The nurse provides care for a client with a long history of ulcerative colitis. The client is most at risk to develop which disorder?

Colon cancer

Crohn disease

Lactase deficiency

Irritable bowel syndrome

Answer and Explanation

The Correct Answer is A

Choice A reason: Colon cancer is the most likely disorder that the client is at risk to develop because it is a type of cancer that affects the large intestine, which is the part of the digestive tract that absorbs water and forms stool. Colon cancer can be caused by various factors, such as genetics, diet, or inflammation. Ulcerative colitis is a chronic inflammatory bowel disease that causes ulcers and inflammation in the inner lining of the colon and rectum, which are the last parts of the large intestine. Ulcerative colitis can increase the risk of colon cancer by causing DNA damage and abnormal cell growth in the colon.

Choice B reason: Crohn disease is not the most likely disorder that the client is at risk to develop because it is a different type of inflammatory bowel disease that causes inflammation and damage in any part of the digestive tract, from the mouth to the anus. Crohn disease can be caused by various factors, such as genetics, immune system, or bacteria. Ulcerative colitis and Crohn disease have some similar symptoms, such as diarrhea, abdominal pain, or weight loss, but they are not the same condition and do not increase the risk of each other.

Choice C reason: Lactase deficiency is not the most likely disorder that the client is at risk to develop because it is a condition where the body does not produce enough lactase, which is an enzyme that breaks down lactose, which is a sugar that is found in milk and dairy products. Lactase deficiency can cause symptoms such as bloating, gas, or diarrhea after consuming lactose. Lactase deficiency can be caused by various factors, such as genetics, age, or intestinal injury. Ulcerative colitis does not affect the production of lactase, but it can cause lactose intolerance, which is a condition where the body cannot digest lactose properly due to the inflammation and damage of the colon.

Choice D reason: Irritable bowel syndrome is not the most likely disorder that the client is at risk to develop because it is a functional disorder that affects the movement and sensitivity of the bowel, causing symptoms such as abdominal pain, cramping, or constipation. Irritable bowel syndrome can be triggered by various factors, such as stress, food, or hormones. Irritable bowel syndrome does not cause inflammation or damage to the bowel, unlike ulcerative colitis, and it does not increase the risk of colon cancer.

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Correct Answer is A

Explanation

Choice A reason: Serum osmolality 380 mOsm/kg is the expected finding because it is a sign of dehydration, which is a common complication of diabetes insipidus. Diabetes insipidus is a condition where the body does not produce enough antidiuretic hormone (ADH), which is a hormone that helps the kidneys retain water and regulate the fluid balance in the body. A severe traumatic brain injury can damage the pituitary gland or the hypothalamus, which are parts of the brain that produce and secrete ADH. Without enough ADH, the kidneys produce large amounts of diluted urine, which causes the loss of water and electrolytes from the body. This increases the concentration of solutes in the blood, which is measured by the serum osmolality. A normal serum osmolality is between 275 and 295 mOsm/kg, while a high serum osmolality is above 300 mOsm/kg.

Choice B reason: Urine output of 500 mL in 24 hours is not the expected finding because it is a sign of oliguria, which is a low urine output. Oliguria can be caused by various factors, such as dehydration, kidney failure, or urinary obstruction, and can result in symptoms such as fluid retention, swelling, or electrolyte imbalance. Oliguria is not a common finding in diabetes insipidus, because the condition causes polyuria, which is a high urine output. Polyuria can be defined as urine output of more than 3 liters in 24 hours, or more than 200 mL per hour.

Choice C reason: Weight gain of 5 pounds in 48 hours is not the expected finding because it is a sign of fluid overload, which is a condition where the body retains too much fluid, which can cause edema, hypertension, and heart failure. Fluid overload can be caused by various factors, such as heart failure, kidney failure, or liver failure, and can result in symptoms such as shortness of breath, chest pain, or fatigue. Fluid overload is not a common finding in diabetes insipidus, because the condition causes dehydration, which is a loss of fluid from the body. Dehydration can cause weight loss, not weight gain.

Choice D reason: Decreased serum hematocrit levels is not the expected finding because it is a sign of anemia, which is a condition where the blood has a low level of hemoglobin, which is the protein that carries oxygen in the red blood cells. Anemia can be caused by various factors, such as blood loss, iron deficiency, or bone marrow failure, and can result in symptoms such as fatigue, weakness, or pallor. Anemia is not a common finding in diabetes insipidus, because the condition does not affect the production or function of the red blood cells. Diabetes insipidus can cause increased serum hematocrit levels, not decreased, because the loss of water from the body can increase the proportion of red blood cells in the blood.

A. Glomerulonephritis B. Fluid volume deficit C. Neurogenic bladder D. Renal calculus

Correct Answer is B

Explanation

Choice A reason: Glomerulonephritis is an inflammation of the glomeruli, the filtering units of the kidneys. It can cause damage to the renal tissue and lead to intrinsic acute kidney injury, not prerenal acute kidney injury.

Choice B reason: Fluid volume deficit is a condition in which the body loses more fluid than it takes in. It can cause hypovolemia, which reduces the blood flow to the kidneys and impairs their function. This is the most common cause of prerenal acute kidney injury, which is a result of decreased perfusion to the kidneys.

Choice C reason: Neurogenic bladder is a dysfunction of the bladder caused by a nerve problem. It can affect the ability to store or empty urine. It can cause urinary retention, which increases the pressure in the urinary tract and damages the kidneys. This is a type of postrenal acute kidney injury, which is a result of obstruction to the urine outflow.

Choice D reason: Renal calculus is a solid mass formed from crystals in the urine. It can block the ureter, the tube that carries urine from the kidney to the bladder. It can cause hydronephrosis, which is a swelling of the kidney due to accumulation of urine. This is another type of postrenal acute kidney injury.

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The nurse provides care for a client with a long history of ulcerative colitis. The client is most at risk to develop which disorder?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client developed diabetes insipidus as a result of a severe traumatic brain injury. Which finding does the nurse expect to observe?

Correct Answer is A

Explanation

Which risk factor is significant for development of prerenal acute kidney injury?

Correct Answer is B

Explanation

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