NUR 130 Exam 6 Practice Questions and Correct Answers

Crohn's Disease Course: prolonged, variable Pathology: Transmural thickening - deep, penetrating granulomas Location: Ileum, ascending colon Bleeding: no Perianal involvement: common Fistulas: common Diarrhea: less severe Abdominal mass: common Ulcerative Colitis Course: exacerbations, remissions Pathology: Mucosal ulcerations Location: rectum Bleeding: common Perianal involvement: rare Fistulas: rare Diarrhea: severe Abdominal mass: rare Crohn's s/s RLQ crampy, abdominal pain and diarrhea unrelieved by defecation, abdominal tenderness and spasms after meals, weepy, edematous intestine that continually empties, fever, leukocytosis, steatorrhea, anorexia, weight loss, nutritional deficits Ulcerative colitis s/s diarrhea, passage of mucus, pus, or blood, LLQ abdominal pain, intermittent tenesmus, bleeding, pallor, anemia, fatigue, anorexia, weight loss, fever, vomiting, dehydration, cramping, electrolyte imbalances, skin lesions Diverticulitis - what is it? diverticulum becomes inflamed, causing perforation, and potential complications such as obstruction, abscess, fistula formation, peritonitis, and hemorrhage Appendicitis - what is it? Appendix becomes inflamed and edematous as a result of becoming kinked or occluded by fecalith, lymphoid hyperplasia, or foreign bodies. Eventually gangrene and perforation occurs A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the patients stools will have what characteristics? A) Watery with blood and mucus B) Hard and black or tarry C) Dry and streaked with blood D) Loose with visible fatty streaks A) Watery w/blood and mucus A patient has had an ileostomy created for the treatment of irritable bowel disease and the patient is now preparing for discharge. What should the patient be taught about changing this device in the home setting? A) Apply antibiotic ointment as ordered after cleaning the stoma. B) Apply a skin barrier to the peristomal skin prior to applying the pouch. C) Dispose of the clamp with each bag change. D) Cleanse the area surrounding the stoma with alcohol or chlorhexidine. B) apply a skin barrier to the peristomal skin prior to applying the pouch A patient admitted with acute diverticulitis has experienced a sudden increase in temperature and complains of a sudden onset of exquisite abdominal tenderness. The nurses rapid assessment reveals that the patients abdomen is uncharacteristically rigid on palpation. What is the nurses best response? A) Administer a Fleet enema as ordered and remain with the patient. B) Contact the primary care provider promptly and report these signs of perforation. C) Position the patient supine and insert an NG tube. D) Page the primary care provider and report that the patient may be obstructed. B) contact the primary care provider promptly and report these signs of perforation