Inflammatory Bowel Disease

The nurse is assessing a client with Crohn's disease who is scheduled for an upper GI series. Which condition would necessitate the cancellation of the procedure? A. Hemorrhoids B. Colon perforation C. Hyperkalemia D. Inflamed colon

B. Colon perforation

The client diagnosed with ulcerative colitis has an ileostomy. Which statement indicates the client needs more teaching concerning the ileostomy? 1. "My stoma should be pink and moist." 2. "I will irrigate my ileostomy every morning." 3. "If I get a red, bumpy, itchy rash I will call my HCP." 4. "I will change my pouch if it starts leaking."

2. "I will irrigate my ileostomy every morning."

The client diagnosed with IBD is prescribed sulfasalazine (Asulfidine), a sulfonamide antibiotic. Which statement best describes the rationale for administering this medication? 1. It is administered rectally to help decrease colon inflammation. 2. This medication slows gastrointestinal motility and reduces diarrhea. 3. This medication kills the bacteria causing the exacerbation. 4. It acts topically on the colon mucosa to decrease inflammation.

4. It acts topically on the colon mucosa to decrease inflammation.

A patient is suspected of having Crohn's disease. The nurse anticipates which diagnostic study will be performed to assess alterations in mucosal integrity and inflammation in the small intestine? A. Capsule endoscopy B. D-xylose test C. Bowel barium enema D. Lactose tolerance test

A. Capsule endoscopy B. D-xylose test C. Bowel barium enema D. Lactose tolerance test

The nurse provides education for a group of nursing students comparing ulcerative colitis and Crohn's disease. The nurse states that which clinical manifestation is common with both disorders? A. Diarrhea B. Hypocalcemia C. Hypertension D. Projectile vomiting

A. Diarrhea B. Hypocalcemia C. Hypertension D. Projectile vomiting

Which times for the medication schedule would a nurse teach when corticosteroid therapy is prescribed for a client with an exacerbation of ulcerative colitis? A. In the early morning with food B. At bedtime with a snack C. Three times a day with meals D. One hour before or 2 hours after eating

A. In the early morning with food

The nurse reviews the list of medications that are being considered to treat a pregnant patient with Crohn's disease. The nurse identifies that which medication is contraindicated? A. Mesalamine B. Sulfasalazine C. Azathioprine D. Methotrexate

A. Mesalamine B. Sulfasalazine C. Azathioprine D. Methotrexate

The nurse reviews the medical record of a patient with inflammatory bowel disease (IBD) and notes hypoalbuminemia. The nurse recognizes that this finding is indicative of which condition? A. Perforation B. Inflammation C. Poor nutrition D. Toxic megacolon

A. Perforation B. Inflammation C. Poor nutrition D. Toxic megacolon

Which condition involves inflammation of all layers of the bowel wall? A. Peritonitis B. Gastroenteritis C. Crohn's disease D. Ulcerative colitis

A. Peritonitis B. Gastroenteritis C. Crohn's disease D. Ulcerative colitis

The nurse provides patient education about managing Crohn's disease and encourages participation in which type of program? A. Weight reduction B. Aerobic exercise C. Stress management D. Smoking cessation

A. Weight reduction B. Aerobic exercise C. Stress management D. Smoking cessation

The nurse is evaluating a client who has been receiving medical intervention for a diagnosis of Crohn's disease. Which expected outcome is most important for this client? A. Performs skin care B. Gains a half pound (0.2 kg) per week C. Tolerates oral fluids D. Experiences less abdominal cramping

B. Gains a half pound (0.2 kg) per week

The nurse is teaching a client with an acute exacerbation of ulcerative colitis about an appropriate diet. Which food selected by the client indicates that the dietary teaching is effective? A. Orange juice B. Scrambled eggs C. Creamed potato soup D. Vanilla milkshake

B. Scrambled eggs

The nurse is performing a physical assessment of a client with ulcerative colitis. Which symptom is often associated with a serious complication of this disorder? A. Loose, blood-tinged stools B. Distention of the abdomen C. Decreased bowel sounds D. Intense abdominal discomfort

C. Decreased bowel sounds

A client is admitted to the hospital with a diagnosis of Crohn's disease. Which is important for the nurse to include in the teaching plan for the client? A. Controlling constipation B. Preventing increased weakness C. Anticipating a sexual alteration D. Meeting nutritional needs

D. Meeting nutritional needs

The client is diagnosed with an acute exacerbation of IBD. Which priority intervention should the nurse implement first? 1. Weigh the client daily and document in the client's chart. 2. Teach coping strategies such as dietary modifications. 3. Record the frequency, amount, and color of stools. 4. Monitor the client's oral fluid intake every shift.

3. Record the frequency, amount, and color of stools.

The nurse reviews the room assignments for clients who are scheduled for admission. One client is being hospitalized to receive IV steroids for management of Crohn's disease. The nurse would question the assignment if the client is scheduled to have a roommate who has which illness? A. Bacterial meningitis B. Pancreatitis C. Thrombophlebitis D. Acute cholecystitis

A. Bacterial meningitis

The nurse is assessing two clients. One client has ulcerative colitis, and the other client has Crohn's disease. Which finding is more likely to be identified in the client with ulcerative colitis than in the client with Crohn's disease? A. Involvement starting distally with rectal bleeding that spreads continuously up the colon B. Inclusion of transmural involvement of the bowel wall C. Pathology beginning proximally with intermittent plaques found along the colon D. Involvement starting proximally

A. Involvement starting distally with rectal bleeding that spreads continuously up the colon

The nurse is eliciting a health history from a client with ulcerative colitis. Which factor would the nurse consider to be most likely associated with the client's colitis? A. Infectious agent B. Genetic disposition C. Dietary components D. Hypertension

B. Genetic disposition

While reviewing the laboratory reports of a patient with chronic inflammation of the gastrointestinal tract, the nurse suspects toxic megacolon in the patient. Which laboratory finding supports the nurse's suspicion? A. Increased albumin B. Increased WBC count C. Increased serum sodium D. Increased magnesium level

A. Increased albumin B. Increased WBC count C. Increased serum sodium D. Increased magnesium level

The nurse is reviewing the laboratory results for a female client diagnosed with Crohn's disease (CD). Which laboratory results would indicate that the client is experiencing an acute inflammatory process related to CD? Select all that apply. 1. Erythrocyte sedimentation rate (ESR) of 10 mm/hr 2. D-dimer of 75 ng/mL (4.5 mmol/L) 3. D-dimer of 40 ng/mL (2.4 mmol/L) 4. White blood cell count 9,000/mm3 (9 × 109/L) 5. White blood cell (WBC) count of 14,000/mm3 (14 × 109/L) 6. Erythrocyte sedimentation rate (ESR) of 30 mm/hr

2. D-dimer of 75 ng/mL (4.5 mmol/L) 5. White blood cell (WBC) count of 14,000/mm3 (14 × 109/L) 6. Erythrocyte sedimentation rate (ESR) of 30 mm/hr

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction? 1. "I need to increase the fiber in my diet." 2. "I will need to avoid caffeinated beverages." 3. "I'm going to learn some stress-reduction techniques." 4. "I can have exacerbations and remissions with Crohn's disease."

1. "I need to increase the fiber in my diet."

The client is diagnosed with Crohn's disease, also known as regional enteritis. Which statement by the client supports this diagnosis? 1. "My pain goes away when I have a bowel movement." 2. "I have bright red blood in my stool all the time." 3. "I have episodes of diarrhea and constipation." 4. "My abdomen is hard and rigid and I have a fever."

1. "My pain goes away when I have a bowel movement."

The client with ulcerative colitis is scheduled for an ileostomy. The nurse is aware the client's stoma will be located in which area of the abdomen? 1. RLQ 2. LLQ 3. Transverse colon 4. RUQ

1. RLQ

A client with ulcerative colitis had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse? 1. This is a normal, expected event. 2. The client is experiencing early signs of ischemic bowel. 3. The client should not have the nasogastric tube removed. 4. This indicates inadequate preoperative bowel preparation.

1. This is a normal, expected event.

Which sign/symptom should the nurse expect to find in a client diagnosed with ulcerative colitis? 1. Twenty bloody stools a day. 2. Oral temperature of 102 ̊F. 3. Hard, rigid abdomen. 4. Urinary stress incontinence.

1. Twenty bloody stools a day.

The client is diagnosed with an acute exacerbation of ulcerative colitis. Which intervention should the nurse implement? 1. Provide a low-residue diet. 2. Rest the client's bowel. 3. Assess vital signs daily. 4. Administer antacids orally.

2. Rest the client's bowel.

The nurse is providing care for a client with ulcerative colitis who underwent the creation of a transverse colostomy. Which observation requires immediate notification of the surgeon? 1. Stoma is beefy red and shiny. 2. Stoma has a purple discoloration. 3. Skin excoriation is noted around the stoma. 4. Semiformed stool is noted in the ostomy pouch.

2. Stoma has a purple discoloration.

The nurse is caring for a client with Crohn's disease. The client has poor oral intake and reports memory loss and weight loss. Upon assessment, the nurse notes a smooth tongue, which the client reports is sore; brittle nails; and pale skin. The client's complete blood cell count (CBC) indicates a high mean corpuscular volume (MCV) and a low mean corpuscular hemoglobin (MCH). Based on the assessment, the nurse would suspect which nutrient deficiency? 1. Zinc deficiency 2. Calcium deficiency 3. Vitamin B9 deficiency 4. Magnesium deficiency

3. Vitamin B9 deficiency

Which reported clinical manifestations would the nurse expect from a client with ulcerative colitis? (SATA) A. Fever B. Diarrhea C. Gain in weight D. Spitting up blood E. Abdominal cramps

A. Fever B. Diarrhea E. Abdominal cramps

A client diagnosed with a severe ulcerative colitis (UC) exacerbation has developed an intestinal abscess. The client asks the nurse to explain what this means. How would the nurse describe this complication? 1. "The bowel has developed localized pockets containing pus in the ulcerated bowel lining." 2. "You are experiencing bleeding from your lower gastrointestinal tract (GI) due to bowel wall erosion." 3. "This happens when the colon becomes extremely dilated and unable to move food contents through the GI tract." 4. "An abnormal connection has developed between two organs due to chronic inflammation and tissue destruction."

1. "The bowel has developed localized pockets containing pus in the ulcerated bowel lining."

The client diagnosed with IBD is prescribed total parental nutrition (TPN). Which intervention should the nurse implement? 1. Check the client's glucose level. 2. Administer an oral hypoglycemic. 3. Assess the peripheral intravenous site. 4. Monitor the client's oral food intake.

1. Check the client's glucose level.

The client diagnosed with inflammatory bowel disease has a serum potassium level of 3.4 mEq/L. Which action should the nurse implement first? 1. Notify the health-care provider. 2. Assess the client for muscle weakness. 3. Request telemetry for the client. 4. Prepare to administer potassium IV.

2. Assess the client for muscle weakness.

A client with Crohn's disease is scheduled to receive an infusion of infliximab. What intervention by the nurse will determine the effectiveness of treatment? 1. Monitoring the leukocyte count for 2 days after the infusion 2. Checking the frequency and consistency of bowel movements 3. Checking serum liver enzyme levels before and after the infusion 4. Carrying out a Hematest on gastric fluids after the infusion is completed

2. Checking the frequency and consistency of bowel movements

The client diagnosed with Crohn's disease is crying and tells the nurse, "I can't take it anymore. I never know when I will get sick and end up here in the hospital." Which statement is the nurse's best response? 1. "I understand how frustrating this must be for you." 2. "You must keep thinking about the good things in your life." 3. "I can see you are very upset. I'll sit down and we can talk." 4. "Are you thinking about doing anything like committing suicide?"

3. "I can see you are very upset. I'll sit down and we can talk."

The nurse is assessing a client with ulcerative colitis (UC). The nurse is gathering information related to the client's bowel habits, and the client reports having approximately five nonbloody stools a day. How would the nurse classify the severity of this client's UC? 1. Mild 2. Severe 3. Moderate 4. Fulminant

3. Moderate

The client diagnosed with ulcerative colitis is prescribed a low-residue diet. Which meal selection indicates the client understands the diet teaching? 1. Grilled hamburger on a wheat bun and fried potatoes. 2. A chicken salad sandwich and lettuce and tomato salad. 3. Roast pork, white rice, and plain custard. 4. Fried fish, whole grain pasta, and fruit salad.

3. Roast pork, white rice, and plain custard.

The client with type 2 diabetes is prescribed prednisone, a steroid, for an acute exacerbation of inflammatory bowel disease. Which intervention should the nurse discuss with the client? 1. Take this medication on an empty stomach. 2. Notify the HCP if experiencing a moon face. 3. Take the steroid medication as prescribed. 4. Notify the HCP if the blood glucose is over 160.

3. Take the steroid medication as prescribed.

A client with Crohn's disease has just had surgery to create an ileostomy. The nurse assesses the client in the postoperative period for which most frequent complication of this type of surgery? 1. Folate deficiency 2. Malabsorption of fat 3. Intestinal obstruction 4. Fluid and electrolyte imbalance

4. Fluid and electrolyte imbalance

The nurse is assessing a client with ulcerative colitis (UC). How would the nurse classify the severity of the client's UC if the client reports 12 bloody stools per day? 1. Mild 2. Severe 3. Moderate 4. Fulminant

4. Fulminant Mild= Less than 4 stools/day with or without blood Moderate= 4-6 stools/day with or without blood Severe= 6-10 bloody stools/day Fulminant= More than 10 bloody stools/day

The nurse is caring for a client with Crohn's disease who has a calcium level of 8 mg/dL (2 mmol/L).Which patterns would the nurse watch for on the electrocardiogram? Select all that apply. 1. Peaked T wave 2. Widened T wave 3. Prominent U wave 4. Prolonged QT interval 5. Prolonged ST segment

4. Prolonged QT interval 5. Prolonged ST segment

A client is experiencing an exacerbation of ulcerative colitis. A low-residue, high-protein diet and IV fluids with vitamins have been prescribed. When implementing these prescriptions, which goal is the nurse trying to achieve? A. Reduce colonic irritation B. Reduce gastric acidity C. Reduce intestinal absorption D. Reduce bowel infection rate

A. Reduce colonic irritation

After many years of coping with ulcerative colitis, a client makes the decision to have a colectomy as advised by the HCP. Which is most likely the significant factor that affected the client's decision? A. It is temporary until the colon heals B. Ulcerative colitis can progress to Crohn's disease C. Without surgery, eating table foods is contraindicated D. Surgical treatment cures ulcerative colitis

D. Surgical treatment cures ulcerative colitis