Canadian Registered Nurse Exam
CRNE Short Answer Questions
Case 1



Canadian Registered Nurse Exam Case 1: Ms. Vicky, a 30-year old single mother, lives with ulcerative colitis and has been diagnosed with toxic megacolon. Her vital signs are 39.8C-temp, 112-HR, 28-RR, 88/50-BP. The physician orders an I.V. of Ringer's lactate, I.V. antibiotics, I.V. steroids and a nasogastric tube. Ms. Vicky is very concerned about her teenage son while she is in the hospital.

1. List two priority nursing interventions.

a. ______________

b. ______________

2. Ms. Vicky's condition deteriorates. What assessment data would clearly indicate that she has a perforated colon?

a. _____________

3. List one life-threatening complication that can result from a perforation of the colon.

a. _____________

4. Following special surgical repair of her perforated colon. Ms. Vicky wants to talk to her son ass soon as she wakes up. What should the nurse do first in this situation?

a. ____________



Canadian Registered Nurse Exam:
Answers and Rationale

1) For 3 points, list both of the following:

a. Insert Nasogastric tube and
b. Administer (establish) I.V. fluids

Rationale: Given Ms. Vicky's diagnosis and current vital signs, the most urgent nursing interventions are to insert the nasogastric to decompress the gastrointestinal tract preventing further complications and to administer I.V. fluids because of a low blood pressure.

2) For 3 points, list any one (1) of the following answers:

- Acute increase in abdominal pain
- Rigid abdomen
- Absent (decreased) bowel sounds

Rationale: Acute increase in abdominal pain or a rigid abdomen indicates bowel perforation. Absence or decreased bowel sounds indicates a decrease or absence in peristalsis.

3) For 3 points, list any one (1) of the following answers:

- Shock (hypovolemic or septic)
- Peritonitis

Rationale: Perforation of the colon results in uncontrollable hemorrhage resulting in shock. Perforation of the colon can also result in peritonitis when the contents of the gastrointestinal track leak into the abdominal cavity.

4) For 3 points, list any one (1) of the following:

- Assist Ms. Vicky with calling her son
- Nurse places a call to Ms. Vicky's son
- Bring the phone to Ms. Vicky

Rationale: These interventions will meet Ms. Vicky's immediate need to talk to her son.


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