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Which of the following differentiates ulcerative colitis from Crohn's disease?
- A. Crohn's disease primarily affects the left colon and rectum, while ulcerative colitis most often affects the right colon and distal ileum.
- B. Crohn's disease presents with shallow ulcerations, whereas ulcerative colitis presents with a cobblestone appearance of the mucosal lining.
- C. The extent of involvement is noncontiguous and segmented with Crohn's disease, whereas it is contiguous and diffuse with ulcerative colitis.
- D. Crohn's disease has primarily mucosal involvement, whereas it is transmural with ulcerative colitis.
Correct Answer: C
Rationale: The correct answer is C. Crohn's disease is characterized by noncontiguous, segmented involvement, meaning it can affect different areas with healthy tissue in between, while ulcerative colitis involves continuous areas of inflammation. Choices A, B, and D are incorrect because Crohn's disease can affect any part of the digestive tract from mouth to anus, can present with shallow ulcerations or deep fissures, and is transmural, meaning it affects the entire thickness of the bowel wall. On the other hand, ulcerative colitis typically affects the colon and rectum, presents with a continuous pattern of inflammation, and primarily involves the mucosal lining of the colon.
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A clinical instructor teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at highest risk for developing diabetes?
- A. The 50-year-old client who does not engage in any physical exercise
- B. The 56-year-old client who drinks three glasses of wine daily
- C. The 42-year-old client who is 50 pounds overweight
- D. The 38-year-old client who smokes one pack of cigarettes daily
Correct Answer: C
Rationale: The 42-year-old client who is 50 pounds overweight is at the highest risk for developing diabetes. Excess weight is a significant risk factor for diabetes as it can lead to insulin resistance and metabolic abnormalities. Choices A, B, and D are also risk factors for diabetes, but being overweight has a stronger association with the development of the condition compared to lack of exercise, excessive alcohol consumption, or smoking.
Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select one that does not apply.
- A. The nurse could have given the insulin subcutaneously.
- B. The nurse did not have to contact the physician.
- C. The nurse should have used regular insulin (Humulin R).
- D. The nurse used the correct insulin.
Correct Answer: C
Rationale: The best evaluation of the nurse reveals that she should have used regular insulin (Humulin R) for IV administration. Regular insulin is the only insulin approved for intravenous administration due to its pharmacokinetic properties. Insulin lispro (Humalog) is not suitable for IV use. Choice A is incorrect because giving insulin intravenously is necessary in this case of high blood sugar. Choice B is incorrect because administering a different insulin without consulting the physician is not appropriate. Choice D is incorrect because the nurse used the incorrect insulin, which could pose risks to the client's health.
Which of the following is the best way to improve nursing's image?
- A. Uniforms should reflect your professionalism.
- B. Introduce yourself with your full name.
- C. Understand the essence of professional behavior in your practice.
- D. Take every opportunity to speak to the public about nursing.
Correct Answer: D
Rationale: The correct answer is D because taking every chance to engage with the public about nursing allows for the improvement of nursing's image and the promotion of the profession. Choice A is incorrect as uniforms should reflect professionalism rather than personality. Choice B is not directly related to improving nursing's image. Choice C, while important, does not directly address improving the image of nursing through public engagement.
A client with a tumor refuses surgery, but the client's partner wants it. Which is the deciding factor in determining if the surgery will be done?
- A. Whether the partner is the client's durable power of attorney for healthcare
- B. Whether the client understands the risk of refusing the procedure
- C. Whether the client's refusal is based on religious belief
- D. Whether the facility's ethical committee reaches a consensus on the case
Correct Answer: B
Rationale: The correct answer is B because the client's understanding of the risks involved in refusing the surgery is crucial in determining the course of action. In this scenario, the client's autonomy and decision-making capacity take precedence. Choice A is not directly relevant to the decision-making process regarding surgery. Choice C, religious beliefs, may influence the decision but should not be the determining factor in this case. Choice D involving the facility's ethical committee is not typically involved in individual patient care decisions.
While administering penicillin intravenously, you notice that the patient becomes hypotensive with a bounding, rapid pulse rate. What is the first action you should take?
- A. Decrease the rate of the intravenous medication flow.
- B. Increase the rate of the intravenous medication flow.
- C. Call the doctor.
- D. Stop the intravenous flow.
Correct Answer: D
Rationale: The correct action to take when a patient becomes hypotensive with a bounding, rapid pulse rate after administering penicillin intravenously is to stop the intravenous flow immediately. This can help prevent further complications by discontinuing the administration of the medication that might be causing the adverse effects. Decreasing or increasing the rate of medication flow may not address the underlying issue of the patient's adverse reaction. While it's important to involve the healthcare provider in such situations, the immediate priority is to halt the administration of the medication.