A nurse in an acute care facility is caring for a toddler.
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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. "I will take a bulk-forming laxative every day.": While bulk-forming laxatives can help manage constipation, taking them without adequate fluid intake can worsen constipation or cause bowel obstruction. Education should emphasize combining fiber with sufficient fluids.
B. "I will avoid strenuous exercise.": Regular physical activity actually promotes intestinal motility and helps prevent opioid-induced constipation. Avoiding exercise would counteract this preventive strategy.
C. "I will increase my intake of high-fiber foods.": Consuming high-fiber foods, such as fruits, vegetables, and whole grains, adds bulk to stool and promotes regular bowel movements. This is a key dietary intervention for preventing constipation in clients taking opioids like oxycodone.
D. "I will limit my fluid intake to 1 liter per day.": Limiting fluids can exacerbate constipation because hydration is necessary to soften stool and support normal bowel function. Clients should maintain adequate fluid intake alongside increased dietary fiber.
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"E"}
Explanation
Rationale for Correct Choices
• Pain medication: Fractures cause pain due to bone and soft tissue injury. Administering analgesics helps manage discomfort, improves cooperation with care, and facilitates movement and participation in activities as tolerated. Pain control also reduces stress responses that can interfere with healing.
• Limb immobilization: Nondisplaced midshaft fractures of the radius and ulna require immobilization using a cast or splint to maintain proper alignment, prevent further injury, and promote bone healing. Immobilization also supports neurovascular protection and decreases the risk of displacement.
Rationale for Incorrect Choices
• Skin traction: Skin traction is typically used for femur or lower limb fractures, not isolated forearm fractures, and is unnecessary for nondisplaced radius and ulna fractures.
• Antibiotics: The fracture is closed and nondisplaced, with no open wound or infection, so prophylactic antibiotics are not indicated.
• Surgical consultation: Surgery is usually reserved for displaced, unstable, or complex fractures. This nondisplaced fracture can be managed conservatively with immobilization.
• Bed rest: While rest is important, strict bed rest is unnecessary for upper extremity fractures. The child can perform limited activities while the arm is immobilized.
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