A nurse is caring for a preschooler who has a new diagnosis of celiac disease. Which of the following findings should the nurse expect?
Pale, oily stools
Redcurrant, jelly-like stools
Increased hemoglobin level
Hematemesis
The Correct Answer is A
A. Pale, oily stools: Celiac disease causes malabsorption due to an immune response to gluten, leading to steatorrhea. The stools are typically pale, foul-smelling, and oily because of impaired fat absorption.
B. Redcurrant, jelly-like stools: This type of stool is characteristic of intussusception, a condition where part of the intestine telescopes into itself, causing bleeding and mucus, not celiac disease.
C. Increased hemoglobin level: Children with celiac disease often experience iron deficiency anemia due to malabsorption, which lowers hemoglobin levels. An increase in hemoglobin would not be expected.
D. Hematemesis: Vomiting blood is not a typical finding in celiac disease. It is more commonly associated with upper gastrointestinal bleeding from ulcers or esophageal varices.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Paroxysmal coughing: This is most characteristic of pertussis (whooping cough), not rubeola (measles). Rubeola is primarily identified by fever, cough, coryza, conjunctivitis, and a distinct rash.
B. Koplik spots: Small, white lesions with a bluish center inside the mouth are pathognomonic for rubeola. They usually appear 2–3 days before the rash and are a key diagnostic feature of the disease.
C. Lymphadenopathy: While enlarged lymph nodes can occur with various viral illnesses, it is not a defining or expected feature of rubeola. The hallmark oral and skin findings are more specific.
D. Steatorrhea: Fatty, foul-smelling stools are associated with malabsorption syndromes such as cystic fibrosis or celiac disease. They are not linked to rubeola infection.
Correct Answer is []
Explanation
• Crohn's disease: The client’s presentation of hematochezia, abdominal pain, fever, anorexia, elevated CRP, hypoalbuminemia, anemia, and positive stool leukocytes points toward Crohn’s, an inflammatory bowel disease with systemic and intestinal involvement.
• Encourage a high-protein diet: Chronic inflammation and malabsorption in Crohn’s disease contribute to weight loss and muscle wasting, so a high-protein diet supports tissue repair and nutritional repletion.
• Record dietary intake: Careful documentation helps identify food triggers, ensures adequate caloric and protein intake, and provides a baseline for evaluating nutritional support interventions.
• Hemoglobin level: Clients with Crohn’s are prone to gastrointestinal blood loss, putting them at risk for anemia; trending hemoglobin values helps track disease activity and bleeding severity.
• Albumin level: Hypoalbuminemia in Crohn’s reflects both malnutrition and protein-losing enteropathy; monitoring this value provides insight into nutritional status and disease progression.
Rationale for Incorrect Choices
• Appendicitis: Appendicitis usually presents with localized right lower quadrant pain, rebound tenderness, and leukocytosis without chronic systemic signs like anemia or hypoalbuminemia, which are more consistent with Crohn’s disease.
• Peptic ulcer disease: Ulcers typically cause epigastric pain and possible melena, but they do not explain systemic inflammation, positive stool leukocytes, or low albumin seen in this case.
• Celiac disease: Celiac often presents with diarrhea, bloating, and steatorrhea, but this client’s hematochezia, fever, and elevated CRP are more consistent with inflammatory bowel disease.
• Administer an enema: This intervention is contraindicated in clients with bowel inflammation due to risk of worsening irritation or triggering perforation.
• Provide a gluten-free diet: While effective in celiac disease, it does not address the inflammation and malabsorption specific to Crohn’s disease.
• Prepare for surgery: Surgery is not the first-line intervention in Crohn’s unless complications like obstruction or perforation occur; conservative management is prioritized initially.
• Abrupt decrease in pain level: This is concerning for ruptured appendix and peritonitis, which are not primary features of Crohn’s disease progression.
• Abdominal rigidity: This is a sign of peritonitis, usually from perforation, which is not the presenting concern for this client with Crohn’s disease.
• Presence of steatorrhea: Steatorrhea is more typical of celiac disease or pancreatic insufficiency rather than Crohn’s, which more commonly presents with bloody stools.
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