Question

Which of the following is NOT commonly recommended for patients with Crohn's disease during a flare-up?

Answer 1

Correct Answers:

High Folic Acid Vegetables

Rationale :

🥦 During a Crohn’s disease flare-up, a low-residue (low-fiber) diet is recommended to reduce bowel stimulation and minimize cramping and diarrhea.

🥦 High-folic-acid vegetables—often high in fiber, such as leafy greens and legumes—can irritate the inflamed intestinal mucosa, worsening symptoms during a flare.

🥦 Corticosteroids and immunosuppressants are commonly prescribed to reduce inflammation and suppress the overactive immune response that drives Crohn’s disease.

🥦 After remission, patients may gradually reintroduce high-fiber and nutrient-rich foods to maintain nutritional balance under medical supervision.

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Answer 2

Correct Answers:

15

Rationale :

Each dose = 40 mEq ÷ 2 = 20 mEq

mL needed = 20 mEq ÷ 6.7 mEq/5 mL = 14.925… ≈ 15 mL

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Answer 3

Correct Answers:

42

Rationale :

250 mL ÷ 6 hr = 42 mL/hr

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Answer 4

Correct Answers:

Petechiae

Rationale :

🔴 In advanced cirrhosis, liver damage leads to decreased production of clotting factors and thrombopoietin, resulting in thrombocytopenia and increased bleeding tendency.

🔴 Petechiae—small, pinpoint red or purple spots on the skin—are a classic sign of impaired coagulation due to low platelet count or clotting deficiencies.

🔴 Hypertension may occur as portal hypertension, but systemic hypertension is not typical in cirrhosis.

🔴 Peripheral ulcers and osteoarthritis are unrelated to liver function failure and are not expected findings.

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Answer 5

Correct Answers:

A patient with ulcerative colitis receiving sulfasalazine who reports low grade fever and orange urine

Rationale :

🔹 Sulfasalazine can cause serious hematologic toxicity such as agranulocytosis or leukopenia, which manifests as low-grade fever or infection.

🔹 Although orange urine is a harmless side effect of the medication, fever is never considered normal and may signal bone marrow suppression.

🔹 This makes the patient at high risk for sepsis, and the nurse must promptly assess and obtain CBC and vital signs.

🔹 The other clients’ findings (e.g., mild bloating from lactulose or metallic taste from metronidazole) are expected effects and do not indicate an immediate threat.

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Answer 6

Correct Answers:

Performing frequent mental status assessments on a patient with hepatic encephalopathy

Rationale :

🔷 Frequent mental status assessments require ongoing evaluation, interpretation, and clinical judgment, which are the responsibility of the RN, not the LPN.

🔷 Hepatic encephalopathy involves fluctuating neurological status, so subtle changes can signal rising ammonia levels or worsening cerebral edema.

🔷 The RN must personally evaluate these findings to determine treatment effectiveness and adjust the care plan.

🔷 Tasks such as reinforcing teaching, administering stable oral medications, and monitoring bowel sounds can be safely delegated to an LPN.

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Answer 7

Correct Answers:

Respiratory rate of 20

Rationale :

💎 A respiratory rate of 20/min is within the normal range (12–20/min) and does not indicate acute distress.

💎 The question asks which data do not warrant immediate intervention, and this value reflects stable respiratory function.

💎 In contrast, decreased bile production and elevated bilirubin indicate worsening liver function, while bradycardia and altered mentation suggest hepatic encephalopathy progression.

💎 Therefore, the normal respiratory rate is expected and does not need urgent action.

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Answer 8

Correct Answers:

Both require frequent surgery

Rationale :

✨ Ulcerative colitis and Crohn’s disease are both forms of inflammatory bowel disease (IBD) characterized by chronic inflammation of the gastrointestinal tract.

✨ The inflammation results in ulceration, edema, and mucosal damage, leading to symptoms such as abdominal pain, diarrhea, and weight loss.

✨ While ulcerative colitis is limited to the colon and rectum, Crohn’s disease can affect any part of the GI tract.

✨ Recognizing their shared inflammatory pathophysiology helps guide management, including anti-inflammatory and immunosuppressive therapy.

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Answer 9

Correct Answers:

Performing a focused Gl assessment for a patient with hepatic encephalopathy

Rationale :

🔹 A focused assessment requires clinical judgment, data interpretation, and critical thinking that are appropriate for the RN.

🔹 In hepatic encephalopathy, subtle changes in GI function and neurological status must be correlated to detect rising ammonia levels or worsening hepatic dysfunction.

🔹 The RN is responsible for initial and focused assessments, while LPNs can collect data but not interpret or evaluate findings.

🔹 Tasks such as giving medications or recording I&O can be safely assigned to an LPN because they do not require complex decision-making.

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Answer 10

Correct Answers:

Bowel Rest

Rationale :

🌿 The initial treatment for uncomplicated diverticulitis is bowel rest to allow the inflamed colon to heal and reduce intra-luminal pressure.

🌿 This involves keeping the patient NPO or on clear liquids, providing IV fluids for hydration, and avoiding solid foods that may irritate the bowel.

🌿 Once symptoms subside, a high-fiber diet can be reintroduced gradually to prevent further diverticula formation.

🌿 Antibiotics may be used for infection control, but resting the bowel is the key initial intervention to reduce inflammation and promote healing.

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Custom NC3 - Fall 2025 - Exam 2-PM

No.

1 :
Which of the following is NOT commonly recommended for patients with Crohn's disease during a flare-up?

2 :
A nurse is preparing to administer potassium chloride elixir 40 mEq divided into 2 equal doses every 12 hr. Available is 6.7 mEq/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.

4 :
A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect?

5 :
Which patient should the nurse assess first?

6 :
Which task should NOT be delegated to the LPN?

7 :
The patient with cirrhosis is not diagnosed with esophageal bleeding. Which assessment data do not warrant immediate intervention by the nurse?

8 :
A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of th following information should the nurse include?

9 :
Which nursing intervention should the RN avoid delegating to the LPN?

10 :
Which intervention is the initial treatment of choice for uncomplicated diverticulitis?

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Custom NC3 - Fall 2025 - Exam 2-PM

No.

1 : Which of the following is NOT commonly recommended for patients with Crohn's disease during a flare-up?

2 : A nurse is preparing to administer potassium chloride elixir 40 mEq divided into 2 equal doses every 12 hr. Available is 6.7 mEq/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.

4 : A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect?

5 : Which patient should the nurse assess first?

6 : Which task should NOT be delegated to the LPN?

7 : The patient with cirrhosis is not diagnosed with esophageal bleeding. Which assessment data do not warrant immediate intervention by the nurse?

8 : A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of th following information should the nurse include?

9 : Which nursing intervention should the RN avoid delegating to the LPN?

10 : Which intervention is the initial treatment of choice for uncomplicated diverticulitis?

1 :
Which of the following is NOT commonly recommended for patients with Crohn's disease during a flare-up?

2 :
A nurse is preparing to administer potassium chloride elixir 40 mEq divided into 2 equal doses every 12 hr. Available is 6.7 mEq/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.

4 :
A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect?

5 :
Which patient should the nurse assess first?

6 :
Which task should NOT be delegated to the LPN?

7 :
The patient with cirrhosis is not diagnosed with esophageal bleeding. Which assessment data do not warrant immediate intervention by the nurse?

8 :
A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of th following information should the nurse include?

9 :
Which nursing intervention should the RN avoid delegating to the LPN?

10 :
Which intervention is the initial treatment of choice for uncomplicated diverticulitis?