Which of the following signs and symptoms from a client who came to the clinic for an exacerbation of Crohn's Disease is the most concerning?
Orthostatic hypotension
WBCs of 83
Lack of appetite for 2 days
Abdominal cramping
The Correct Answer is B
A. Orthostatic hypotension can be concerning, but it is not as immediately alarming as a very elevated WBC count. It could indicate dehydration or blood loss, which are common in Crohn's disease exacerbations, but it is not as critical as an infection or severe inflammation.
B. A WBC count of 83 (normal range is typically 4,000-11,000) is significantly elevated and suggests a severe infection or inflammatory response, which is a critical concern in Crohn's disease exacerbations. This could indicate a life-threatening complication such as an abscess or perforation.
C. Lack of appetite for 2 days is common during an exacerbation of Crohn's disease, though it can contribute to dehydration or malnutrition, it is not as immediately concerning as an elevated WBC count.
D. Abdominal cramping is a typical symptom of Crohn's disease and may worsen during exacerbations, but it is not the most concerning finding compared to a severely elevated WBC count.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Hypertension and headache are not typical signs of hypermagnesemia. These symptoms are more commonly associated with conditions like hypertension or intracranial pressure.
B. Tachycardia and tachypnea are not characteristic of hypermagnesemia. In fact, hypermagnesemia typically causes bradycardia and hypoventilation due to the depressant effect of magnesium on the cardiovascular and respiratory systems.
C. Depressed deep tendon reflexes are a classic sign of hypermagnesemia. Magnesium sulfate acts as a central nervous system depressant, and elevated magnesium levels can impair neuromuscular function, leading to reduced reflexes.
D. Positive Trousseau's sign is indicative of hypocalcemia, not hypermagnesemia. It is a sign of low calcium levels, where a blood pressure cuff inflated above systolic pressure for 3 minutes causes muscle spasms in the hand and forearm.
Correct Answer is B
Explanation
A. The patient should increase fluid intake to 6 to 8 glasses of water daily, not 1 to 2 glasses, to help flush bacteria out of the urinary tract.
B. Phenazopyridine (Pyridium) can cause orange or red discoloration of urine, which is a harmless and temporary side effect that resolves after the medication is stopped. This indicates the patient understands the teaching.
C. Stopping medications prematurely can lead to incomplete treatment of the infection and potential antibiotic resistance. Patients should complete the full course of prescribed antibiotics.
D. Sulfamethoxazole-trimethoprim (Bactrim) is an antibacterial, and phenazopyridine is a urinary analgesic; neither medication is used to treat fungal infections.
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