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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.

Temperature

Vomiting

Pain rating

Abdominal findings

Stool

Answer and Explanation

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

Temperature: A temperature of 37.4°C is within normal limits and does not specifically support any of the three conditions. While low-grade fever may be seen in appendicitis or Crohn’s flares, the absence of fever at this time limits its diagnostic value in this case.
Vomiting: Vomiting in intussusception is common and often non-bilious in early stages, aligning with the child's light-colored emesis. Vomiting also occurs in appendicitis, especially in the early stages. However, it is not a prominent or early symptom of Crohn’s disease unless obstruction is present.
Pain rating: Severe, intermittent abdominal pain where the child draws their knees to the chest and then returns to normal behavior is a classic symptom of intussusception. Neither Crohn’s disease nor appendicitis typically presents with this pattern, appendicitis pain is usually constant and worsening, while Crohn’s pain is chronic and non-episodic.
Abdominal findings: A distended abdomen with hypoactive bowel sounds and a palpable sausage-shaped mass in the right upper quadrant is highly indicative of intussusception. These findings are not characteristic of appendicitis, which usually involves RLQ pain, or Crohn’s, which rarely presents with a discrete palpable mass.
Stool: The presence of blood and mucus in the stool ("currant jelly stool") is strongly associated with intussusception and may also occur in Crohn’s disease during flares due to colonic inflammation. Appendicitis does not typically cause bloody or mucoid stools, making this finding inconsistent with that diagnosis.

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Correct Answer is D

Explanation

A. Weight gain 2.3 kg (5 lb): Mild weight gain can occur with oral contraceptive use and is generally not dangerous. This finding does not require immediate reporting.

B. Frequent nausea: Nausea is a common side effect, especially during the first few months of therapy. While bothersome, it is usually not an urgent concern unless severe or persistent.

C. Breast tenderness: Breast tenderness is a common, mild side effect of oral contraceptives and does not typically indicate a serious problem requiring immediate intervention.

D. Persistent headache: A new, persistent, or severe headache can indicate vascular complications, such as hypertension or increased risk of thromboembolism, which are serious adverse effects of oral contraceptives. This finding requires immediate reporting.

A. "I don't think you will benefit from reviewing your therapist's notes right now." B. "Are you not happy with your treatment?" C. "Why are you interested in seeing your therapist's notes?" D. "We can provide a copy of your records, but the therapist's notes are not included."

Correct Answer is D

Explanation

Rationale:

A. "I don't think you will benefit from reviewing your therapist's notes right now.": This statement dismisses the client’s request without addressing legal and policy guidelines regarding access to records. It also inappropriately assumes the client’s capacity to benefit from the information.

B. "Are you not happy with your treatment?": This redirects the conversation away from the request and implies dissatisfaction, which can create defensiveness. It does not provide the client with accurate information about their right to access medical records.

C. "Why are you interested in seeing your therapist's notes?": Asking “why” can sound confrontational and does not answer the client’s question. The focus should be on explaining what parts of the record can be shared, according to policy and law.

D. "We can provide a copy of your records, but the therapist's notes are not included.": Psychotherapy notes are excluded from standard medical record disclosures under HIPAA, as they are kept separate to protect sensitive details.

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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.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has been taking oral contraceptives for the past 6 months. Which of the following findings should the nurse immediately report to the provider?

Correct Answer is D

Explanation

A nurse in a mental health clinic receives a request from a client who is undergoing psychotherapy to obtain a copy of the therapist's notes. Which of the following responses should the nurse make?

Correct Answer is D

Explanation

A nurse is delegating tasks to a group of staff members. Which of the following tasks should the nurse assign to an assistive personnel?

A nurse is caring for a female client who requests a contraceptive diaphragm. Which of the following actions should the nurse take first?

A nurse is planning care for a client who is receiving hemodialysis. Which of the following actions should the nurse include in the plan of care?

A charge nurse is delegating tasks for a group of clients on a medical surgical unit. Which of the following tasks should the nurse delegate to the assistive personnel?

A nurse is caring for a client who is scheduled for surgery. The client states, "I have decided not to have the surgery." Which of the following responses should the nurse make to the client?

A nurse is reviewing laboratory data from a client who has chronic kidney disease. Which of the following findings should the nurse expect?

A community health nurse is working with a group of clients. The nurse practices the ethical principle of distributive justice by performing which of the following tasks?

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.