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Crohn disease: Taking charge of a lifelong disorder

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doi: 10.1097/01.NURSE.0000458888.36547.1c
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INSTRUCTIONS Crohn disease: Taking charge of a lifelong disorder

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PROVIDER ACCREDITATION

Lippincott Williams & Wilkins, publisher of Nursing2014 journal, will award 2.0 contact hours for this continuing nursing education activity.

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Crohn disease: Taking charge of a lifelong disorder

GENERAL PURPOSE: To provide information that can be used to help patients with Crohn disease. LEARNING OBJECTIVES: After reading this article and taking this test, you should be able to: 1. Explain the pathophysiology of Crohn disease. 2. Identify signs and symptoms of Crohn disease. 3. Describe nursing interventions for patients with Crohn disease.

  1. Crohn disease most commonly involves the
    1. stomach and distal colon.
    2. small intestine and distal colon.
    3. distal ileum and proximal colon.
    4. proximal ileum and distal colon.
  2. Among patients with Crohn disease,
    1. 60% have ileal disease only.
    2. 50% have ileocolic disease.
    3. 40% have jejunal disease only.
    4. 10% have colonic disease only.
  3. Which statement about Crohn disease is correct?
    1. It typically starts in adolescence.
    2. It's more common in men.
    3. It's more common in women.
    4. It's typically diagnosed between ages 40 and 50.
  4. Which environmental factor doesn't play a role in Crohn disease?
    1. air pollution
    2. a western diet high in sugar and polyunsaturated fats
    3. exposure to cigarette smoke
    4. living in rural areas
  5. Crohn disease frequently develops after
    1. gastric bypass surgery.
    2. use of nonsteroidal anti-inflammatory drugs.
    3. infectious gastroenteritis.
    4. use of oral contraceptives.
  6. One mutation associated with Crohn disease is the
    1. MSH2 gene.
    2. NOD2/CARD15 gene.
    3. PMS2 gene.
    4. EPCAM gene.
  7. Crohn disease commonly begins as which type of lesion?
    1. aphthoid
    2. leukoplakia
    3. fordyce spots
    4. mucoceles
  8. Nutritional deficiencies accompanying Crohn disease are caused by
    1. absence of intrinsic factor.
    2. disruption of the mucosal absorptive surface.
    3. rapid passage of food.
    4. lack of digestive enzymes.
  9. Within 10 years of diagnosis, 50% of patients with Crohn disease will require surgery to repair a
    1. fissure.
    2. bowel perforation.
    3. perirectal abscess.
    4. fistula.
  10. Which diagnostic test can best help pinpoint the location of diseased bowel?
    1. MR enterography
    2. CT scan
    3. barium enema
    4. wireless capsule endoscopy
  11. Among the primary management goals for a patient with Crohn disease is
    1. preventing immunosuppression.
    2. encouraging the patient to eat dairy products and limit liquid intake.
    3. controlling signs and symptoms and maintaining clinical remission.
    4. advising the patient to eat three large meals per day rather than frequent small ones.
  12. Which of the following is associated with fistula formation in Crohn disease?
    1. gas-forming foods
    2. drinking alcohol
    3. smoking
    4. eating dairy products
  13. In patients with Crohn disease, chronic anemia is typically caused by
    1. an iron-deficient diet.
    2. disturbed iron metabolism.
    3. poor absorption of iron.
    4. excessive iron excretion.
  14. Corticosteroids can cause all of the following adverse reactions except
    1. hypertension.
    2. loss of bone mass.
    3. mood swings.
    4. hypoglycemia.
  15. The purpose of biologic therapies for Crohn disease is to
    1. decrease intestinal inflammation.
    2. prevent serious infection.
    3. heal fistulas.
    4. prevent anemia.
  16. Which statement about SBS is accurate?
    1. Patients with SBS have less than 500 cm of small intestine.
    2. Patients with SBS have less than 200 cm of large intestine.
    3. SBS may cause bowel leakage.
    4. Some patients with SBS become dependent on parenteral nutrition.
  17. In patients with Crohn disease, which blood test result indicates increased inflammation?
    1. increased albumin
    2. decreased white blood cell count
    3. increased C-reactive protein
    4. decreased erythrocyte sedimentation rate
  18. Dietary recommendations for patients with Crohn disease are determined by
    1. the patient using trial and error.
    2. standard dietary guidelines for Crohn disease.
    3. the patient's healthcare provider.
    4. a nutritionist.
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