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?

Correct Answer: D

Rationale: In the context of a client with irritable bowel syndrome, the diagnostic test that would help differentiate between Crohn's disease and ulcerative colitis is a colonoscopy with biopsy, which is option D. This test allows direct visualization of the colon and rectum, providing essential information about the mucosal lining, presence of inflammation, and specific features indicative of either Crohn's disease or ulcerative colitis. A colonoscopy with biopsy is considered the gold standard for diagnosing inflammatory bowel diseases like Crohn's and ulcerative colitis due to its ability to provide detailed information for accurate differentiation. Option A, an abdominal CT scan, may show some features suggestive of inflammatory bowel disease but lacks the ability to provide the detailed mucosal information that a colonoscopy with biopsy offers. Option B, an abdominal x-ray, is not specific or sensitive enough to differentiate between Crohn's disease and ulcerative colitis. Option C, a barium swallow, is used to evaluate the esophagus and stomach, making it irrelevant for assessing the colon and differentiating between these two specific conditions. Understanding the diagnostic tests specific to gastrointestinal disorders is crucial in nursing practice, as it guides appropriate treatment plans and interventions. By choosing the correct test based on the clinical presentation, healthcare providers can ensure timely and accurate diagnosis, leading to better outcomes for patients with gastrointestinal conditions.

Correct Answer: C

Rationale: In a client with Crohn's disease, the correct answer for the symptom that should not be a direct result of antibiotic therapy is option C) Decrease in body weight. Crohn's disease is a chronic inflammatory condition that affects the gastrointestinal tract, leading to symptoms such as abdominal pain, diarrhea, weight loss, and malnutrition. Antibiotic therapy is often used to manage infections or complications in Crohn's disease, but it is not primarily aimed at causing weight loss. Option A) Decrease in bleeding is incorrect because antibiotics can help resolve infections that may be contributing to gastrointestinal bleeding in Crohn's disease. Option B) Decrease in temperature is incorrect as antibiotics can help reduce fever associated with infections. Option D) Decrease in the number of stools is incorrect because antibiotics can help improve diarrhea by treating underlying infections or inflammation in Crohn's disease. From an educational perspective, understanding the expected outcomes of antibiotic therapy in Crohn's disease is essential for nurses caring for these patients. By knowing the appropriate responses to treatment, nurses can monitor and evaluate the effectiveness of interventions and provide comprehensive care to promote positive patient outcomes. Additionally, differentiating between expected and unexpected responses to therapy helps nurses identify potential complications and adjust the plan of care accordingly.

Correct Answer: D

Rationale: In the context of medical surgical nursing, understanding the rationale behind the surgical management of ulcerative colitis is crucial for providing effective patient care. In this scenario, the correct answer is D) Bowel perforation. Ulcerative colitis is a chronic inflammatory condition that primarily affects the colon and rectum. In severe cases, ulcerative colitis can lead to complications such as toxic megacolon, which can result in bowel perforation. Surgical management in ulcerative colitis is often indicated for patients who do not respond to medical therapy or who develop serious complications like bowel perforation. Now, let's analyze why the other options are incorrect: A) Gastritis: Gastritis refers to inflammation of the stomach lining, which is not a direct complication of ulcerative colitis. B) Bowel herniation: While bowel herniation can occur in various conditions, it is not a common complication specifically associated with ulcerative colitis. C) Bowel outpouching: This is more commonly seen in conditions like diverticulosis/diverticulitis and is not a typical complication of ulcerative colitis. Educationally, this question highlights the importance of recognizing the potential complications of ulcerative colitis and the need for timely surgical intervention in cases of bowel perforation to prevent further complications like sepsis or peritonitis. Understanding these concepts is essential for nurses caring for patients with ulcerative colitis to ensure prompt identification and appropriate management of complications.

Correct Answer: A

Rationale: In the context of irritable bowel disease (IBD), the most appropriate medication for treating associated pain is Acetaminophen (Option A). Acetaminophen is preferred over other options for several reasons. Firstly, it is a non-opioid analgesic that helps relieve pain without causing the potential risks and side effects associated with opiates (Option B), such as respiratory depression, constipation, and the risk of dependence. Steroids (Option C) are not typically used for treating pain in IBD; they are more commonly used for reducing inflammation in conditions like Crohn's disease or ulcerative colitis. Stool softeners (Option D) are primarily used to prevent or treat constipation and do not directly address pain associated with IBD. Educationally, understanding the rationale behind selecting Acetaminophen for pain management in IBD is crucial for nursing students. It reinforces the importance of selecting appropriate analgesics based on the patient's condition, potential side effects, and overall treatment goals. This knowledge helps students develop critical thinking skills in pharmacology and patient care, ensuring safe and effective pain management practices in clinical settings.

Correct Answer: D

Rationale: In the context of recovery from ostomy surgery for ulcerative colitis, the first priority of client care should be skin care (option D). This is because proper skin care around the stoma is crucial to prevent skin breakdown, irritation, and infection which are common issues in ostomy patients. Maintaining skin integrity is essential for the overall well-being and comfort of the patient. Regarding why the other options are not the first priority: - Body image (option A): While body image is important for a patient's psychosocial well-being, immediate post-operative care should focus on physiological needs like skin care to prevent complications. - Ostomy care (option B): While important, the question specifies "during the first few days of recovery," where skin care takes precedence over routine ostomy care. - Sexual concerns (option C): While sexuality and intimacy are important aspects of a patient's life, they are not the immediate priority in the early days of post-operative care. In an educational context, understanding the prioritization of care based on the patient's immediate needs post-surgery is crucial for nursing students and healthcare professionals. Emphasizing the importance of skin care in ostomy patients can prevent complications and promote better outcomes for patients undergoing such surgeries.