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

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. An inverted P wave is not typically associated with hypokalemia but may indicate other conduction abnormalities such as atrial ectopic rhythms.
B. A wide QRS complex is more commonly associated with hyperkalemia rather than hypokalemia. It may also indicate other conduction delays or ventricular issues.
C. An elevated ST segment suggests myocardial injury or pericarditis, not hypokalemia.
D. A flattened T wave is a hallmark of hypokalemia. Low potassium levels affect the repolarization phase of the cardiac cycle, leading to T wave flattening or inversion and, in severe cases, the presence of a U wave.

A. Removing and applying the fixator for showers. B. Documenting pin site assessment and care. C. Encouraging the patient to lie prone several times per day. D. Turning the patient every 3 hours.

Correct Answer is B

Explanation

A. Removing and applying the fixator for showers is not appropriate. The external fixator should not be removed by the nurse without proper medical guidance. Showers should be managed in a way that prevents the fixator from becoming wet or contaminated.
B. Documenting pin site assessment and care is essential for clients with external fixation. The nurse should regularly assess pin sites for signs of infection (e.g., redness, swelling, drainage) and ensure proper care is provided to prevent complications.
C. Encouraging the patient to lie prone several times per day may not be necessary or appropriate unless specifically ordered by the provider. The patient’s positioning should be based on comfort and the provider’s instructions to avoid strain on the injured limb.
D. Turning the patient every 3 hours is a general nursing practice for preventing pressure ulcers, but it is not specific to the care of a client with external fixation. The focus should be on protecting the fixator and ensuring the limb is properly supported.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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