prepU ch. 41 GI

A client with Crohn's disease is to receive prednisone as part of the treatment plan. Which of the following instructions would be appropriate? "Make sure to increase your salt intake to compensate for the loss of fluid." "Once your symptoms improve, you can stop taking the drug." "Avoid contact with other people who might have an infection." "Take the drug on an empty stomach to avoid upsetting your stomach."

"Avoid contact with other people who might have an infection."

After undergoing a total cystectomy and urinary diversion, a client has a Kock pouch (continent internal reservoir) in place. Which statement by the client indicates a need for further teaching? "I'll have to wear an external collection pouch for the rest of my life." "I'll have to catheterize my pouch every 2 hours." "I'll need to drink at least eight glasses of water a day." "I should eat foods from all the food groups."

"I'll have to wear an external collection pouch for the rest of my life."

Medical management of a patient with peritonitis includes fluid, electrolyte, and colloid replacement. The nurse knows to prepare the initial, most appropriate intravenous solution. Which of the following is the correct solution? D10W 0.9% NS 0.45% of NS D5W

0.9% NS

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 Frank blood in the stool Abdominal distention A change in bowel habits

A change in bowel habits

A community health nurse is performing a home visit to a 53-year-old patient who requires twice-weekly wound care on her foot. The patient mentions that she is currently having hemorrhoids, a problem that she has not previously experienced. What treatment measure should the nurse recommend to this patient? Daily application of topical antibiotics A high-fiber diet with increased fruit intake Decreased fluid intake Bathing, rather than showering, once per day

A high-fiber diet with increased fruit intake

What is the most common cause of small-bowel obstruction? Volvulus Neoplasms Hernias Adhesions

Adhesions

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

Assist client to increase dietary fiber.

A client presents to the emergency room with a possible diagnosis of appendicitis. The health care provider asks the nurse to assess for tenderness at McBurney's point. The nurse knows to palpate which area? Between the umbilicus and the left iliac crest Between the umbilicus and the anterior superior iliac spine In the left periumbilical area In the upper right quadrant slightly below the diaphragm

Between the umbilicus and the anterior superior iliac spine

Which drug is considered a stimulant laxative? Mineral oil Bisacodyl Psyllium hydrophilic mucilloid Magnesium hydroxide

Bisacodyl

The nurse is performing an abdominal assessment for a patient with diarrhea and auscultates a loud rumbling sound in the left lower quadrant. What will the nurse document this sound as on the nurse's notes? Peristalsis Tenesmus Loud bowel sounds Borborygmus

Borborygmus

A patient is admitted to the hospital after not having had a bowel movement in several days. The nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. What complication can this patient develop related to this problem? Diverticulitis Bowel perforation Rectal fissures Appendicitis

Bowel perforation

The nurse is talking with a group of clients who are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider? Daily bowel movements Abdominal cramping when having a bowel movement Excess gas Change in bowel habits

Change in bowel habits

A client informs the nurse of having abdominal pain that is relieved when having a bowel movement. The health care provider diagnosed the client with irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder? Chronic constipation with sporadic bouts of diarrhea Weight loss due to malabsorption Client is awakened from sleep due to abdominal pain. Blood and mucus in the stool

Chronic constipation with sporadic bouts of diarrhea

The nurse is irrigating a client's colostomy when the client begins to report cramping. What is the appropriate action by the nurse? Change irrigation fluid to normal saline. Increase the rate of administration. Discontinue the irrigation immediately. Clamp the tubing and allow client to rest.

Clamp the tubing and allow client to rest.

A patient is suspected to have diverticulosis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling? CT scan Flexible sigmoidoscopy Colonoscopy Barium enema

Colonoscopy

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? Irritable bowel syndrome Diverticulitis Crohn's disease Ulcerative colitis

Crohn's disease

An older adult client seeks help for chronic constipation. What factor related to aging can cause constipation in elderly clients? Decreased production of hydrochloric acid Decreased abdominal strength Increased intestinal bacteria Increased intestinal motility

Decreased abdominal strength

The nurse is preparing a client for a test that involves inserting a thick barium paste into the rectum with radiographs taken as the client expels the barium. What test will the nurse prepare the client for? Defecography Abdominal radiography Colonic transit studies Kidneys, ureters, bladder (KUB)

Defecography

Which is one of the primary symptoms of irritable bowel syndrome (IBS)? Diarrhea Abdominal distention 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. Avoid unprocessed bran. Drink 8 to 10 glasses of fluid daily. Avoid daily exercise.

Drink 8 to 10 glasses of fluid daily.

The nurse is teaching a client with an ostomy how to change the pouching system. Which information should the nurse include when teaching a client with no peristomal skin irritation? Apply triamcinolone acetonide spray Dust with nystatin powder Apply barrier powder Dry skin thoroughly after washing

Dry skin thoroughly after washing

A client has been recently diagnosed with an anorectal condition. The nurse is reviewing interventions that will assist the client with managing the therapeutic regimen. What would not be included? Instruct the client to cleanse perianal area with warm water. Encourage the client to avoid exercise. Teach the client how to do sitz baths at home using warm water three to four times each day. Encourage the client to follow diet and medication instructions.

Encourage the client to avoid exercise.

The nurse is caring for a patient who has malabsorption syndrome with an undetermined cause. What procedure will the nurse assist with that is the best diagnostic test for this illness? Pancreatic function tests Stool specimen for ova and parasites Endoscopy with mucosal biopsy Ultrasound

Endoscopy with mucosal biopsy

A client underwent a continent ileostomy. Within which time frame should the client expect to empty the reservoir? Every 4 to 6 hours Two to three times daily At least once every 2 days At least once a day

Every 4 to 6 hours

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? Administer a laxative to relieve the client's constipation. Perform the test for rebound tenderness. Explain to the client why analgesics are being withheld. 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.

Which characteristic is a risk factor for colorectal cancer? History of skin cancer Low-fat, low-protein, high-fiber diet Familial polyposis Age younger than 40 years

Familial polyposis

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? Flexible sigmoidoscopy Anorectal manometry Transit study Barium enema

Flexible sigmoidoscopy

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

Impaired ability to absorb food

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, what would the nurse stress the importance of? Wearing an appliance pouch only at bedtime Taking only enteric-coated medications Consuming a low-protein, high-fiber diet Increasing fluid intake to prevent dehydration

Increasing fluid intake to prevent dehydration

Crohn's disease is a condition of malabsorption caused by which pathophysiological process? Infectious disease Inflammation of all layers of intestinal mucosa Disaccharidase deficiency Gastric resection

Inflammation of all layers of intestinal mucosa

Which is the most prominent sign of inflammatory bowel disease? Intermittent pain and diarrhea Abdominal distention and constipation Increased peristalsis and diarrhea Hyperactive bowel sounds and constipation

Intermittent pain and diarrhea

A patient is not having daily bowel movements and has begun taking a laxative for this problem. What should the nurse educate the patient about regarding laxative use? Laxatives should never be the first response for the treatment of constipation; natural methods should be employed first. Laxatives should not be routinely taken due to destruction of nerve endings in the colon. When taking the laxatives, plenty of fluid should be taken as well. The laxatives should be taken no more than 3 times a week or laxative addiction will result.

Laxatives should not be routinely taken due to destruction of nerve endings in the colon.

Diet modifications for patient diagnosed with chronic inflammatory bowel disease include which of the following? Low residue Iron restriction Calorie restriction Low protein

Low residue

Vomiting results in which of the following acid-base imbalances? Respiratory alkalosis Respiratory acidosis Metabolic acidosis Metabolic alkalosis

Metabolic alkalosis

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

Metamucil

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? The appendix may develop gangrene and rupture, especially in a middle-aged client. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

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

The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder? One part of the intestine telescopes into another portion of the intestine. The bowel protrudes through a weakened area in the abdominal wall. A loop of intestine adheres to an area that is healing slowly after surgery. The bowel twists and turns itself and obstructs the intestinal lumen.

One part of the intestine telescopes into another portion of the intestine.

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

Peritonitis

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 Weight gain Duodenal ulcers Polyps

Polyps

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? Left upper quadrant Right upper quadrant Left lower quadrant Right lower quadrant

Right lower quadrant

A client presents to the ED with acute abdominal pain, fever, nausea, and vomiting. During the client's examination, the lower left abdominal quadrant is palpated, causing the client to report pain in the RLQ. This positive sign is referred to as ________ and suggests the client may be experiencing ________. McBurney sign; perforation Rovsing sign; acute appendicitis McBurney sign; acute appendicitis Rovsing sign; perforation

Rovsing sign; acute appendicitis

A client is diagnosed with Zollinger-Ellison syndrome. The nurse knows to assess the client for which characteristic clinical feature of this syndrome? Steatorrhea Folate deficiency Decreased intestinal lactose Lymphadenopathy

Steatorrhea

The nurse is reviewing the laboratory test results of a client with Crohn disease. Which of the following would the nurse most likely find? Increased albumin levels Decreased erythrocyte sedimentation rate Stool cultures negative for microorganisms or parasite Decreased white blood cell count

Stool cultures negative for microorganisms or parasite

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? Prepare the client for a gastrostomy tube placement. Administer topical ointment to the rectal area to decrease bleeding. Test all stools for occult blood. Administer morphine (Duramorph PF) routinely, as ordered.

Test all stools for occult blood.

A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which statement best indicates that the disease process is under control? The client expresses positive feelings about himself. The client verbalizes a manageable level of discomfort. The client exhibits signs of adequate GI perfusion. The client maintains skin integrity.

The client exhibits signs of adequate GI perfusion.

Which is a true statement regarding regional enteritis (Crohn's disease)? It has a progressive disease pattern. It is characterized by pain in the lower left abdominal quadrant. The lesions are in continuous contact with one another. The clusters of ulcers take on a cobblestone appearance.

The clusters of ulcers take on a cobblestone appearance.

A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important? The consistency of stool and comfort when passing stool That the stool is formed and soft The client is able to fully evacuate with each bowel movement That the client has a bowel movement daily

The consistency of stool and comfort when passing stool

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? 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. 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.

A client is being seen in the clinic for reports of painful hemorrhoids. The nurse assesses the client and observes the hemorrhoids are prolapsed but able to be placed back in the rectum manually. The nurse documents the hemorrhoids as what degree? Third degree First degree Fourth degree Second degree

Third degree First degree hemorrhoids do not prolapse and protrude into the anal canal. Second degree hemorrhoids prolapse outside the anal canal during defecation but reduce spontaneously. Third degree hemorrhoids prolapse to the extent that they require manual reduction. Fourth degree hemorrhoids prolapse to the extent that they may not be reduced.

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

Ulcerative colitis

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

Usual pattern of elimination

A client is admitted to the emergency department with reports right lower quadrant pain. Blood specimens are drawn and sent to the laboratory. Which laboratory finding should be reported to the health care provider immediately? Serum sodium 135 mEq/L Hematocrit 42% White blood cell (WBC) count 22.8/mm3 Serum potassium 4.2 mEq/L

White blood cell (WBC) count 22.8/mm3

A client with a history of constipation is instructed to consume a high fiber diet. Which statement by the client about an appropriate food choice indicates the need for additional teaching? Dried lentils White bread Brown rice Popcorn

White bread

A longitudinal tear or ulceration in the lining of the anal canal is termed a(n): hemorrhoid. anal fissure. anal fistula. anorectal abscess.

anal fissure

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: fistula. pilonidal cyst. fissure. hemorrhoid.

fissure

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

high-fiber diet.

The nurse caring for an older adult client diagnosed with diarrhea is administering and monitoring the client's medications. Because one of the client's medications is digitalis (digoxin), the nurse monitors the client closely for: hyperkalemia. hypernatremia. hypokalemia. hyponatremia.

hypokalemia.

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

A nurse is reviewing lab results for a client with an intestinal obstruction, and infection is suspected. What would be an expected finding? leukopenia, decreased hematocrit; low sodium, potassium, and chloride leukocytosis; elevated hematocrit; low sodium, potassium, and chloride leukocytosis; metabolic alkalosis; elevated sodium, potassium, and chloride leukopenia; metabolic acidosis; elevated sodium, potassium, and chloride

leukocytosis; elevated hematocrit; low sodium, potassium, and chloride

A nurse is performing focused assessment on her clients. She expects to hear hypoactive bowel sounds in a client with: Crohn's disease. complete bowel obstruction. gastroenteritis. paralytic ileus.

paralytic ileus.

A client is admitted from the emergency department with complaints of severe abdominal pain and an elevated white blood cell count. The physician diagnoses appendicitis. The nurse knows the client is at greatest risk for: ulceration of the appendix. rupture of the appendix. emotional distress related to the pain. inflammation of the gallbladder.

rupture of the appendix

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? rectal bleeding and a change in bowel habits jaundice and vomiting tenderness and pain in the right upper abdominal quadrant severe abdominal pain with direct palpation or rebound tenderness

severe abdominal pain with direct palpation or rebound tenderness

The nurse teaches the client whose surgery will result in a sigmoid colostomy that the feces expelled through the colostomy will be fluid. mushy. semi mushy. solid.

solid.