A nurse is caring for a client.

Exhibits

For each assessment finding, click to specify if the finding is consistent with ulcerative colitis, diverticulitis, or Crohn's disease. Each finding may support more than 1 disease process.

Steatorrhea

Weight loss

Diarrhea

Fever

Anemia

Answer and Explanation

The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A,B"},"C":{"answers":"A,B,C"},"D":{"answers":"A,B,C"},"E":{"answers":"A,C"}}

Steatorrhea (Fatty stool) Consistent with Crohn's Disease

Steatorrhea refers to the presence of fat in the stool, which often results in fatty, foul-smelling stools. This is seen in Crohn's disease due to malabsorption in the small intestine (especially in the ileum), where fat is not absorbed properly. Ulcerative colitis typically affects the colon, not the small intestine, and does not usually result in steatorrhea. Diverticulitis is an infection or inflammation of diverticula in the colon and is not associated with steatorrhea.

Weight Loss

Consistent with Ulcerative Colitis and Crohn's Disease

Weight loss is a common finding in both ulcerative colitis and Crohn’s disease. In Crohn's disease, weight loss occurs due to malabsorption and inflammatory damage in the gastrointestinal tract. In ulcerative colitis, weight loss can occur during flare-ups due to poor nutrient absorption and inflammation of the colon. Diverticulitis may cause weight loss if it leads to complications like chronic inflammation, but it is not a primary or typical symptom.

Diarrhea

Consistent with Ulcerative Colitis, Diverticulitis and Crohn's Disease

Diarrhea is a hallmark symptom of both ulcerative colitis and Crohn's disease. In ulcerative colitis, diarrhea is usually accompanied by blood and mucus, as the disease primarily affects the colon. In Crohn’s disease, diarrhea is also common, but it may be more chronic and associated with areas of the GI tract other than the colon, such as the small intestine. Diverticulitis typically presents with abdominal pain, fever, and changes in bowel habits- diarrhea in 25% of patients.

Fever

Consistent with Ulcerative Colitis, Diverticulitis, and Crohn's Disease

Fever can be seen in all three conditions, though it is more commonly associated with diverticulitis during an acute infection of the diverticula. Fever in ulcerative colitis and Crohn’s disease can occur during active inflammation or flare-ups, especially if there is significant bowel involvement or complications like perforation or abscess. In Crohn's disease, fever is often seen in more severe or complicated disease phases, but it is not always present. Diverticulitis often presents with fever, especially in the case of an infection or abscess formation.

Anemia

Consistent with Ulcerative Colitis and Crohn's Disease

Anemia can be seen in both ulcerative colitis and Crohn's disease. In ulcerative colitis, chronic blood loss due to inflammation and ulceration in the colon can lead to iron-deficiency anemia. In Crohn's disease, anemia can result from chronic inflammation, bleeding, or malabsorption of nutrients (like iron, vitamin B12, or folic acid). Diverticulitis may also cause anemia, particularly if there is significant bleeding, but it is not a hallmark feature like it is in ulcerative colitis and Crohn’s disease.

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Correct Answer is C

Explanation

A. Sinus arrhythmia is typically not life-threatening and does not require immediate assessment unless other symptoms are present.
B. Epidural analgesia can cause some weakness in the lower extremities, but this is a known side effect and not an emergency.
C. Tachypnea, especially with a new onset in a client with a hip fracture, may indicate complications such as a fat embolism or pulmonary embolism, which require immediate assessment.
D. An HbA1c of 7.2% is slightly above the target but is not an immediate concern compared to other acute symptoms.

A. Pale and a 24-hr fluid deficit of 30 mL B. Decreased appetite and irritability C. Temperature 38° C (100.4° F) and pulse rate 124/min D. Sunken fontanels and dry mucous membranes

Correct Answer is D

Explanation

A. A small fluid deficit of 30 mL is not concerning unless it worsens or additional symptoms develop.
B. Decreased appetite and irritability can be expected with gastroenteritis and may not require immediate intervention.
C. A mild fever and increased pulse rate can be expected, but if these values remain stable and other signs of dehydration or worsening illness are absent, they do not require immediate intervention.
D. Sunken fontanels and dry mucous membranes are signs of dehydration and should be reported to the provider immediately.

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System	Findings
General	Adult child accompanying parent reports decline in client, expressing concern over memory and thought process, appetite, and self-care. Adult child states, "My sibling and I hired help at home for my parent. We thought that would help but it has not. I found the title to the car today, signed over to me."
Physical	Client makes poor eye contact, speaks in a monotone voice, and has a lack of facial expression. Client reports sleeping 7 hr a night and getting up "once or twice per night to go to the bathroom." Client reports not wanting to eat anymore. Client's child reports their parent has lost about 8 lb in the past month. Heart rate 68/min
Affect	Client says, "Why don't you just leave me? I am of no use."

A nurse is caring for a client. Exhibits For each assessment finding, click to specify if the finding is consistent with ulcerative colitis, diverticulitis, or Crohn's disease. Each finding may support more than 1 disease process.

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Naxlex Comprehensive Predictor Exams

A nurse is receiving change-of-shift report for a group of clients. Which of the following clients should the nurse plan to assess first?

Correct Answer is C

Explanation

A nurse is caring for an infant who has gastroenteritis. Which of the following assessment findings should the nurse report to the provider?

Correct Answer is D

Explanation

A nurse is preparing to insert an IV catheter for a client. Which of the following actions should the nurse plan to take?

A charge nurse is teaching new staff members about factors that increase a client's risk to become violent. Which of the following risk factors should the nurse include as the best predictor of future violence?

A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of the following factors places the client at risk for aspiration?

A nurse is preparing to obtain a health history from a client who is on bedrest. Which of the following positions should the nurse take to place the client at ease?

A nurse is assisting with food selection for a client who follows kosher dietary traditions. Which of the following food choices should the nurse include on the client's food tray?

A nurse is caring for a client who has end-stage liver disease and is undergoing a paracentesis. Which of the following actions should the nurse take to evaluate the effectiveness of the procedure?

A nurse is caring for a client in a clinic. Exhibits Based on the information in the client's medical record, which of the following findings require immediate follow-up? Select the 4 findings that require follow-up.

A nurse is caring for a client.

Exhibits

For each assessment finding, click to specify if the finding is consistent with ulcerative colitis, diverticulitis, or Crohn's disease. Each finding may support more than 1 disease process.