Celiac Disease Study Guide

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Sample questions from Celiac Disease Study Guide

This material has 12 questions with answers and rationales. Here are the first 5.

1. 1.A school-age child has abdominal distention, bulky stools, poor weight gain, and a parent with celiac disease. Which explanation best connects these findings with the suspected disorder?

   • A.An IgE-mediated wheat allergy causes immediate intestinal swelling and temporary lactose intolerance.
   • B.An immune response to gluten injures small-intestinal villi, reducing nutrient absorption in a genetically susceptible child.
   • C.A deficiency of pancreatic enzymes causes gluten to accumulate and directly damage the stomach lining.
   • D.An intestinal infection destroys colonic villi and is commonly transmitted between parents and children.

   Rationale: Celiac disease is an immune-mediated disorder triggered by gluten in genetically susceptible people. Small-intestinal villous injury causes malabsorption, which can produce bulky stools and poor growth; a first-degree relative increases risk. IgE-mediated wheat allergy is a different disorder. Pancreatic enzyme deficiency does not explain celiac disease, and celiac disease is neither infectious nor a disorder of colonic villi.

2. 2.An adult with chronic diarrhea and iron deficiency is scheduled for initial celiac disease testing. The patient asks whether to stop eating gluten now. Which nursing response is most appropriate?

   • A.Begin a gluten-free diet immediately because dietary changes do not affect antibody testing.
   • B.Avoid gluten for two weeks, then request a stool culture to confirm celiac disease.
   • C.Continue your usual gluten-containing diet until the evaluation is complete; initial blood testing commonly includes tissue transglutaminase IgA and total IgA.
   • D.Eat gluten only the evening before testing; a positive genetic test alone will confirm the diagnosis.

   Rationale: Gluten restriction can lower celiac antibodies and allow intestinal healing, potentially producing false-negative blood tests or biopsies. Tissue transglutaminase IgA with total IgA is a common initial approach; IgA deficiency may require IgG-based testing. A stool culture does not diagnose celiac disease. One evening of gluten does not reliably restore test sensitivity, and susceptibility genes alone cannot establish the diagnosis.

3. 3.A pregnant patient with newly diagnosed celiac disease reports fatigue and dizziness. Hemoglobin is 8.8 g/dL, ferritin is low, and the patient becomes lightheaded when standing. Which nursing plan best addresses immediate safety and ongoing nutritional needs?

   • A.Assist with ambulation, assess orthostatic vital signs, notify the clinician, and coordinate prescribed iron replacement and pregnancy-appropriate nutrition follow-up.
   • B.Encourage independent ambulation to improve endurance and postpone iron replacement until diarrhea resolves.
   • C.Recommend avoiding all carbohydrate foods and use weight gain alone to evaluate nutritional recovery.
   • D.Explain that a gluten-free diet will correct the anemia immediately, so additional assessment and supplements are unnecessary.

   Rationale: Symptomatic anemia and positional dizziness warrant fall precautions, assessment, and clinician notification. Iron replacement and dietitian-supported gluten-free nutrition help address malabsorption and pregnancy needs, including assessment of folate and other deficiencies. Independent ambulation increases fall risk, and replacement should not automatically wait for diarrhea to resolve. Avoiding all carbohydrates is unnecessarily restrictive. Intestinal healing and correction of anemia take time, and weight alone does not establish adequate nutrition.

4. 4.An adolescent with celiac disease reports fewer symptoms and wants to manage meals independently. Which statement shows correct understanding of lifelong treatment and follow-up?

   • A.I can occasionally eat regular pizza if it does not cause abdominal pain.
   • B.I can remove breading from cooked chicken because the gluten stays in the coating.
   • C.Once my antibody levels become normal, I can stop the diet and routine follow-up.
   • D.I will choose foods without wheat, barley, or rye, use a separate toaster, and keep follow-up visits even when I feel well.

   Answer and rationale are in the full material.

5. 5.An older adult with celiac-associated dermatitis herpetiformis is prescribed oral dapsone for severe itching. Which teaching should the nurse prioritize?

   • A.Dapsone heals the intestinal villi, so gluten restriction is needed only when the rash returns.
   • B.Dapsone can relieve the rash quickly, but a lifelong gluten-free diet remains necessary; complete ordered G6PD and blood-count testing and report shortness of breath or blue-gray lips promptly.
   • C.Dapsone replaces vitamin and mineral supplements and requires monitoring only if abdominal pain develops.
   • D.Stop the gluten-free diet during treatment so the clinician can judge whether dapsone alone controls the disease.

   Answer and rationale are in the full material.