Which of the following is a characteristic feature of Crohn's disease?
Formation of fistulas and abscesses.
Symptoms confined to the large intestine.
Improvement with the use of antibiotics.
Presence of rectal bleeding.
The Correct Answer is A
Choice A rationale
Formation of fistulas (abnormal connections between organs) and abscesses (collections of pus) are characteristic complications of Crohn's disease. The transmural inflammation in Crohn's disease can penetrate through the bowel wall, leading to these developments.
Choice B rationale
Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus, although it most commonly involves the ileum and colon. Symptoms are not confined to the large intestine. Ulcerative colitis, another inflammatory bowel disease, primarily affects the colon.
Choice C rationale
While antibiotics may be used to treat secondary infections or complications of Crohn's disease, they are not a primary treatment for the underlying inflammatory process and do not typically lead to improvement of the disease itself. Crohn's disease is a chronic inflammatory condition that requires immunomodulatory or anti-inflammatory medications.
Choice D rationale
Rectal bleeding is more commonly associated with ulcerative colitis, where the inflammation is typically limited to the mucosal layer of the colon and rectum, leading to ulceration and bleeding. While some bleeding can occur in Crohn's disease, it is generally less prominent than in ulcerative colitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Checking blood glucose levels for hypoglycemia once yearly is insufficient for a patient taking high doses of oral glucocorticoids for an extended period. Glucocorticoids can cause hyperglycemia by increasing gluconeogenesis and insulin resistance. Therefore, blood glucose monitoring should be more frequent, especially when initiating or adjusting the dosage. Normal fasting blood glucose levels are typically 70-99 mg/dL.
Choice B rationale
Limiting the intake of calcium-rich foods is incorrect advice for a patient on long-term glucocorticoid therapy. Glucocorticoids can decrease calcium absorption from the gut and increase bone resorption, leading to osteoporosis. Therefore, patients on these medications should be encouraged to maintain an adequate intake of calcium and vitamin D to help preserve bone density. Normal total serum calcium levels range from 8.6 to 10.2 mg/dL.
Choice C rationale
Monitoring for fractures over the next several months is an important instruction for a patient taking high doses of oral glucocorticoids long-term. Glucocorticoids increase the risk of osteoporosis and subsequent fractures, particularly vertebral compression fractures and hip fractures, due to their effects on bone metabolism. Regular monitoring and preventive measures are crucial.
Choice D rationale
Glucocorticoids do not boost immunity; instead, they suppress the immune system by inhibiting the production and function of various immune cells and inflammatory mediators. This immunosuppressive effect is why they are used to treat autoimmune diseases like rheumatoid arthritis, but it also increases the risk of infections.
Correct Answer is A
Explanation
Choice A rationale
Elevating the affected leg promotes venous return and lymphatic drainage, which helps to reduce swelling and inflammation associated with cellulitis. Gravity assists in the removal of excess fluid from the interstitial spaces, thereby alleviating pressure and promoting healing.
Choice B rationale
Applying fresh ice packs every 4 hours can provide some pain relief and vasoconstriction, potentially reducing inflammation in the initial stages of cellulitis. However, heat is generally preferred after the acute inflammatory phase to promote circulation and healing. Frequent, prolonged ice application might impede blood flow.
Choice C rationale
While rest is important for healing, enforcing strict bedrest for 3 days might not be necessary and could increase the risk of complications such as deep vein thrombosis. Moderate activity with elevation is usually recommended to promote circulation without exacerbating the infection.
Choice D rationale
Cellulitis is a deep infection of the skin and subcutaneous tissues, typically caused by bacteria entering through a break in the skin. Applying topical antibiotic ointment is unlikely to reach the deeper infected tissues and is not the primary treatment. Systemic antibiotics are required to treat cellulitis effectively.
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