NURSING PRACTICE — Care of
Clients with Physiologic and
Psychosocial Alterations, Part A
Below is the complete Section 3 (Questions 1–100) in
correct exam format, with the question,answer and a
rationale for each.
1. The first question she asked from Nurses Gayle is, how do
you differentiate a patient with Crohn's Disease from that of
ulcerative colitis in terms of the following:
A. Presence of bleeding: severe in Crohn's Disease while in
Ulcerative Colitis bleeding is mild.
B. Presence of diarrhea: severe in Crohn's Disease in Ulcerative
Colitis it is mild.
C. Affected area: Crohn's Disease is the descending while in
Ulcerative Colitis is the ascending colon
D. Course of the disease: Crohn's Disease is prolonged and variable.
Ulcerative Colitis has a remission and exacerbation
Answer: D. Course of the disease: Crohn's Disease is
prolonged and variable. Ulcerative Colitis has a remission
and exacerbation
Rationale: Crohn's disease has a prolonged and variable course,
while ulcerative colitis is characterized by remissions and
exacerbations. Bleeding is more severe in ulcerative colitis, diarrhea
is more severe in ulcerative colitis, and Crohn's disease can affect
any part of the GI tract while ulcerative colitis typically affects the
colon and rectum.
2. Nurse Limjap further asked another orientee, Ms. Sharon
"In preventing recurrence of Crohn's and Ulcerative Colitis,
what specific therapeutic regimen is effective to both
condition? The BEST response of nurse Sharon is.
A. Corticosteroids
B. Anti-cholinergic
C. Antacids
D. Anti-spasmodics
Answer: B. Anti-cholinergic
1
,Rationale: Anticholinergic medications are effective in both Crohn's
disease and ulcerative colitis for reducing bowel motility and
spasms, which helps prevent recurrence of symptoms.
Corticosteroids are used for acute flares, not prevention.
3. As a nurse, Ms. Lyn, what systematic complication do you
likely expect when you are caring for a patient with Crohn's
Disease? The BEST response of Nurse Lyn to Ms. Limjap is.
A. Megacolon
B. Perforation
C. Small bowel Obstruction
D. Hemorrhage
Answer: C. Small bowel Obstruction
Rationale: Small bowel obstruction is a common complication of
Crohn's disease due to the inflammatory process causing strictures
and narrowing of the bowel lumen. Megacolon is more associated
with ulcerative colitis.
4. The succeeding questions of Ms. Limjap to the orientees
include the following: What diagnostic test is usually
ordered to patients with Ulcerative Colitis in order to
distinguish this condition from other diseases of the colon?
A. Proctosigmoidoscopy
B. Albumin Study
C. Colonoscopy
D. Ultra Sound
Answer: C. Colonoscopy
Rationale: Colonoscopy is the diagnostic test of choice for
ulcerative colitis as it allows direct visualization of the entire colon
and enables biopsy to distinguish it from other diseases such as
Crohn's disease.
5. If you are carrying for patients who are passing out large
volume of stools brought about by Ulcerative Colitis, which
of the following nursing diagnoses is the MOST appropriate
to be formulated and incorporated in your nursing care
plan?
2
, 1.
Imbalanced nutrition less than body requirements R/T impaired
absorption
2.
3.
Risk for Deficient Fluid Volume R/T abnormal fluid loss
4.
5.
Risk for Ineffective tissue perfusion R/T low hemoglobin
6.
7.
Acute Diarrhea R/T inflammation of the bowel
8.
A. 2 & 3
B. 1, 2 & 3
C. 1, 2, 3 & 4
D. 1 & 2
Answer: B. 1, 2 & 3
Rationale: Imbalanced nutrition (1), risk for deficient fluid volume
(2), and risk for ineffective tissue perfusion (3) are all appropriate
nursing diagnoses for a patient with ulcerative colitis passing large
volumes of stool. Acute diarrhea (4) is a medical diagnosis, not a
nursing diagnosis.
Situation - Ms. Betsy, 56, year, a former dressmaker,
married was brought the medical counter because of severe
abdominal pain radiating to the scapular region. Health
history revealed that she has been fond of eating fatty
prepare food. Patient appeared jaundice with facial
grimaces. The physician on duty (POD) examined her and an
impression of Cholelithiasis was given by the POD. Patient
was ordered to be admitted for further work-up and possible
surgery.
6. During the admission interview, which of the following
questions would the Nurse APPROPRIATELY asks when a
patient is complaining of biliary colic?
A. When do you feel the pain? Is it before you sleep at night?
B. Do you feel the pain and tenderness in the left upper quadrant of
3
Clients with Physiologic and
Psychosocial Alterations, Part A
Below is the complete Section 3 (Questions 1–100) in
correct exam format, with the question,answer and a
rationale for each.
1. The first question she asked from Nurses Gayle is, how do
you differentiate a patient with Crohn's Disease from that of
ulcerative colitis in terms of the following:
A. Presence of bleeding: severe in Crohn's Disease while in
Ulcerative Colitis bleeding is mild.
B. Presence of diarrhea: severe in Crohn's Disease in Ulcerative
Colitis it is mild.
C. Affected area: Crohn's Disease is the descending while in
Ulcerative Colitis is the ascending colon
D. Course of the disease: Crohn's Disease is prolonged and variable.
Ulcerative Colitis has a remission and exacerbation
Answer: D. Course of the disease: Crohn's Disease is
prolonged and variable. Ulcerative Colitis has a remission
and exacerbation
Rationale: Crohn's disease has a prolonged and variable course,
while ulcerative colitis is characterized by remissions and
exacerbations. Bleeding is more severe in ulcerative colitis, diarrhea
is more severe in ulcerative colitis, and Crohn's disease can affect
any part of the GI tract while ulcerative colitis typically affects the
colon and rectum.
2. Nurse Limjap further asked another orientee, Ms. Sharon
"In preventing recurrence of Crohn's and Ulcerative Colitis,
what specific therapeutic regimen is effective to both
condition? The BEST response of nurse Sharon is.
A. Corticosteroids
B. Anti-cholinergic
C. Antacids
D. Anti-spasmodics
Answer: B. Anti-cholinergic
1
,Rationale: Anticholinergic medications are effective in both Crohn's
disease and ulcerative colitis for reducing bowel motility and
spasms, which helps prevent recurrence of symptoms.
Corticosteroids are used for acute flares, not prevention.
3. As a nurse, Ms. Lyn, what systematic complication do you
likely expect when you are caring for a patient with Crohn's
Disease? The BEST response of Nurse Lyn to Ms. Limjap is.
A. Megacolon
B. Perforation
C. Small bowel Obstruction
D. Hemorrhage
Answer: C. Small bowel Obstruction
Rationale: Small bowel obstruction is a common complication of
Crohn's disease due to the inflammatory process causing strictures
and narrowing of the bowel lumen. Megacolon is more associated
with ulcerative colitis.
4. The succeeding questions of Ms. Limjap to the orientees
include the following: What diagnostic test is usually
ordered to patients with Ulcerative Colitis in order to
distinguish this condition from other diseases of the colon?
A. Proctosigmoidoscopy
B. Albumin Study
C. Colonoscopy
D. Ultra Sound
Answer: C. Colonoscopy
Rationale: Colonoscopy is the diagnostic test of choice for
ulcerative colitis as it allows direct visualization of the entire colon
and enables biopsy to distinguish it from other diseases such as
Crohn's disease.
5. If you are carrying for patients who are passing out large
volume of stools brought about by Ulcerative Colitis, which
of the following nursing diagnoses is the MOST appropriate
to be formulated and incorporated in your nursing care
plan?
2
, 1.
Imbalanced nutrition less than body requirements R/T impaired
absorption
2.
3.
Risk for Deficient Fluid Volume R/T abnormal fluid loss
4.
5.
Risk for Ineffective tissue perfusion R/T low hemoglobin
6.
7.
Acute Diarrhea R/T inflammation of the bowel
8.
A. 2 & 3
B. 1, 2 & 3
C. 1, 2, 3 & 4
D. 1 & 2
Answer: B. 1, 2 & 3
Rationale: Imbalanced nutrition (1), risk for deficient fluid volume
(2), and risk for ineffective tissue perfusion (3) are all appropriate
nursing diagnoses for a patient with ulcerative colitis passing large
volumes of stool. Acute diarrhea (4) is a medical diagnosis, not a
nursing diagnosis.
Situation - Ms. Betsy, 56, year, a former dressmaker,
married was brought the medical counter because of severe
abdominal pain radiating to the scapular region. Health
history revealed that she has been fond of eating fatty
prepare food. Patient appeared jaundice with facial
grimaces. The physician on duty (POD) examined her and an
impression of Cholelithiasis was given by the POD. Patient
was ordered to be admitted for further work-up and possible
surgery.
6. During the admission interview, which of the following
questions would the Nurse APPROPRIATELY asks when a
patient is complaining of biliary colic?
A. When do you feel the pain? Is it before you sleep at night?
B. Do you feel the pain and tenderness in the left upper quadrant of
3
