiasis or its pain. Increasing fluids will not assist in reducing cholelithiasis or its pain. While all clients should cease smoking, it has no relationship to cholelithiasis.
B) The client who is experiencing cholelithiasis should be instructed on the relationship between increased fat consumption and the severity of pain associated with cholelithiasis. While all clients should be instructed to reduce sodium intake, decreasing sodium will not assist in reducing cholelithiasis or its pain. Increasing fluids will not assist in reducing cholelithiasis or its pain. While all clients should cease smoking, it has no relationship to cholelithiasis.
C) The client who is experiencing cholelithiasis should be instructed on the relationship between increased fat consumption and the severity of pain associated with cholelithiasis. While all clients should be instructed to reduce sodium intake, decreasing sodium will not assist in reducing cholelithiasis or its pain. Increasing fluids will not assist in reducing cholelithiasis or its pain. While all clients should cease smoking, it has no relationship to cholelithiasis.
D) The client who is experiencing cholelithiasis should be instructed on the relationship between increased fat consumption and the severity of pain associated with cholelithiasis. While all clients should be instructed to reduce sodium intake, decreasing sodium will not assist in reducing cholelithiasis or its pain. Increasing fluids will not assist in reducing cholelithiasis or its pain. While all clients should cease smoking, it has no relationship to cholelithiasis.

Question 20

The nurse provides teaching on the diagnosis Risk for Deficient Fluid Volume to a client with ulcerative colitis.Which client statement indicates understanding of this information?
A) "I will drink 1 liter of fluid each day."
B) "I will continue to use a moisturizer on my skin."
C) "I should report dry patches of skin immediately to my doctor."
D) "If I have two liquid stools in any day, I will report this to my health care provider."

Accepted Answer

A) The client with irritable bowel syndrome is taught to maintain a higher-than-normal fluid intake to maintain hydration. The client's dry patches could be due to fluid deficit but would not require immediate notification. Two liquid stools a day is not excessive, but the client needs to take in enough fluid to account for the stools as well as the normal fluid needs of the body. Moisturizing the skin is a positive action of the client but does not indicate appropriate understanding of the teaching that is appropriate for this diagnosis.
B) The client with irritable bowel syndrome is taught to maintain a higher-than-normal fluid intake to maintain hydration. The client's dry patches could be due to fluid deficit but would not require immediate notification. Two liquid stools a day is not excessive, but the client needs to take in enough fluid to account for the stools as well as the normal fluid needs of the body. Moisturizing the skin is a positive action of the client but does not indicate appropriate understanding of the teaching that is appropriate for this diagnosis.
C) The client with irritable bowel syndrome is taught to maintain a higher-than-normal fluid intake to maintain hydration. The client's dry patches could be due to fluid deficit but would not require immediate notification. Two liquid stools a day is not excessive, but the client needs to take in enough fluid to account for the stools as well as the normal fluid needs of the body. Moisturizing the skin is a positive action of the client but does not indicate appropriate understanding of the teaching that is appropriate for this diagnosis.
D) The client with irritable bowel syndrome is taught to maintain a higher-than-normal fluid intake to maintain hydration. The client's dry patches could be due to fluid deficit but would not require immediate notification. Two liquid stools a day is not excessive, but the client needs to take in enough fluid to account for the stools as well as the normal fluid needs of the body. Moisturizing the skin is a positive action of the client but does not indicate appropriate understanding of the teaching that is appropriate for this diagnosis.

Quiz 10: Inflammation

The nurse is caring for an African-American client with nephritis.For which long-term complication should the nurse include interventions to prevent when planning this client's care?

A nurse caring for a pediatric client with inflammatory bowel disease (IBD) understands that there are variances in the presentation of IBD between children and adults.Which variances does the nurse anticipate for this pediatric client? Select all that apply.

A client is being scheduled for diagnostic tests to determine the presence of ulcerative colitis.For which diagnostic tests should the nurse plan to provide teaching? Select all that apply.

The nurse is caring for an adolescent client who has been non-adherent with the medical plan of care to treat Crohn disease.In order to increase adherent behavior,which complication associated with Crohn disease will the nurse include in the client's teaching plan?

A client who is 4 days post-cholecystectomy has T-tube drainage totaling 600 mL in 24 hours.Which actions by the nurse are appropriate based on this data? Select all that apply.

A nurse is receiving a client from the emergency department diagnosed with an acute exacerbation of ulcerative colitis (UC) .The nurse anticipates the client may present with which clinical characteristics? Select all that apply.

The nurse is evaluating care provided to an older adult client with a history of cholecystitis 5 months ago.Which statement indicates the client met a goal in the plan of care?

The nurse conducts an evaluation after completing a training session for community members on ways to prevent nephritis.When evaluating the success of this session,what responses should the members provide as evidence that learning has been successful? Select all that apply.

A nurse is caring for a client with severe acute abdominal pain secondary to cholelithiasis.Which nursing actions promote effective pain management? Select all that apply.

The nurse educator in a gastrostomy clinic is teaching a group of clients about how nutrition plays a role in the formation of gallstones.Which client would the nurse expect to benefit the most from this teaching session?

A home health nurse is evaluating a client who had a colostomy placed 6 weeks ago for the treatment of ulcerative colitis.Which assessment will cause the nurse to conclude that teaching goals for this client have been met?

The nurse is caring for a client newly admitted to the hospital with uncomplicated cholelithiasis.Based on this data,which laboratory value does the nurse anticipate to be elevated?

The nurse has identified the diagnosis Excess Fluid Volume as appropriate for a client with acute glomerulonephritis.What should the nurse assess to learn the most accurate indication of this client's fluid balance?

An adolescent client is experiencing abdominal pain with diarrhea and bloody stools.Based on this data,which specific type of inflammatory bowel disease does the nurse suspect the client is experiencing?

The nurse is teaching the family of a school-age client diagnosed with inflammatory bowel disease on the administration of prednisone at home.At which time should the nurse instruct the parents to provide the medication to the client?

The nurse is caring for a client newly admitted to the medical-surgical unit with glomerulonephritis.Which classic manifestations of this disorder should the nurse expect to assess in this client? Select all that apply.

The nurse is caring for an older adult client with cholecystitis.The client has been admitted to the hospital for diagnostic testing and pain control.Which nursing diagnosis would be a priority for this client?

A client with cholelithiasis is in the clinic for a follow-up assessment following hospitalization.What lifestyle modification should the nurse teach the client to decrease the pain associated with the disease process?

The nurse provides teaching on the diagnosis Risk for Deficient Fluid Volume to a client with ulcerative colitis.Which client statement indicates understanding of this information?