Nursing Elites

1. If a client had irritable bowel syndrome, which of the following diagnostic tests would determine if the diagnosis is Crohn’s disease or ulcerative colitis?

• A. Abdominal computed tomography (CT) scan
• B. Abdominal x-ray
• C. Barium swallow
• D. Colonoscopy with biopsy

Correct answer: D

Rationale: A colonoscopy with biopsy is the most definitive diagnostic test to differentiate between Crohn's disease and ulcerative colitis.

2. Britney, a 20 y.o. student is admitted with acute pancreatitis. Which laboratory findings do you expect to be abnormal for this patient?

• A. Serum creatinine and BUN
• B. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
• C. Serum amylase and lipase
• D. Cardiac enzymes

Correct answer: C

Rationale: Serum amylase and lipase levels are typically elevated in patients with acute pancreatitis.

3. A client is admitted with a diagnosis of ulcerative colitis. Which of the following symptoms should the nurse expect the client to report when responding to questions about his bowel elimination pattern?

• A. Constipation.
• B. Bloody, diarrheal stools.
• C. Steatorrhea.
• D. Alternating periods of constipation and diarrhea.

Correct answer: B

Rationale: Diarrhea is the primary symptom of ulcerative colitis. It is profuse and severe; the client may pass as many as 15 to 20 watery stools per day. Stools may contain blood, mucus, and pus. The frequent diarrhea is often accompanied by anorexia and nausea. Constipation is not a sign or symptom of ulcerative colitis. Steatorrhea (fatty stools) is more typical of pancreatitis and cholecystitis. Alternating diarrhea and constipation is associated with irritable bowel syndrome.

4. The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician?

• A. Bloody diarrhea
• B. Hypotension
• C. A hemoglobin of 12 mg/dL
• D. Rebound tenderness

Correct answer: D

Rationale: Rebound tenderness is a sign of peritonitis, a serious complication that needs to be reported to the physician immediately.

5. Glenda has cholelithiasis (gallstones). You expect her to complain of:

• A. Pain in the right upper quadrant, radiating to the shoulder.
• B. Pain in the right lower quadrant, with rebound tenderness.
• C. Pain in the left upper quadrant, with shortness of breath.
• D. Pain in the left lower quadrant, with mild cramping.

Correct answer: A

Rationale: Patients with cholelithiasis often complain of pain in the right upper quadrant, radiating to the shoulder.

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