Exhibits

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

Temperature

Vomiting

Abdominal findings

Stool

Pain rating

Answer and Explanation

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

Rationale:

Temperature: The child’s temperature is 37.4°C (99.3°F), which is mildly elevated. Crohn’s disease typically causes intermittent fever during flare-ups. Appendicitis often presents with a higher fever in later stages. Intussusception can cause low-grade fever due to bowel inflammation, making it the most consistent with this finding.
Vomiting: Vomiting is uncommon in Crohn’s disease unless there’s obstruction or severe disease. In appendicitis, vomiting usually follows the onset of pain and is related to peritoneal irritation. Intussusception often involves vomiting early due to intermittent bowel obstruction, making it consistent with this client’s symptoms.
Abdominal findings: Crohn’s disease rarely produces a palpable abdominal mass or sudden distension. Appendicitis can cause right-sided tenderness and decreased bowel sounds but does not typically involve a mass. Intussusception often presents with a distended abdomen, hypoactive bowel sounds, and a sausage-shaped mass in the right upper quadrant, as described.
Stool: Crohn’s disease can lead to bloody, mucus-filled stools due to ulceration in the intestinal lining. Appendicitis does not typically alter stool characteristics unless perforation occurs. Intussusception is well known for producing “currant jelly” stools, composed of blood and mucus, aligning with this child’s bowel movement description.
Pain rating: A FLACC score of 5 indicates moderate pain. Crohn’s pain tends to be chronic and crampy rather than episodic. Appendicitis pain worsens over time and becomes localized, typically in the right lower quadrant. Intussusception causes intermittent, severe abdominal pain with sudden relief, matching the child’s pain episodes and behavior.

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Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

Rationale for Correct Choices:

Endometritis: Endometritis is a common postpartum infection of the uterine lining, often following cesarean birth, especially with risk factors like prolonged rupture of membranes and anemia. Clinical features include uterine tenderness, foul-smelling lochia, and fever, all of which are present in this case.
Uterus and lochia assessment: A uterus that is tender and slightly elevated, with moderate dark brown, malodorous lochia, is a hallmark of endometritis. The boggy fundus that firms with massage also suggests poor involution, frequently associated with infection.

Rationale for Incorrect Choices:

Mastitis: While the client reports breast discomfort, mastitis typically presents with unilateral breast pain, localized redness, and flu-like symptoms. The findings here are more consistent with engorgement than with infectious mastitis.
Pneumonia: The client has no respiratory distress, productive cough, or abnormal lung sounds (only slightly diminished bases), and oxygen saturation is normal. These signs are insufficient to support pneumonia.
Fever: Although fever is present (38.2°C), it is a nonspecific symptom that could occur with any postpartum infection or inflammation. It supports infection but does not localize the source as definitively as the uterine and lochia findings.
WBC count: The elevated WBC count (33,000/mm³) indicates infection or inflammation, but again, it is nonspecific. It supports the diagnosis but does not point solely to endometritis without clinical context from the uterus and lochia.

A. Trochanter roll B. Footboard C. Sheepskin heel pad D. Abduction pillow

Correct Answer is B

Explanation

Rationale:

A. Trochanter roll: A trochanter roll is used to prevent external rotation of the hips in clients who are immobile. It does not support the feet or ankles and therefore does not prevent plantar flexion contractures.

B. Footboard: A footboard helps maintain the foot in a dorsiflexed, neutral position by providing firm support against the soles. This prevents foot drop, a common plantar flexion contracture in clients with limited mobility.

C. Sheepskin heel pad: Sheepskin heel pads protect the heels from pressure ulcers by reducing friction and shear but do not maintain ankle alignment or prevent plantar flexion of the feet.

D. Abduction pillow: An abduction pillow is placed between the legs to maintain hip alignment after procedures like hip replacement. It offers no support to the feet and does not prevent plantar flexion.

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Exhibits For each potential assessment finding, click to specify if the 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 on a postpartum unit is caring for a client. Exhibits Complete the following sentence by using the lists of options. The client is most likely experiencing by the client's dropdown as evidenced by the client’s dropdown.

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

A nurse is caring for a client who has a spinal cord injury. Which of the following support devices should the nurse plan to use to prevent plantar flexion contractures?

Correct Answer is B

Explanation

A nurse is caring for a client who is receiving IV fluid therapy. For which of the following findings should the nurse monitor as an adverse effect of the IV fluid therapy?

A nurse in an emergency department is assessing four clients. Which of the following clients should the nurse see first?

A charge nurse is observing a conflict between two nurses who both insist that the charge nurse favors the other when making assignments. Which of the following conflict-resolution strategies should the charge nurse use?

A nurse is measuring the fundal height of a client who is at 36 weeks of gestation. The client suddenly reports nausea. Which of the following actions should the nurse take?

A nurse is assessing a client who has obsessive-compulsive personality disorder. Which of the following manifestations should the nurse expect?

A nurse is providing nutrition teaching for a client who has hypertension. Which of the following foods should the nurse suggest the client include in their diet?

Exhibits

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