Chapter 47

The nurse is providing care for a client whose inflammatory bowel disease has necessitated hospital treatment. Which of the following would most likely be included in the client's medication regimen? a. Antidiarrheal medications 30 minutes before a meal b. Antiemetics on a PRN basis c. Vitamin B12 injections to prevent pernicious anemia d. Beta adrenergic blockers to reduce bowel motility

a. Antidiarrheal medications 30 minutes before a meal

A nurse is providing care for a client who has a diagnosis of irritable bowel syndrome (IBS). When planning this client's care, the nurse should collaborate with the client and prioritize what goal? a. Client will accurately identify foods that trigger symptoms. b. Client will demonstrate appropriate care of his ileostomy. c. Client will demonstrate appropriate use of standard infection control precautions. d. Client will adhere to recommended guidelines for mobility and activity.

a. Client will accurately identify foods that trigger symptoms.

A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite? a. High levels of alcohol consumption b. History of bowel obstruction c. History of diverticulitis d. Longstanding psychosocial stress

a. High levels of alcohol consumption

A client is admitted to the medical unit with a diagnosis of intestinal obstruction. When planning this client's care, which of the following nursing diagnoses should the nurse prioritize? a. Ineffective Tissue Perfusion Related to Bowel Ischemia b. Imbalanced Nutrition: Less Than Body Requirements Related to Impaired Absorption c. Anxiety Related to Bowel Obstruction and Subsequent Hospitalization d. Impaired Skin Integrity Related to Bowel Obstruction

a. Ineffective Tissue Perfusion Related to Bowel Ischemia

A teenage client with a pilonidal cyst has been brought for care by her mother. The nurse who is contributing to the client's care knows that treatment will be chosen based on what risk? a. Risk for infection b. Risk for bowel incontinence c. Risk for constipation d. Risk for impaired tissue perfusion

a. Risk for infection

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: a. fissure. b. fistula. c. hemorrhoid. d. pilonidal cyst.

a. fissure.

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? a. "Limit your fluid intake temporarily so you don't get diarrhea." b. "Avoid taking the drug on a long-term basis." c. "Make sure to take a multivitamin with each dose." d. "Take this on an empty stomach to ensure maximum effect."

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

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? a. "I don't understand this; I took the medication the doctor ordered and followed the diet." b. "I didn't eat anything I shouldn't have; I just ate roast beef on rye bread." c. "I don't understand why this happened again; I didn't travel out of the country." d. "I don't like oatmeal, so it doesn't matter that I can't have it."

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

A nurse is conducting health screening with a diverse group of clients. Which client likely has the most risk factors for developing hemorrhoids? a. A 45-year-old teacher who stands for 6 hours per day b. A pregnant woman at 28 weeks' gestation c. A 37-year-old construction worker who does heavy lifting d. A 60-year-old professional who is under stress

b. A pregnant woman at 28 weeks' gestation

A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response? a. Administer a Fleet enema as prescribed and remain with the client. b. Contact the primary provider promptly and report these signs of perforation. c. Position the client supine and insert an NG tube. d. Page the primary provider and report that the client may be obstructed.

b. Contact the primary provider promptly and report these signs of perforation.

The nurse is caring for a client who is undergoing diagnostic testing for suspected malabsorption. When taking this client's health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis? a. Recurrent constipation coupled with weight loss b. Foul-smelling diarrhea that contains fat c. Fever accompanied by a rigid, tender abdomen d. Bloody bowel movements accompanied by fecal incontinence

b. Foul-smelling diarrhea that contains fat

An adult client has been diagnosed with diverticular disease after ongoing challenges with constipation. The client will be treated on an outpatient basis. What components of treatment should the nurse anticipate? Select all that apply. a. anticholinergic medications b. Increased fiber intake c. Enemas on alternating days d. Reduced fat intake e. Fluid reduction

b. Increased fiber intake d. Reduced fat intake

Celiac sprue is an example of which category of malabsorption? a. Infectious diseases causing generalized malabsorption b. Mucosal disorders causing generalized malabsorption c. Luminal problems causing malabsorption d. Postoperative malabsorption

b. Mucosal disorders causing generalized malabsorption

A nurse caring for a client with a newly created ileostomy assesses the client and notes that the client has not had ostomy output for the past 12 hours. The client also reports worsening nausea. What is the nurse's priority action? a. Facilitate a referral to the wound-ostomy-continence (WOC) nurse. b. Report signs and symptoms of obstruction to the health care provider. c. Encourage the client to mobilize in order to enhance motility. d. Contact the physician and obtain a swab of the stoma for culture.

b. Report signs and symptoms of obstruction to the health care provider.

A 16-year-old presents at the emergency department reporting right lower quadrant pain and is subsequently diagnosed with appendicitis. When planning this client's nursing care, the nurse should prioritize what nursing diagnosis? a. Imbalanced Nutrition: Less Than Body Requirements Related to Decreased Oral Intake b. Risk for Infection Related to Possible Rupture of Appendix c. Constipation Related to Decreased Bowel Motility and Decreased Fluid Intake d. Chronic Pain Related to Appendicitis

b. Risk for Infection Related to Possible Rupture of Appendix

A client admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this client? a. Spinach b. Tofu c. Multigrain bagel d. Blueberries

b. Tofu

A client's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather than ulcerative colitis, as the cause of the client's signs and symptoms? a. A pattern of distinct exacerbations and remissions b. Severe diarrhea c. An absence of blood in stool d. Involvement of the rectal mucosa

c. An absence of blood in stool

A nurse is working with a client who has chronic constipation. What should be included in client teaching to promote normal bowel function? a. Use glycerin suppositories on a regular basis. b. Limit physical activity in order to promote bowel peristalsis. c. Consume high-residue, high-fiber foods. d. Resist the urge to defecate until the urge becomes intense.

c. Consume high-residue, high-fiber foods.

A client's screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this client's health problem? a. Adherence to a high-fiber diet will help the polyps resolve. b. The client should be assured that these are a normal, age-related physiologic change. c. The client's polyps constitute a risk factor for cancer. d. The presence of polyps is associated with an increased risk of bowel obstruction.

c. The client's polyps constitute a risk factor for cancer.

A nurse is talking with a client who is scheduled to have a hemicolectomy with the creation of a colostomy. The client admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. What nursing action is most appropriate? a. Reassure the client that the procedure is relatively low risk and that clients are usually successful in adjusting to an ostomy. b. Provide the client with educational materials that match the client's learning style. c. Encourage the client to write down these concerns and questions to bring forward to the surgeon. d. Maintain an open dialogue with the client and facilitate a referral to the wound-ostomy-continence (WOC) nurse.

d. Maintain an open dialogue with the client and facilitate a referral to the wound-ostomy-continence (WOC) nurse.