A nurse in an acute care facility is caring for a toddler.
For each assessment finding below, click to specify if the assessment finding is consistent with Crohn's disease, appendicitis, or intussusception. Each finding may support more than 1 disease process.
Pain rating
Vomiting
Stool
Temperature
Abdominal findings
The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B,C"},"C":{"answers":"A,C"},"D":{"answers":"B"},"E":{"answers":"C"}}
- Pain rating: Severe, intermittent abdominal pain where the child draws their knees to the chest and then returns to normal behavior is a classic symptom of intussusception. Neither Crohn’s disease nor appendicitis typically presents with this pattern, appendicitis pain is usually constant and worsening, while Crohn’s pain is chronic and non-episodic.
- Vomiting: Vomiting in intussusception is common and often non-bilious in early stages, aligning with the child's light-colored emesis. Vomiting also occurs in appendicitis, especially in the early stages. However, it is not a prominent or early symptom of Crohn’s disease unless obstruction is present.
- Stool: The presence of blood and mucus in the stool ("currant jelly stool") is strongly associated with intussusception and may also occur in Crohn’s disease during flares due to colonic inflammation. Appendicitis does not typically cause bloody or mucoid stools, making this finding inconsistent with that diagnosis.
- Temperature: A temperature of 37.4°C is within normal limits, appendicitis however may present with low grade fever. The absence of fever at this time limits its diagnostic value in this case.
- Abdominal findings: A distended abdomen with hypoactive bowel sounds and a palpable sausage-shaped mass in the right upper quadrant is highly indicative of intussusception. These findings are not characteristic of appendicitis, which usually involves RLQ pain, or Crohn’s, which rarely presents with a discrete palpable mass.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "The proxy should manage legal issues for the client." Legal matters are outside the scope of a health care proxy’s role. The proxy is authorized only to make medical decisions and does not handle legal or court-related concerns on behalf of the client.
B. "The proxy can make treatment decisions if the client is under anesthesia." The health care proxy is activated when the client is temporarily or permanently incapacitated, such as during surgery under anesthesia. At that point, the proxy can make treatment decisions aligned with the client’s values and previously expressed wishes.
C. "The proxy can make financial decisions if the need arises." Financial decisions are the responsibility of a financial power of attorney, not a health care proxy. A DPAHC limits the proxy’s authority strictly to medical and treatment-related decisions.
D. "The proxy should make health care decisions for the client regardless of the client's ability to do so." The health care proxy is not active while the client is competent and able to make decisions. The proxy only assumes responsibility when the client lacks decision-making capacity due to illness, unconsciousness, or cognitive impairment.
Correct Answer is D
Explanation
A. Ham sandwich with milk. Ham is pork, which is strictly forbidden in kosher diets. Additionally, kosher law prohibits mixing meat and dairy in the same meal, making this option doubly inappropriate.
B. Bacon and cheese quiche with milk. Bacon is derived from pork and is non-kosher. The combination of meat (if using real bacon) and dairy (cheese and milk) also violates kosher dietary restrictions.
C. Shrimp salad and tomato soup with milk. Shellfish like shrimp are not kosher and are strictly avoided. Even though tomato soup and milk may be acceptable, the presence of shrimp makes this tray non-compliant with kosher laws.
D. Scrambled eggs and toast with milk. Eggs are permitted in a kosher diet as long as they do not contain blood spots, and dairy products like milk are also allowed. Since this meal contains no meat or non-kosher items, it aligns with kosher guidelines.
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