The nurse is writing a care plan for a client who was diagnosed with Crohn's disease a year ago and is now hospitalized with a fourth acute exacerbation. Which client problem should receive the highest priority?

Fluid overload

Altered body image

Imbalanced nutrition - less than body requirements

Social isolation

Answer and Explanation

The Correct Answer is C

C.   Crohn's disease exacerbation often leads to malnutrition due to decreased oral intake, malabsorption, and increased nutrient losses through diarrhea. Addressing imbalanced nutrition is crucial to replenish depleted nutrient stores, support healing, and prevent further complications.
A.   While fluid overload can be a concern in certain situations, such as when administering intravenous fluids or in clients with renal impairment, it is not typically a primary concern in clients hospitalized with Crohn's disease exacerbation. Crohn's disease is more commonly associated with dehydration due to diarrhea and malabsorption rather than fluid overload.
B.   In the acute phase of Crohn's disease exacerbation, addressing immediate physiological needs and stabilizing the client's condition typically take precedence over psychosocial concerns.
D. Social isolation can be a concern for clients with chronic illnesses, including Crohn's disease, as it may impact their quality of life and emotional well-being. However, in the acute phase of exacerbation, addressing physiological needs and stabilizing the client's condition typically takes precedence over psychosocial concerns such as social isolation.

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Correct Answer is B

Explanation

B. Bowel sounds are typically present and indicate normal gastrointestinal motility. A change from normoactive (normal) to absent bowel sounds can indicate bowel obstruction, perforation, or peritonitis, which are serious complications of diverticulitis. This change warrants immediate reporting to the physician as it may indicate a worsening condition requiring urgent intervention.
A. A temperature of 101.2°F (38.4°C) is slightly elevated and may indicate the presence of infection, which is concerning in the context of diverticulitis. Fever is a common symptom of diverticulitis, but an elevated temperature may also suggest worsening infection or the development of complications such as abscess formation or perforation.
C. Left lower quadrant discomfort is a common symptom of diverticulitis due to inflammation in the sigmoid colon, where diverticula are most prevalent. While discomfort is expected in diverticulitis, the severity and persistence of pain should be assessed.
D. An elevated white blood cell (WBC) count is indicative of inflammation or infection and is commonly seen in diverticulitis. However, the significance of the elevation depends on the degree of increase and the presence of other clinical findings.

A. "Frequency is greater in the northern United States." B. "Fluid excess is implicated in many cases of renal stones." C. "Diet plays a role in the formation of some types of stones." D. "Women have a greater risk overall than men."

Correct Answer is C

Explanation

C. Dietary factors, such as high intake of certain foods (e.g., animal protein, sodium, oxalate-rich foods) and low intake of others (e.g., fluids, calcium), can influence the composition of urine and contribute to the formation of renal stones. For example, calcium oxalate stones can form when there is an imbalance of calcium and oxalate in the urine, while uric acid stones can form in individuals with high purine diets.
A. The frequency of renal stones can vary depending on factors such as climate, dietary habits, and genetic predisposition, but it is not specifically associated with the northern United States.
B. Dehydration and inadequate fluid intake can contribute to the formation of renal stones, particularly calcium-based stones. Insufficient fluid intake can lead to concentrated urine, which increases the risk of stone formation and not vice versa.
D. The risk of renal stones is equal in both men and women.

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The nurse is writing a care plan for a client who was diagnosed with Crohn's disease a year ago and is now hospitalized with a fourth acute exacerbation. Which client problem should receive the highest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses a client admitted four hours ago with a diagnosis of diverticulitis. Which clinical manifestation must be reported immediately to the physician?

Correct Answer is B

Explanation

The nurse educator is speaking with a community group about renal disorders. Which statement is appropriate for the educator to include regarding renal stones?

Correct Answer is C

Explanation

A client with a new diagnosis of GERD is preparing for discharge from the hospital. Which foods will the nurse teach this client to avoid? (SELECT ALL THAT APPLY)

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The nurse is assessing a client who has a large bowel obstruction. Which late clinical finding would the nurse expect?

Which of the following is a common symptom of ulcerative colitis?