The nurse is caring for a client with ulcerative colitis. Which findings does the nurse determine is consistent with this diagnosis? (Select all that apply)
Hypercalcemia.
Hypernatremia.
Frothy, fatty stools.
Bloody stool.
10 to 20 liquid stools daily.
Complains of pain at right lower abdominal quadrant.
Complains of pain at left lower abdominal quadrant.
Correct Answer : D,E,G
Choice A reason: Hypercalcemia is not associated with ulcerative colitis, which affects the colon and causes diarrhea. Bloody stools are typical, making this incorrect, as it’s unrelated to the nurse’s expected findings in a client with ulcerative colitis during assessment.
Choice B reason: Hypernatremia may occur with dehydration but isn’t specific to ulcerative colitis. Frequent bloody stools are hallmark signs, making this incorrect, as it’s not a primary finding compared to the nurse’s expected manifestations in ulcerative colitis diagnosis.
Choice C reason: Frothy, fatty stools indicate malabsorption, typical in Crohn’s or pancreatic issues, not ulcerative colitis. Bloody stools are correct, making this incorrect, as it doesn’t align with the nurse’s anticipated findings in a client with ulcerative colitis.
Choice D reason: Bloody stool is a classic finding in ulcerative colitis due to mucosal inflammation and ulceration. This aligns with gastrointestinal assessment, making it a correct finding the nurse would determine is consistent with the client’s ulcerative colitis diagnosis.
Choice E reason: 10 to 20 liquid stools daily reflect severe diarrhea, a key feature of ulcerative colitis exacerbations. This aligns with clinical manifestations, making it a correct finding the nurse would identify in a client diagnosed with ulcerative colitis during assessment.
Choice F reason: Right lower quadrant pain is more typical of Crohn’s or appendicitis, not ulcerative colitis, which affects the left colon. Left quadrant pain is correct, making this incorrect, as it doesn’t support the nurse’s findings for ulcerative colitis diagnosis.
Choice G reason: Left lower quadrant pain is consistent with ulcerative colitis, as inflammation often affects the sigmoid colon. This aligns with abdominal assessment, making it a correct finding the nurse would expect in a client with ulcerative colitis during evaluation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Limiting dietary fiber is incorrect for IBS, as soluble fiber helps regulate bowel movements. This indicates a need for further teaching, making it the correct statement, as it contradicts the nurse’s instructions to include fiber for IBS symptom management.
Choice B reason: Drinking 8 to 10 cups of fluid daily supports hydration and bowel function in IBS, showing understanding. This is incorrect, as it aligns with the nurse’s teaching, unlike the fiber limitation statement requiring further client education.
Choice C reason: Eating regular meals and chewing well stabilizes digestion in IBS, reflecting correct understanding. This is incorrect, as it aligns with the nurse’s instructions, unlike the fiber limitation statement that indicates a need for further teaching.
Choice D reason: Taking prescribed medications to regulate bowel patterns is appropriate for IBS management, showing understanding. This is incorrect, as it aligns with the nurse’s teaching, unlike the incorrect fiber limitation statement needing further client instruction.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A reason: Disagreements among team members signal conflicting values, an early ethical dilemma indicator. This aligns with healthcare ethics, making it a correct situation, as it highlights potential ethical tensions that the nurse should recognize as requiring resolution in patient care.
Choice B reason: Failure to discuss end-of-life issues with the patient violates autonomy, creating an ethical dilemma. This aligns with ethical principles of patient involvement, making it a correct early sign the nurse should identify in healthcare decision-making processes.
Choice C reason: Aggressive pain management is a clinical decision, not inherently an ethical dilemma unless harm is suspected. Disagreements or belief in harm are clearer signs, making this incorrect, as it lacks the ethical conflict context in the nurse’s evaluation.
Choice D reason: Believing treatment is harmful raises ethical concerns about beneficence and nonmaleficence, indicating a dilemma. This aligns with ethical care standards, making it a correct situation the nurse should recognize as an early sign of an ethical issue in treatment decisions.
Choice E reason: Following an advance directive despite family objections creates an ethical conflict between patient autonomy and family wishes. This aligns with end-of-life ethics, making it a correct early sign of a dilemma the nurse should identify in patient care.
Choice F reason: Providing hope to the family is supportive and not inherently an ethical dilemma unless it involves deception. Failure to discuss end-of-life issues is a clearer sign, making this incorrect, as it lacks the ethical conflict context in the nurse’s assessment.
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