A nurse is educating a client about preventing skin cancer.
Which of the following client statements indicates a need for further teaching?

Choice A rationale
This statement is not entirely accurate. Crohn’s disease does not resemble a second-degree burn. It is an inflammatory bowel disease that can affect any part of the gastrointestinal tract.
Choice B rationale
While this statement is technically correct, it uses medical jargon that may be difficult for a patient to understand. Crohn’s disease is indeed characterized by transmural granulomatous inflammation, meaning it affects the entire wall of the gastrointestinal tract. However, this description may not be easily understood by a patient without a medical background.
Choice C rationale
This statement is partially correct but not entirely accurate. Crohn’s disease can cause inflammation in the mucosa and sub-mucosa of the colon and rectal linings, but it is not limited to these areas. It can affect any part of the gastrointestinal tract from the mouth to the anus.
Choice D rationale
This is the most simplistic and non-medical description of the disorder. Crohn’s disease can indeed give the appearance of a “patchwork quilt” in the gastrointestinal tract, with some areas

clear and others inflamed or ulcerated. This description provides a visual analogy that may be easier for a patient to understand.

Choice C rationale
Hepatic encephalopathy is a condition that can cause confusion or delirium in patients with end-stage liver disease and increasing ascites. It occurs when the liver is unable to remove toxins from the blood, such as ammonia, which can then accumulate in the brain and affect mental function. This condition is common in patients with cirrhosis or end-stage liver disease, and can manifest as confusion, changes in sleep patterns, mood alterations, and, in severe cases, coma.
Choice A rationale
While dementia can cause confusion and changes in mental status, it is typically a progressive condition that develops over time. In the context of a patient with end-stage liver failure and

increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice B rationale
Schizophrenia is a chronic mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior. It is not typically associated with end-stage liver disease or ascites. In the context of a patient with end-stage liver failure and increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice D rationale
While a urinary tract infection (UTI) can cause confusion, especially in older adults, it would not typically be the primary suspect in a patient with end-stage liver failure and increasing ascites. In such a patient, hepatic encephalopathy is a more likely cause of confusion or delirium.