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Crohn's Disease: Multiple Choice Questions and Answers, Exams of Nursing

Georgian Court University (GCU)Nursing

A series of multiple choice questions and answers focusing on crohn's disease, a chronic inflammatory bowel disease. it covers various aspects of the disease, including symptoms, diagnosis, treatment, and complications. The questions are designed to test understanding of key concepts related to crohn's disease and its management. the detailed answers offer valuable insights into the pathophysiology and clinical presentation of the condition, making it a useful resource for students of nursing and medicine.

Typology: Exams

2024/2025

Available from 05/01/2025

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NU371 : INFLAMMATORY BOWEL DISORDERS AND
DISEASES: TEST QUESTIONS WITH ACCURATE
SOLUTIONS
1) A patient is taking prednisone 60 mg per day for the treatment of an acute
exacerbation of Crohn's disease. The patient has developed lymphopenia with a
lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client
for?
a) The onset of a bacterial infection
b) Bleeding
c) Abdominal pain
d) Diarrhea -- Correct Answer โœ”โœ” a) The onset of a bacterial infection
Lymphopenia (a lymphocyte count less than 1,500/mm3) can result from ionizing
radiation, long-term use of corticosteroids, uremia, infections (particularly viral
infections), some neoplasms (e.g., breast and lung cancers, advanced Hodgkin
disease), and some protein-losing enteropathies (in which the lymphocytes within
the intestines are lost) (Kipps, 2010). When lymphopenia is mild, it is often without
sequelae; when severe, it can result in bacterial infections (due to low B
lymphocytes) or in opportunistic infections (due to low T lymphocytes).
2) The nurse is obtaining information from a client with Crohn's disease about his
medication history. What medication would the nurse include when asking about
what medications the client has taken for suppression of the inflammatory and
immune response?
a) Nonsteroidal anti-inflammatory
b) Angiotensin-converting enzyme inhibitors (ACE-I)
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NU371 : INFLAMMATORY BOWEL DISORDERS AND

DISEASES: TEST QUESTIONS WITH ACCURATE

SOLUTIONS

  1. A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The patient has developed lymphopenia with a lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client for? a) The onset of a bacterial infection b) Bleeding c) Abdominal pain d) Diarrhea -- Correct Answer โœ”โœ” a) The onset of a bacterial infection Lymphopenia (a lymphocyte count less than 1,500/mm3) can result from ionizing radiation, long-term use of corticosteroids, uremia, infections (particularly viral infections), some neoplasms (e.g., breast and lung cancers, advanced Hodgkin disease), and some protein-losing enteropathies (in which the lymphocytes within the intestines are lost) (Kipps, 2010). When lymphopenia is mild, it is often without sequelae; when severe, it can result in bacterial infections (due to low B lymphocytes) or in opportunistic infections (due to low T lymphocytes).
  2. The nurse is obtaining information from a client with Crohn's disease about his medication history. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response? a) Nonsteroidal anti-inflammatory b) Angiotensin-converting enzyme inhibitors (ACE-I)

c) Diuretics d) Corticosteroids -- Correct Answer โœ”โœ” d) Corticosteroids The nurse obtains a history of immunizations, recent and past infectious diseases, and recent exposure to infectious diseases. The nurse reviews the client's drug history because certain drugs, such as corticosteroids, suppress the inflammatory and immune responses. Nonsteroidal anti-inflammatory medication does not suppress the inflammatory and immune responses of Crohn's disease. An ACE-I prevents the conversion of angiotensin I to angiotensin II and does not suppress the inflammatory or immune response. Diuretics also do not suppress the immune response but help reduce excess fluid from the kidneys.

  1. A client informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The client states that the physician told him he has irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder? a) Weight loss due to malabsorption b) Blood and mucus in the stool c) Chronic constipation with sporadic bouts of diarrhea d) Client is awakened from sleep due to abdominal pain. -- Correct Answer โœ”โœ” c) Chronic constipation with sporadic bouts of diarrhea Most clients with irritable bowel syndrome (IBS) describe having chronic constipation with sporadic bouts of diarrhea. Some report the opposite pattern, although less commonly. Most clients experience various degrees of abdominal pain that defecation may relieve. Weight usually remains stable, indicating that when diarrhea occurs, malabsorption of nutrients does not accompany it. Stools may have mucus, but blood is not usually found because the bowel is not locally inflamed. The sleep is not disturbed from abdominal pain.
  1. The nurse has performed client education for a 15-year-old boy with Crohn disease and his parents regarding the cobblestone lesions in his small intestine. Which comment by the family indicates learning has occurred? a) "I have to be careful because I am prone to not absorbing nutrients." b) "I have a lot of diarrhea every day because of how my small intestine is damaged." c) "I may end up with a colectomy because the disease is continuous from the beginning to the end of my intestines." d) "It's unusual for someone my age to get Crohn disease." -- Correct Answer โœ”โœ” a) "I have to be careful because I am prone to not absorbing nutrients." Crohn disease typically affects the small intestine more than the large intestine and its onset is between the ages of 10 to 20 years. The cobblestone lesions in the small intestine prevent absorption of nutrients that normally occurs. The diarrhea is not directly related to the cobblestone lesions, and ulcerative colitis is characterized by the disease affecting the intestine(s) in a continuous pattern.
  2. Crohn disease not only affects adults but also can occur in children. The nurse assesses for which major manifestation in children with Crohn disease? a) Dental caries b) Halitosis c) Malnutrition d) Weight gain -- Correct Answer โœ”โœ” c) Malnutrition When Crohn disease occurs in children, one of the major manifestations may be retardation of growth and significant malnutrition.
  3. Crohn disease is recognized by sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. The nurse recognizes these lesions to be defined by which description? a) Mosaic b) Pyramidal

c) Cobblestone d) Triangular -- Correct Answer โœ”โœ” c) Cobblestone A characteristic feature of Crohn disease is the sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. When there are multiple lesions, they are often referred to as "skip lesions" because they are interspersed between what appear to be normal segments of the bowel. The surface of the inflamed bowel usually has a characteristic "cobblestone" appearance resulting from the fissures and crevices that develop, surrounded by areas of submucosal edema.

  1. A nurse is assessing the bowel sounds of a client who has Crohn's disease. What assessment technique would the nurse use? a) Auscultation b) Palpation c) Percussion d) Inspection -- Correct Answer โœ”โœ” a) Auscultation Auscultation refers to the assessment technique of listening with a stethoscope to sounds produced in the body, such as bowel sounds. Palpation uses the sense of touch, percussion is the act of striking one object against another to produce sound, and inspection refers to observing.
  2. A client with Crohn's disease in remission is admitted to the nursing unit for follow- up care. The remission state is characterized by: a) permanent relief from the signs and symptoms. b) disappearance of signs and symptoms associated with the disease. c) periodic occurrence in clients with long-standing diseases. d) reactivation of the disease and presence of symptoms. -- Correct Answer โœ”โœ” b) disappearance of signs and symptoms associated with the disease. Remission is a temporary state of disappearance of the signs and symptoms related to a particular disease. It is of short duration, but the duration is unpredictable. It is a condition opposite to exacerbation, which is characterized by reactivation of

in his elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in his stool. Which diagnosis would his care team first suspect? a) Crohn disease b) Ulcerative colitis c) Diverticulitis d) Colon cancer -- Correct Answer โœ”โœ” a) Crohn disease Crohn disease, like ulcerative colitis, causes diarrhea, fecal urgency, weight loss, and systemic symptoms such as erythema nodosum and arthritis. Unlike ulcerative colitis, it also causes steatorrhea but is not as likely to cause blood in the stool. The granulomatous "skip" lesions confirm the diagnosis of Crohn disease. Neither diverticulitis nor colon cancer would cause this combination of symptoms and signs.

  1. The nurse is caring for a 77-year-old patient diagnosed with Crohn's disease. What would be especially important to monitor this patient for? a) Pain b) Fluid overload c) Fatigue d) Dehydration -- Correct Answer โœ”โœ” d) Dehydration Elderly patients can become dehydrated quickly and develop low potassium levels (i.e., hypokalemia) as a result of diarrhea. The nurse observes for clinical manifestations of muscle weakness, dysrhythmias, or decreased peristaltic motility that may lead to paralytic ileus. All options would be important to monitor, but especially important is monitoring for dehydration.
  2. Crohn disease is treated by several measures. Treatment with sulfasalazine will focus on which aspect of this disease? a) Immune suppression b) Inflammatory suppression c) Increased appetite

d) Decreased bleeding tendency -- Correct Answer โœ”โœ” b) Inflammatory suppression Treatment methods focus on terminating the inflammatory response and promoting healing, maintaining adequate nutrition, and preventing and treating complications. Several medications have been successful in suppressing the inflammatory reaction, including corticosteroids, sulfasalazine, metronidazole, azathioprine, 6-mercaptopurine, methotrexate, and infliximab.

  1. A nurse reading a sigmoidoscopy report notes that a client was found to have skip lesions. The nurse interprets this as an indication of: a) Crohn disease b) Ulcerative colitis c) Peptic ulcer d) Zollinger-Ellison syndrome -- Correct Answer โœ”โœ” a) Crohn disease Skip lesions, demarcated granulomatous lesions that are surrounded by normal- appearing mucosal tissue, are a characteristic feature of Crohn disease.
  2. Patients with irritable bowel disease (IBD) are at significantly increased risk for which of the following? a) Osteoporosis b) Deep vein thrombosis c) Hypotension d) Pneumonia -- Correct Answer โœ”โœ” a) Osteoporosis Patients with IBD also have a significantly increased risk of osteoporotic fractures due to decreased bone mineral density. Patients are not at increased risk of deep vein thrombosis, hypotension, or pneumonia.
  3. Inflammatory bowel disease (IBD) is used to designate two related inflammatory intestinal disorders: Crohn disease and ulcerative colitis. The nurse recognizes the

e) Intestinal obstruction -- Correct Answer โœ”โœ” a) Crohn disease b) Ulcerative colitis c) Lactase deficiency d) Fecal impaction All of the disorders except intestinal obstruction will result in chronic diarrhea.

  1. A client is admitted with inflammatory bowel syndrome (Crohn's disease). When planning care for the healthcare team, which would be included? Select all that apply. a) lactulose therapy b) high-fiber diet c) high-protein milkshakes d) corticosteroid therapy e) antidiarrheal medications -- Correct Answer โœ”โœ” d) corticosteroid therapy f) antidiarrheal medications Inflammatory bowel syndrome (Crohn's disease) is an inflammatory bowel disease caused by inflammation to the lining of the digestive tract which can lead to abdominal pain, severe diarrhea, and even malnutrition. Corticosteroids such as prednisone reduce the signs and symptoms of diarrhea, pain, and bleeding by decreasing inflammation. Antidiarrheals, such as diphenoxylate (Lomotil), combat diarrhea by decreasing peristalsis. Lactulose is used to treat chronic constipation and would aggravate the symptoms of Crohn's disease. A high-fiber diet and milk and milk products are contraindicated in clients with Crohn's disease because they may promote diarrhea.
  2. Which of the following agents would be least appropriate to use as treatment for ulcerative colitis? a) Salsalate b) Balsalazide c) Olsalazine

d) Mesalamine -- Correct Answer โœ”โœ” a) Salsalate Salsalate is used to treat pain, fever, and inflammation in adults. Balsalazide can be used to treat mild to moderate acute ulcerative colitis in adults. Olsalazine can be used to treat ulcerative colitis and other inflammatory bowel diseases in adults. Mesalamine is used to treat ulcerative colitis and other inflammatory bowel diseases in adults.

  1. Which is a true statement regarding regional enteritis (Crohn's disease)? a) It has a progressive disease pattern. b) It is characterized by pain in the lower left abdominal quadrant. c) The clusters of ulcers take on a cobblestone appearance. d) The lesions are in continuous contact with one another. -- Correct Answer โœ”โœ” c) The clusters of ulcers take on a cobblestone appearance. The clusters of ulcers take on a cobblestone appearance. It is characterized by remissions and exacerbations. The pain is located in the lower right quadrant. The lesions are not in continuous contact with one another and are separated by normal tissue.
  2. A client diagnosed with ulcerative colitis has been experiencing more than six bloody stools daily with evidence of toxicity. The nurse should question which order from the physician? a) Colonoscopy b) Stool specimen c) Ova and parasite examination d) Physical examination -- Correct Answer โœ”โœ” a) Colonoscopy Diagnosis of ulcerative colitis is based on history and physical examination. The diagnosis usually is confirmed by sigmoidoscopy, colonoscopy, biopsy, and by negative stool examinations for infectious or other causes. Colonoscopy should not be performed on people with severe disease because of the danger of perforation; however, it may be performed after demonstrated improvement to determine the extent of disease and need for subsequent cancer surveillance.