NSG 233 MED SURG 2 EXAM 4 FINAL PAPER
2026 QUESTIONS WITH VERIFIED ANSWERS
GRADED A+
◉ What are risk factors for developing an IBD? Answer: 1) First
degree relative has the disease.
2) Caucasian or Ashkenazi Jewish Background
3) Living in a northern climate
4) Living in an urban area
5) Men are at slightly higher risk for ulcerative colitis; women for
Crohn's disease.
6) 20-29 are greatest risk for Crohn's disease; 60+ are greater risk
for ulcerative colitis.
7) Current smokers are at risk for Crohn's disease; ex-smokers or
nonsmokers are at risk for ulcerative colitis.
◉ What is the cause of IBD? Answer: Exact cause is unknown.
Theories include environmental triggers, food, tobacco, and viral
illnesses in people genetically predisposed to developing an IBD can
trigger the cell mediated immune response that results in the
inflammatory changes that characterize the IBDs.
,◉ What is Crohn's disease? Answer: A type of IBD characterized by
periods of remission and exacerbation. A subacute and chronic
inflammation of the GI tract wall that extends through all layers.
Most commonly occurs in distal ileum and ascending colon.
◉ Describe the pathophysiology of Crohn's disease. Answer:
Inflammatory process begins with crypt inflammation and
abscesses, which turn into small, focal ulcers. They deepen into
longitudinal and transverse ulcers, separated by edematous patches
(characteristic cobblestone appearance). Fistulas, fissures, and
abscesses can form as the inflammation extends into the
peritoneum. Granulomas may occur in lymph nodes, the peritoneum,
and through layers of the bowel in ~50% of patients. Diseased
bowel segments are sharply demarcated by adjoining areas of
normal bowel tissue (skip lesions-->regional enteritis). With
advancing disease, the bowel wall thickens and becomes fibrotic,
and the intestinal lumen narrows. Diseased bowl loops sometimes
will adhere to the other loops that surround them.
◉ Pathophysiology of Crohn's disease (list) Answer: -Affects
segmental areas of the bowel: distal ileum & the beginning of the
colon.
-Ulcers are not continuous, and granulomas are common.
-Formation of a fistula, fissure, and abscess can occur.
-Advanced cases: lining of the bowel has a cobblestone appearance;
can lead to obstruction as the condition progresses.
,-Increased risk of colon cancer, though not as high as ulcerative
colitis.
◉ What are the clinical manifestations of Crohn's disease? Answer: -
Onset of symptoms is insidious. Prominent lower quadrant
abdominal pain and diarrhea unrelieved by defecation.
-Scar tissue & formation of granulomas interfere with ability of the
intestine to transport products of upper intestinal digestion through
the constricted lumen--> CRAMPY ABDOMINAL PAIN
-Abdominal tenderness & spasm.
-Eating stimulates peristalsis-->CRAMPY PAIN AFTER MEALS
(patients tend to limit food intake, reducing amounts/types of food
they eat such that nutritional requirements are often not met) -->
Results in: WEIGHT LOSS, MALNUTRITION, SECONDARY ANEMIA
-Ulcers in membranous lining of intestine plus other inflammatory
changes--> WEEPING, EDEMATOUS INTESTINE that continuously
EMPTIES AN IRRITATING DISCHARGE IN THE COLON.
-Disrupted absorption-->CHRONIC DIARRHEA & NUTRITIONAL
DEFICITS
, (person may appear thin and emaciated from inadequate food intake
and constant fluid loss)
-Inflamed intestine may perforate, leading to INTRA-ABDOMINAL &
ANAL ABCESSES.
-Fever & leukocytosis
-Chronic symptoms: diarrhea, abdominal pain, steatorrhea
(excessive fat in feces), anorexia, weight loss, nutritional deficiencies
-~1/3 of patients experience abscesses, fistulas, and fissures.
-Manifestations can extend beyond GI tract: joint disorders, skin
lesions, ocular disorders, and oral ulcers.
◉ Major manifestations of Crohn's disease (list). Answer: -Right
lower quadrant abdominal pain with right side tenderness.
-Cramping after meals
-Diarrhea unrelieved by evacuation
-Malnutrition r/t poor intake, poor absorption, leads to weight loss
and anemia
-Low grade fever
2026 QUESTIONS WITH VERIFIED ANSWERS
GRADED A+
◉ What are risk factors for developing an IBD? Answer: 1) First
degree relative has the disease.
2) Caucasian or Ashkenazi Jewish Background
3) Living in a northern climate
4) Living in an urban area
5) Men are at slightly higher risk for ulcerative colitis; women for
Crohn's disease.
6) 20-29 are greatest risk for Crohn's disease; 60+ are greater risk
for ulcerative colitis.
7) Current smokers are at risk for Crohn's disease; ex-smokers or
nonsmokers are at risk for ulcerative colitis.
◉ What is the cause of IBD? Answer: Exact cause is unknown.
Theories include environmental triggers, food, tobacco, and viral
illnesses in people genetically predisposed to developing an IBD can
trigger the cell mediated immune response that results in the
inflammatory changes that characterize the IBDs.
,◉ What is Crohn's disease? Answer: A type of IBD characterized by
periods of remission and exacerbation. A subacute and chronic
inflammation of the GI tract wall that extends through all layers.
Most commonly occurs in distal ileum and ascending colon.
◉ Describe the pathophysiology of Crohn's disease. Answer:
Inflammatory process begins with crypt inflammation and
abscesses, which turn into small, focal ulcers. They deepen into
longitudinal and transverse ulcers, separated by edematous patches
(characteristic cobblestone appearance). Fistulas, fissures, and
abscesses can form as the inflammation extends into the
peritoneum. Granulomas may occur in lymph nodes, the peritoneum,
and through layers of the bowel in ~50% of patients. Diseased
bowel segments are sharply demarcated by adjoining areas of
normal bowel tissue (skip lesions-->regional enteritis). With
advancing disease, the bowel wall thickens and becomes fibrotic,
and the intestinal lumen narrows. Diseased bowl loops sometimes
will adhere to the other loops that surround them.
◉ Pathophysiology of Crohn's disease (list) Answer: -Affects
segmental areas of the bowel: distal ileum & the beginning of the
colon.
-Ulcers are not continuous, and granulomas are common.
-Formation of a fistula, fissure, and abscess can occur.
-Advanced cases: lining of the bowel has a cobblestone appearance;
can lead to obstruction as the condition progresses.
,-Increased risk of colon cancer, though not as high as ulcerative
colitis.
◉ What are the clinical manifestations of Crohn's disease? Answer: -
Onset of symptoms is insidious. Prominent lower quadrant
abdominal pain and diarrhea unrelieved by defecation.
-Scar tissue & formation of granulomas interfere with ability of the
intestine to transport products of upper intestinal digestion through
the constricted lumen--> CRAMPY ABDOMINAL PAIN
-Abdominal tenderness & spasm.
-Eating stimulates peristalsis-->CRAMPY PAIN AFTER MEALS
(patients tend to limit food intake, reducing amounts/types of food
they eat such that nutritional requirements are often not met) -->
Results in: WEIGHT LOSS, MALNUTRITION, SECONDARY ANEMIA
-Ulcers in membranous lining of intestine plus other inflammatory
changes--> WEEPING, EDEMATOUS INTESTINE that continuously
EMPTIES AN IRRITATING DISCHARGE IN THE COLON.
-Disrupted absorption-->CHRONIC DIARRHEA & NUTRITIONAL
DEFICITS
, (person may appear thin and emaciated from inadequate food intake
and constant fluid loss)
-Inflamed intestine may perforate, leading to INTRA-ABDOMINAL &
ANAL ABCESSES.
-Fever & leukocytosis
-Chronic symptoms: diarrhea, abdominal pain, steatorrhea
(excessive fat in feces), anorexia, weight loss, nutritional deficiencies
-~1/3 of patients experience abscesses, fistulas, and fissures.
-Manifestations can extend beyond GI tract: joint disorders, skin
lesions, ocular disorders, and oral ulcers.
◉ Major manifestations of Crohn's disease (list). Answer: -Right
lower quadrant abdominal pain with right side tenderness.
-Cramping after meals
-Diarrhea unrelieved by evacuation
-Malnutrition r/t poor intake, poor absorption, leads to weight loss
and anemia
-Low grade fever
