A nurse in an acute care facility is caring for a toddler.

Exhibits

For each assessment finding below, click to specify if the assessment finding is consistent with Crohn's disease, appendicitis, or intussusception. Each finding may support more than 1 disease process.

Stool

Abdominal findings

Pain rating

Vomiting

Temperature

Answer and Explanation

The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"C"},"C":{"answers":"A,B,C"},"D":{"answers":"B,C"},"E":{"answers":"A,B"}}

Rationale:

• Stool: The presence of blood and mucus in the stool (“currant jelly” stool) is classic for intussusception, caused by ischemia and mucosal sloughing of the affected bowel segment.

• Abdominal findings: A distended abdomen with a small, palpable, oblong mass in the right upper quadrant is characteristic of the telescoping bowel seen in intussusception.

• Pain rating: Severe, intermittent, colicky abdominal pain causing the child to draw knees to chest is hallmark of intussusception due to periodic intestinal obstruction and ischemia. Children with Crohn’s may report chronic mild to moderate pain, often intermittent. Pain in appendicitis is usually steady, localized and worsens over time.

• Vomiting : Vomiting is common in intussusception due to partial bowel obstruction, often light-colored and non-bilious in early stages. In appendicitis, nausea and vomiting are common early symptoms.

•Temperature: In Crohn's disease low-grade fever is common due to the chronic inflammatory process, while in appendicitis, low-grade fever is common due to inflammation or early infection.

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Correct Answer is ["A","E"]

Explanation

Rationale for Correct Choices

• Seizures: The client’s BP of 166/110 mm Hg, +3 pitting edema, hyperreflexia (4+), and 3+ proteinuria are hallmark findings of severe preeclampsia, which places the client at high risk for progression to eclampsia (seizures). Cerebral edema and vasospasm associated with preeclampsia can precipitate convulsions if untreated.

• Placental abruption: Severe hypertension causes vasoconstriction and endothelial damage in uteroplacental vessels, predisposing the placenta to premature separation. This can lead to fetal distress, decreased movement, and potential maternal hemorrhage, both consistent with placental abruption risk in preeclampsia.

Rationale for Incorrect Choices

• Hypoglycemia: This condition is not related to preeclampsia; it more commonly occurs in clients with diabetes or from medication effects such as insulin overuse.

• Cervical insufficiency: This condition involves painless cervical dilation leading to preterm birth, unrelated to hypertension or proteinuria.

• Heart failure: Although hypertension increases cardiac workload, the current findings (normal heart rate, no dyspnea, clear lungs) do not indicate heart failure in this client.

A. A client who describes feeling disconnected from those around him following the hurricane. B. A client who describes having persistent feelings of anger about the hurricane. C. A client who has frequent nightmares about the hurricane. D. A client who moved to an apartment located on higher ground than her previous home. E. A client who expresses a realization that life will not return to the way it was before the hurricane.

Correct Answer is ["A","B","C"]

Explanation

Rationale:
A. A client who describes feeling disconnected from those around him following the hurricane: Emotional detachment or a sense of estrangement from others is a hallmark symptom of posttraumatic stress disorder (PTSD).

B. A client who describes having persistent feelings of anger about the hurricane: Ongoing irritability, anger, or emotional outbursts several months after a traumatic event may indicate unresolved trauma or hyperarousal, which are common features of PTSD.

C. A client who has frequent nightmares about the hurricane: Recurrent distressing dreams or flashbacks related to the traumatic event are hallmark re-experiencing symptoms of PTSD. Such nightmares suggest the trauma continues to affect the client’s sleep and mental health, justifying referral for further assessment.

D. A client who moved to an apartment located on higher ground than her previous home: Moving to a new location demonstrates adaptive coping and an effort to regain a sense of safety. This behavior does not indicate the presence of PTSD symptoms.

E. A client who expresses a realization that life will not return to the way it was before the hurricane: Acceptance and acknowledgment of change represent a healthy adjustment process. While grief or sadness may accompany this awareness, it reflects adaptation rather than pathological stress or trauma.

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A nurse in an acute care facility is caring for a toddler. Exhibits For each assessment finding below, click to specify if the assessment finding is consistent with Crohn's disease, appendicitis, or intussusception. Each finding may support more than 1 disease process.

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Naxlex Comprehensive Predictor Exams

The nurse is continuing to care for the client. Exhibits Which of the following conditions is the client is at greatest risk for developing? Select all that apply

Correct Answer is ["A","E"]

Explanation

A nurse is counseling a group of clients from a town that was affected by a hurricane 6 months ago. For which of the following clients should the nurse initiate a referral to assess for the presence of posttraumatic stress disorder? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

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A nurse in an acute care facility is caring for a toddler.

Exhibits

For each assessment finding below, click to specify if the assessment finding is consistent with Crohn's disease, appendicitis, or intussusception. Each finding may support more than 1 disease process.