NURS2207 QUESTIONS AND CORRECT ANSWERS WITH RATIONALES
2024-2025 LATEST UPDATE//GRADED A+
Which autoantigens are responsible for the development of Crohn disease?
1. Crypt epithelial cells
2. Thyroid cell surface
3. Basement membranes of the lungs
4. Basement membranes of the glomeruli - answer-1. Crypt epithelial cells
Rationale:
Crypt epithelial cells are considered the autoantigens responsible for Crohn disease. Thyroid cell
surfaces are autoantigens responsible for Hashimoto thyroiditis. The pulmonary and glomerular
basement membranes act as autoantigens responsible for Goodpasture syndrome.
Parenteral vitamins are prescribed for the client with Crohn disease. The client asks why the vitamins
have to be given intravenously (IV) rather than by mouth. Which rationales will the nurse provide?
Select all that apply. One, some, or all responses may be correct.
1. "They provide more rapid action results."
2. "They decrease colon irritability."
3. "Oral vitamins are less effective."
4. "Intestinal absorption may be inadequate."
5. "Allergic responses are less likely to occur." - answer-ANS: 1, 3, 4
Rationale:
Absorption through the gastrointestinal (GI) tract is impaired, and parenteral administration goes
directly into the intravascular compartment. Disease of the GI tract hampers absorption. Because the
mucosa of the intestinal tract is damaged, its ability to absorb vitamins taken orally is greatly impaired.
IV vitamins do not decrease colonic irritability. Route of administration does not affect allergic response.
While awaiting surgery, a client with a history of Crohn disease is receiving total parenteral nutrition
(TPN) on an outpatient basis. The nurse teaches the client that TPN helps prepare for surgery by which
process?
1. Decreasing fecal bulk
2. Preventing bowel infection
,3. Providing stimulation of secretions
4. Maintaining negative nitrogen balance - answer-1. Decreasing fecal bulk
Rationale:
By decreasing fecal bulk and bowel stimulation, TPN provides rest for the bowel while the client awaits
surgery. TPN does not prevent a bowel infection. TPN does not stimulate gastrointestinal secretions.
TPN promotes positive nitrogen balance.
A client is admitted to the hospital with a diagnosis of Crohn disease. Which is important for the nurse to
include in the teaching plan for the client?
1. Controlling constipation
2. Meeting nutritional needs
3. Preventing increased weakness
4. Anticipating a sexual alteration - answer-2. Meeting nutritional needs
Rationale:
To avoid gastrointestinal pain and diarrhea, these clients often refuse to eat and become malnourished.
The consumption of a high-calorie, high-protein diet is advised. Diarrhea, not constipation, is a problem
with Crohn disease. Preventing an increase in weakness is a secondary concern that results from
malnutrition; correcting the malnutrition will increase strength. Anticipating a sexual alteration generally
is not a problem with Crohn disease.
A client with Crohn disease is admitted to the hospital with a history of chronic, bloody diarrhea, weight
loss, and signs of general malnutrition. The client has anemia, a low serum albumin level, and signs of
negative nitrogen balance. The nurse concludes that the client's health status is related to which major
deficiency?
1. Ferrous sulfate
2. Protein
3. Ascorbic acid
4. Linoleic acid - answer-2. Protein
Rationale:
Protein deficiency causes a low serum albumin level, which permits fluid shifts from the intravascular to
the interstitial compartment, resulting in edema. Decreased protein also causes anemia; protein intake
must be increased. Although a deficiency of ferrous sulfate will result in anemia, it will not cause the
other adaptations. Ascorbic acid is unrelated to these adaptations. Linoleic acid is unrelated to these
adaptations.
,A client with the diagnosis of Crohn disease tells the nurse, "My partner dates other people. I believe
that behavior has caused an increase in my symptoms." Which is an appropriate initial nursing
response?
1. Help the client explore personal attitudes.
2. Educate the partner about the illness and events that affect the client's symptoms.
3. Suggest the client should not date the partner to determine if symptoms change.
4. Schedule the client and the partner for a counseling session. - answer-1. Help the client explore
personal attitudes.
Rationale:
Because emotional stress can influence the progress of Crohn disease, initially the nurse should help the
client explore self-attitudes to aid in better understanding the feelings engendered by the partner dating
others. Initially, the nurse should help the client explore the situation and the feelings it engenders
rather than involve the partner. The client should make the decision about continuing to date the
partner. Scheduling the client and the partner for a counseling session is premature; the client is not
ready for a joint counseling session.
A client with severe Crohn disease develops a small bowel obstruction. Which clinical finding would the
nurse expect the client to report?
1. Bloody vomitus
2. Projectile vomiting
3. Bleeding with defecation
4. Pain in the left lower quadrant - answer-2. Projectile vomiting
Rationale:
Nausea and vomiting, accompanied by diffuse abdominal pain, commonly occur in clients with small
bowel obstruction; the vomiting may be projectile and may contain bile or fecal material. Hematemesis
is associated more closely with peptic ulcer disease. Bleeding with defecation is associated with
hemorrhoids and anal fissures. Pain in the left lower quadrant is associated with diverticulitis. Pain
associated with a small bowel obstruction usually is more diffuse.
The nurse is assessing a client with Crohn disease who is scheduled for an upper gastrointestinal series.
Which condition would necessitate the cancellation of the procedure?
1. Hemorrhoids
2. Hyperkalemia
, 3. Inflamed colon
4. Colon perforation - answer-4. Colon perforation
Rationale:
When a client has a perforated viscera, barium can leak out of the intestinal tract and cause
inflammation or an abscess. Although hemorrhoids may be irritating, they do not contraindicate barium
studies. Serum potassium is unaffected; barium is insoluble and will not affect blood content. Barium
studies are not contraindicated when the bowel is inflamed. An upper gastrointestinal series is useful in
diagnosing ulcerative colitis and Crohn disease.
A client with Crohn disease is admitted to the hospital with abdominal pain, fever, poor skin turgor, and
having experienced 10 liquid bowel movements in the past 24 hours. The nurse suspects that the client
is dehydrated based on which assessment findings? Select all that apply. One, some, or all responses
may be correct.
1. Moist skin
2. Sunken eyes
3. Decreased apical pulse
4. Dry mucous membranes
5. Increased blood pressure - answer-ANS: 2, 4
Rationale:
Sunken eyes and loss of skin turgor occur because of decreased intracellular and interstitial fluid
associated with dehydration. Dry mucous membranes occur because of decreased intracellular and
interstitial fluid associated with dehydration. The skin will be dry, not moist, with dehydration. The first
sign of dehydration usually is tachycardia. The blood pressure will decrease, not increase, because of
hypovolemia.
The nurse reviews the room assignments for clients who are scheduled for admission. One client is being
hospitalized to receive intravenous steroids for management of Crohn disease. The nurse would
question the assignment if the client is scheduled to have a roommate who has which illness?
1. Pancreatitis
2. Thrombophlebitis
3. Bacterial meningitis
4. Acute cholecystitis - answer-3. Bacterial meningitis
Rationale:
2024-2025 LATEST UPDATE//GRADED A+
Which autoantigens are responsible for the development of Crohn disease?
1. Crypt epithelial cells
2. Thyroid cell surface
3. Basement membranes of the lungs
4. Basement membranes of the glomeruli - answer-1. Crypt epithelial cells
Rationale:
Crypt epithelial cells are considered the autoantigens responsible for Crohn disease. Thyroid cell
surfaces are autoantigens responsible for Hashimoto thyroiditis. The pulmonary and glomerular
basement membranes act as autoantigens responsible for Goodpasture syndrome.
Parenteral vitamins are prescribed for the client with Crohn disease. The client asks why the vitamins
have to be given intravenously (IV) rather than by mouth. Which rationales will the nurse provide?
Select all that apply. One, some, or all responses may be correct.
1. "They provide more rapid action results."
2. "They decrease colon irritability."
3. "Oral vitamins are less effective."
4. "Intestinal absorption may be inadequate."
5. "Allergic responses are less likely to occur." - answer-ANS: 1, 3, 4
Rationale:
Absorption through the gastrointestinal (GI) tract is impaired, and parenteral administration goes
directly into the intravascular compartment. Disease of the GI tract hampers absorption. Because the
mucosa of the intestinal tract is damaged, its ability to absorb vitamins taken orally is greatly impaired.
IV vitamins do not decrease colonic irritability. Route of administration does not affect allergic response.
While awaiting surgery, a client with a history of Crohn disease is receiving total parenteral nutrition
(TPN) on an outpatient basis. The nurse teaches the client that TPN helps prepare for surgery by which
process?
1. Decreasing fecal bulk
2. Preventing bowel infection
,3. Providing stimulation of secretions
4. Maintaining negative nitrogen balance - answer-1. Decreasing fecal bulk
Rationale:
By decreasing fecal bulk and bowel stimulation, TPN provides rest for the bowel while the client awaits
surgery. TPN does not prevent a bowel infection. TPN does not stimulate gastrointestinal secretions.
TPN promotes positive nitrogen balance.
A client is admitted to the hospital with a diagnosis of Crohn disease. Which is important for the nurse to
include in the teaching plan for the client?
1. Controlling constipation
2. Meeting nutritional needs
3. Preventing increased weakness
4. Anticipating a sexual alteration - answer-2. Meeting nutritional needs
Rationale:
To avoid gastrointestinal pain and diarrhea, these clients often refuse to eat and become malnourished.
The consumption of a high-calorie, high-protein diet is advised. Diarrhea, not constipation, is a problem
with Crohn disease. Preventing an increase in weakness is a secondary concern that results from
malnutrition; correcting the malnutrition will increase strength. Anticipating a sexual alteration generally
is not a problem with Crohn disease.
A client with Crohn disease is admitted to the hospital with a history of chronic, bloody diarrhea, weight
loss, and signs of general malnutrition. The client has anemia, a low serum albumin level, and signs of
negative nitrogen balance. The nurse concludes that the client's health status is related to which major
deficiency?
1. Ferrous sulfate
2. Protein
3. Ascorbic acid
4. Linoleic acid - answer-2. Protein
Rationale:
Protein deficiency causes a low serum albumin level, which permits fluid shifts from the intravascular to
the interstitial compartment, resulting in edema. Decreased protein also causes anemia; protein intake
must be increased. Although a deficiency of ferrous sulfate will result in anemia, it will not cause the
other adaptations. Ascorbic acid is unrelated to these adaptations. Linoleic acid is unrelated to these
adaptations.
,A client with the diagnosis of Crohn disease tells the nurse, "My partner dates other people. I believe
that behavior has caused an increase in my symptoms." Which is an appropriate initial nursing
response?
1. Help the client explore personal attitudes.
2. Educate the partner about the illness and events that affect the client's symptoms.
3. Suggest the client should not date the partner to determine if symptoms change.
4. Schedule the client and the partner for a counseling session. - answer-1. Help the client explore
personal attitudes.
Rationale:
Because emotional stress can influence the progress of Crohn disease, initially the nurse should help the
client explore self-attitudes to aid in better understanding the feelings engendered by the partner dating
others. Initially, the nurse should help the client explore the situation and the feelings it engenders
rather than involve the partner. The client should make the decision about continuing to date the
partner. Scheduling the client and the partner for a counseling session is premature; the client is not
ready for a joint counseling session.
A client with severe Crohn disease develops a small bowel obstruction. Which clinical finding would the
nurse expect the client to report?
1. Bloody vomitus
2. Projectile vomiting
3. Bleeding with defecation
4. Pain in the left lower quadrant - answer-2. Projectile vomiting
Rationale:
Nausea and vomiting, accompanied by diffuse abdominal pain, commonly occur in clients with small
bowel obstruction; the vomiting may be projectile and may contain bile or fecal material. Hematemesis
is associated more closely with peptic ulcer disease. Bleeding with defecation is associated with
hemorrhoids and anal fissures. Pain in the left lower quadrant is associated with diverticulitis. Pain
associated with a small bowel obstruction usually is more diffuse.
The nurse is assessing a client with Crohn disease who is scheduled for an upper gastrointestinal series.
Which condition would necessitate the cancellation of the procedure?
1. Hemorrhoids
2. Hyperkalemia
, 3. Inflamed colon
4. Colon perforation - answer-4. Colon perforation
Rationale:
When a client has a perforated viscera, barium can leak out of the intestinal tract and cause
inflammation or an abscess. Although hemorrhoids may be irritating, they do not contraindicate barium
studies. Serum potassium is unaffected; barium is insoluble and will not affect blood content. Barium
studies are not contraindicated when the bowel is inflamed. An upper gastrointestinal series is useful in
diagnosing ulcerative colitis and Crohn disease.
A client with Crohn disease is admitted to the hospital with abdominal pain, fever, poor skin turgor, and
having experienced 10 liquid bowel movements in the past 24 hours. The nurse suspects that the client
is dehydrated based on which assessment findings? Select all that apply. One, some, or all responses
may be correct.
1. Moist skin
2. Sunken eyes
3. Decreased apical pulse
4. Dry mucous membranes
5. Increased blood pressure - answer-ANS: 2, 4
Rationale:
Sunken eyes and loss of skin turgor occur because of decreased intracellular and interstitial fluid
associated with dehydration. Dry mucous membranes occur because of decreased intracellular and
interstitial fluid associated with dehydration. The skin will be dry, not moist, with dehydration. The first
sign of dehydration usually is tachycardia. The blood pressure will decrease, not increase, because of
hypovolemia.
The nurse reviews the room assignments for clients who are scheduled for admission. One client is being
hospitalized to receive intravenous steroids for management of Crohn disease. The nurse would
question the assignment if the client is scheduled to have a roommate who has which illness?
1. Pancreatitis
2. Thrombophlebitis
3. Bacterial meningitis
4. Acute cholecystitis - answer-3. Bacterial meningitis
Rationale:
