Chapter 41- Rectal Disorders

The presence of mucus and pus in the stools suggests which condition? Ulcerative colitis Intestinal malabsorption Disorders of the colon Small-bowel disease

Ulcerative colitis

The nurse is performing a community screening for colorectal cancer. Which characteristic should the nurse include in the screening? History of skin cancer Age younger than 40 years Familial polyposis Low-fat, low-protein, high-fiber diet

Familial polyposis

The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition? Disorders of the colon Ulcerative colitis Small-bowel disease Intestinal malabsorption

Ulcerative colitis

After assessing a client with peritonitis, how would the nurse most likely document the client's bowel sounds? Mild High-pitched Hyperactive Absent

Absent

When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. The appendix may develop gangrene and rupture, especially in a middle-aged client. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage.

Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

A client has been brought into the ED via ambulance, reporting acute generalized abdominal pain, nausea, fever, and constipation. The healthcare provider suspects appendicitis, but testing has not been performed yet to make a definitive diagnosis. What will the nurse most likely do while initially caring for this client? Perform the test for rebound tenderness. Explain to the client why analgesics are being withheld. Administer a laxative to relieve the client's constipation. Frequently palpate the abdomen to assess for changes that might indicate the onset of a perforation.

Explain to the client why analgesics are being withheld.

A nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. What else would the nurse expect to find? severe abdominal pain with direct palpation or rebound tenderness tenderness and pain in the right upper abdominal quadrant rectal bleeding and a change in bowel habits jaundice and vomiting

Severe abdominal pain with direct palpation or rebound tenderness

An older adult client in a long-term care facility is concerned about bowel regularity. During a client education session, the nurse reinforces the medically acceptable definition of "regularity." What is the actual measurement of "regular"? stool consistency and client comfort one bowel movement every other day one bowel movement daily two bowel movements daily

Stool consistency and client comfort

The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation? Current medications Activity levels Alcohol consumption Usual pattern of elimination

Usual pattern of elimination

The nurse is assessing a client for constipation. To identify the cause of constipation, the nurse should begin by reviewing the client's: current medications. alcohol consumption. activity levels. usual pattern of elimination.

usual pattern of elimination.

A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult? "I don't like oatmeal, so it doesn't matter that I can't have it." "I don't understand this; I took the medication the doctor ordered and followed the diet." "I don't understand why this happened again; I didn't travel out of the country." "I didn't eat anything I shouldn't have; I just ate roast beef on rye bread."

"I didn't eat anything I shouldn't have; I just ate roast beef on rye bread."

A nurse is teaching an older adult client about good bowel habits. Which statement by the client indicates to the nurse that additional teaching is required? "I need to drink 2 to 3 liters of fluids every day." "I should eat a fiber-rich diet with raw, leafy vegetables, unpeeled fruit, and whole grain bread." "I need to use laxatives regularly to prevent constipation." "I should exercise four times per week."

"I need to use laxatives regularly to prevent constipation."

A nurse is caring for a client with constipation whose primary provider has recommended senna for the management of this condition. The nurse should provide which of the following education points? "Make sure to take a multivitamin with each dose." "Take this on an empty stomach to ensure maximum effect." "Avoid taking the drug on a long-term basis." "Limit your fluid intake temporarily so you don't get diarrhea."

"Avoid taking the drug on a long-term basis."

A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder? Abdominal pain Abdominal distention Frank blood in the stool A change in bowel habits

A change in bowel habits

An elderly client diagnosed with diarrhea is taking digoxin. Which electrolyte imbalance should the nurse be alert to? Hypernatremia Hyperkalemia Hyponatremia Hypokalemia

Hypokalemia

Which of the following is considered a bulk-forming laxative? Mineral oil Metamucil Milk of Magnesia Dulcolax

Metamucil

A nurse is interviewing a client about past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? Hemorrhoids Duodenal ulcers Weight gain Polyps

Polyps

The nurse is performing and documenting the findings of an abdominal assessment. When the nurse hears intestinal rumbling and the client then experiences diarrhea, the nurse documents the presence of which condition? Borborygmus Tenesmus Azotorrhea Diverticulitis

Potassium-rich foods

When the nurse interviews a client with internal hemorrhoids, what would the nurse expect the client to report? Constipation Discharge that includes pus Rectal bleeding Severe pain

Rectal bleeding

A client who has undergone colostomy surgery is experiencing constipation. Which intervention should a nurse consider for such a client? Instruct the client to avoid prune or apple juice Suggest fluid intake of at least 2 L/day Instruct the client to keep a record of food intake Assist the client regarding the correct diet or to minimize food intake

Suggest fluid intake of at least 2 L/day

Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes: caffeinated products. high-fiber diet. spicy foods. fluids with meals.

high-fiber diet.

The nurse is irrigating a colostomy when the patient says, "You will have to stop, I am cramping so badly." What is the priority action by the nurse? Clamp the tubing and give the patient a rest period. Replace the fluid with cooler water since it is probably too warm. Inform the patient that it will only last a minute and continue with the procedure. Stop the irrigation and remove the tube.

Clamp the tubing and give the patient a rest period

Which is one of the primary symptoms of irritable bowel syndrome (IBS)? Abdominal distention Diarrhea Pain Bloating

Diarrhea

The nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching? Use laxatives weekly. Drink 8 to 10 glasses of fluid daily. Avoid unprocessed bran. Avoid daily exercise.

Drink 8 to 10 glasses of fluid daily.

What information should the nurse include in the teaching plan for a client being treated for diverticulosis? Avoid daily exercise; indulge only in mild activity Avoid unprocessed bran in the diet Use laxatives or enemas at least once a week Drink at least 8 to 10 large glasses of fluid every day

Drink at least 8 to 10 large glasses of fluid every day

A client with Crohn's disease is losing weight. For which reason will the nurse anticipate the client being prescribed parenteral nutrition? Insufficient oral intake Prolonged preoperative nutritional needs Unwilling to ingest nutrients orally Impaired ability to absorb food

Impaired ability to absorb food

A patient visited a nurse practitioner because he had diarrhea for 2 weeks. He described his stool as large and greasy. The nurse knows that this description is consistent with a diagnosis of: A disorder of the large bowel. Inflammatory colitis. Intestinal malabsorption. A small bowel disorder.

Intestinal malabsorption.

The instructor is teaching a group of students about irritable bowel syndrome (IBS) and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an antidiarrheal agent commonly administered for IBS? Lubiprostone Loperamide Dicyclomine Peppermint oil

Loperamide

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and board-like. What complication does the nurse determine may be occurring at this time? Constipation Peritonitis Accumulation of gas Paralytic ileus

Peritonitis

Post appendectomy, a nurse should assess the patient for abdominal rigidity and tenderness, fever, loss of bowel sounds, and tachycardia, all clinical signs of: An abscess under the diaphragm. A pelvic abscess. Peritonitis An ileus.

Peritonitis

Which type of diarrhea is caused by increased production of water and electrolytes by the intestinal mucosa and their secretion into the intestinal lumen? Secretory diarrhea Diarrheal disease Osmotic diarrhea Mixed diarrhea

Secretory diarrhea

A client reports taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about taking a stimulant laxative? If the client is drinking 8 glasses of water per day, it is all right to continue taking them. The client should take a fiber supplement along with the stimulant laxative. They can be habit forming and will require increasing doses to be effective. The laxative is safe to take with other medication the client is taking.

They can be habit forming and will require increasing doses to be effective.

A resident at a long-term care facility lost the ability to swallow following a stroke 4 years ago. The client receives nutrition via a PEG tube, has adapted well to the tube feedings, and remains physically and socially active. Occasionally, the client develops constipation that requires administration of a laxative to restore regular bowel function. What is the most likely cause of this client's constipation? lack of free water intake increased fiber lack of solid food lack of exercise

lack of free water intake

Celiac disease (celiac sprue) is an example of which category of malabsorption? Luminal problems causing malabsorption Mucosal disorders causing generalized malabsorption Postoperative malabsorption Infectious diseases

Mucosal disorders causing generalized malabsorption

Which of the following would a nurse expect to assess in a client with peritonitis? Decreased pulse rate Board-like abdomen Hyperactive bowel sounds Deep slow respirations

Board-like abdomen

A client reports severe pain and bleeding while having a bowel movement. Upon inspection, the health care provider notes a linear tear in the anal canal tissue. The client is diagnosed with a: pilonidal cyst. hemorrhoid. fistula. fissure.

Fissure

The nurse in an extended-care facility reports that a resident has clinical manifestations of fecal incontinence. The health care provider orders a diagnostic study to rule out inflammation. Which study will the nurse prepare the client for? Transit study Barium enema Flexible sigmoidoscopy Anorectal manometry

Flexible sigmoidoscopy

A client is diagnosed with colon cancer, located in the lower third of the rectum. What does the nurse understand will be the surgical treatment option for this client? Abdominoperineal resection Colectomy A low colectomy Segmental resection

Abdominoperineal resection

A client reports constipation. Which nursing measure would be most effective in helping the client reduce constipation? Obtain medical and allergy history. Assist client to increase dietary fiber. Provide adequate quantity of food. Obtain complete food history.

Assist client to increase dietary fiber

A patient with IBD would be encouraged to increase fluids, use vitamins and iron supplements, and follow a diet designed to reduce inflammation. Select the meal choice that would be recommended for a low-residue diet. Broiled chicken with low-fiber pasta A fruit salad with yogurt Salami on whole grain bread and V-8 juice A peanut butter sandwich and fruit cup

Broiled chicken with low-fiber pasta

Which statement provides accurate information regarding cancer of the colon and rectum? Rectal cancer affects more than twice as many people as colon cancer. The incidence of colon and rectal cancer decreases with age. Colorectal cancer is the third most common site of cancer in the United States. Colon cancer has no hereditary component.

Colorectal cancer is the third most common site of cancer in the United States.

A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of? Ulcerative colitis Irritable bowel syndrome Diverticulitis Crohn's disease

Crohn's disease

A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location? Right upper quadrant Left upper quadrant Right lower quadrant Left lower quadrant

Right lower quadrant

The nurse is monitoring a client's postoperative course after an appendectomy. The nurse's assessment reveals that the client has vomited, has abdominal tenderness and rigidity, and has tachycardia. The nurse reports to the physician that the client has signs/symptoms of which complication? Peritonitis Ileus Hemorrhage Pelvic abscess

Peritonitis

Which of the following is the most common symptom of a polyp? Diarrhea Anorexia Rectal bleeding Abdominal pain

Rectal bleeding

A client realizes that regular use of laxatives has greatly improved bowel patterns. However, the nurse cautions this client against the prolonged use of laxatives for which reason? The client may develop arthritis or arthralgia. The client may lose his or her appetite. The client's natural bowel function may become sluggish. The client may develop inflammatory bowel disease.

The client's natural bowel function may become sluggish

A client is admitted to the hospital for diagnostic testing to rule out colorectal cancer. Which intervention should the nurse include on the plan of care? Administer morphine (Duramorph PF) routinely, as ordered. Administer topical ointment to the rectal area to decrease bleeding. Prepare the client for a gastrostomy tube placement. Test all stools for occult blood.

Test all stools for occult blood.