Intestinal & Rectal Disorders

When interviewing a client with internal hemorrhoids, what would the nurse expect the client to report? A) Rectal bleeding B) Itching C) Soreness D) Pain

A) Rectal bleeding

In women, which of the following types of cancer exceeds colorectal cancer? A) Breast B) Liver C) Lung D) Skin

A) Breast

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

D) Colorectal cancer is the third most common site of cancer in the U.S.

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? A) Pelvic abscess B) Hemorrhage C) Peritonitis D) Ileus

C) Peritonitis

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"? A) Stool consistency and client comfort B) One bowel movement daily C) Two bowel movements daily D) One bowel movement every other day

A) Stool consistency and client comfort

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? A) Replace the fluid with cooler water since it is probably too warm. B) Stop the irrigation and remove the tube. C) Clamp the tubing and give the patient a rest period. D) Inform the patient that it will only last a minute and continue with the procedure.

C) Clamp the tubing and give the patient a rest period.

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) Hemorrhoid B) Pilonidal cyst C) Fissure D) Fistula

C) Fissure

Straining at stool initiates the _____ maneuver that results in a potentially dangerous increase in BP.

Valsalva

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. A) A fruit salad with yogurt B) Salami on whole grain bread and V-8 juice C) A peanut butter sandwich and fruit cup D) Broiled chicken with low-fiber pasta

D) Broiled chicken with low-fiber pasta

A client with enteritis reports frequent diarrhea. What assessment should the nurse should anticipate? A) Respiratory acidosis B) Metabolic alkalosis C) Respiratory alkalosis D) Metabolic acidosis

D) Metabolic acidosis

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? A) Change in bowel habits B) Abdominal cramping when having a bowel movement C) Excess gas D) Daily bowel movements

A) Change in bowel habits

Which of the following is the most common symptom of a polyp? A) Rectal bleeding B) Diarrhea C) Abdominal pain D) Anorexia

A) Rectal bleeding

A nurse is caring for a client who had an ileal conduit 3 days earlier. The nurse examines the stoma site and determines that she should consult with the ostomy nurse. Which assessment finding indicates the need for further consultation? A) Beefy red stoma site B) Red, sensitive skin around the stoma site C) Stoma site not sensitive to touch D) Clear mucus mixed with yellow urine drained from the appliance bag

B) Red, sensitive skin around the stoma site

A nurse is applying an ostomy appliance to the ileostomy of a client with ulcerative colitis. Which action is appropriate? A) Scrubbing fecal material from the skin surrounding the stoma B) Maintaining wrinkles in the faceplate so it doesn't irritate the skin C) Gently washing the area surrounding the stoma using a facecloth and mild soap D) Cutting the faceplate opening no more than 2 in larger than the stoma

C) Gently washing the area surrounding the stoma using a facecloth and mild soap

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? A) Small bowel disease B) Intestinal malabsorption C) Ulcerative colitis D) Disorders of the colon

C) Ulcerative colitis

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? A) Hematocrit 42% B) Serum potassium 4.2 mEq/L C) WBC 22.8/mm3 D) Serum sodium 135 mEq/L

C) WBC 22.8/mm3

Vomiting results in which of the following acid-base imbalances? A) Respiratory acidosis B) Metabolic acidosis C) Respiratory alkalosis D) Metabolic alkalosis

D) Metabolic alkalosis

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? A) Paralytic ileus B) Constipation C) Accumulation of gas D) Peritonitis

D) Peritonitis

In addition to teaching a client with constipation to increase dietary fiber intake to 25 g/day, which of the following would the nurse include as important? A) Avoiding bran cereals and beans in the diet B) Limiting fluid intake to 5 to 6 glasses per day C) Minimizing activity levels for at least 2 months D) Adding fiber-rich foods to the diet gradually

D) Adding fiber-rich foods to the diet gradually

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

D) Hypokalemia

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? A) The client's natural bowel function may become sluggish. B) The client may develop inflammatory bowel disease. C) The client may develop arthritis or arthralgia. D) The client mat lose his or her appetite.

A) The client's natural bowel function may become sluggish.

In Crohn's disease, the common clinical manifestations include abdominal pain and _____.

Diarrhea

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? A) Right lower quadrant B) Left lower quadrant C) Right upper quadrant D) Left upper quadrant

A) Right lower quadrant

_____, the most common cause of acute surgical abdomen in the U.S., is the most common reason for emergency abdominal surgery.

Appendicitis

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? A) Abdominal pain B) A change in bowel habits C) Frank blood in the stool D) Abdominal distention

B) A change in bowel habits

What symptoms of perforation might the nurse observe in a client with an intestinal obstruction? Select all that apply. A) Abdominal distention B) Sudden drop in body temperature C) Sudden, sustained abdominal pain D) Intermittent, severe pain

C) Sudden, sustained abdominal pain

T or F: Diverticula may occur anywhere in the small intestine or colon, but most commonly occur in the ascending colon.

False

T or F: The patient with irritable bowel syndrome (IBS) should select foods low in fiber in order to minimize intestinal irritation.

False

_____ is a chronic functional disorder characterized by recurrent abdominal pain associated with diarrhea, constipation, or both.

Irritable bowel syndrome (IBS)

T or F: Celiac disease is a disorder of malabsorption caused by an autoimmune response to consumption of products that contain the protein gluten.

True

T or F: Decompression of the bowel through an NGT is necessary for all patients with small bowel obstructions.

True

T or F: Diarrhea is defined as the increased frequency of more then three bowel movements per day.

True

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? A) Colonoscopy B) CT scan C) Barium enema D) Flexible sigmoidoscopy

A) Colonoscopy

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: A) Hypokalemia B) Hyponatremia C) Hyperkalemia D) Hypernatremia

A) Hypokalemia

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

A) Low residue

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"? A) Stool consistency and client comfort B) One bowel movement daily C) One bowel movement every other day D) Two bowel movements daily

A) Stool consistency and client comfort

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 like oatmeal, so it doesn't matter that I can't have it." D) "I don't understand why this happened again; I didn't travel out of the country."

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

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? A) Apply barrier powder B) Dry skin thoroughly after washing C) Dust with nystatin powder D) Apply triamcinolone acetonide spray

B) Dry skin thoroughly after washing

Which of the following is considered a bulk-forming laxative? A) Mineral oil B) Metamucil C) Dulcolax D) Milk of magnesia

B) Metamucil

A client presents to the emergency department with complaints of acute GI distress, bloody diarrhea, weight loss, and fever. Which condition in the family history is most pertinent to the client's current health problem? A) Hypertension B) Ulcerative colitis C) Appendicitis D) Gastroesophageal reflux disease

B) Ulcerative colitis

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

B) Usual pattern of elimination

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? A) "I should eat a fiber-rich diet with raw, leafy vegetables, unpeeled fruit, and whole grain bread." B) "I should exercise four times per week." C) "I need to use laxatives regularly to prevent constipation." D) "I need to drink 2-3 L of fluids every day."

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

The nurse is performing a rectal assessment and notices a longitudinal tear or ulceration in the lining of the anal canal. The nurse documents the finding as which condition? A) Anorectal abscess B) Hemorrhoid C) Anal fissure D) Anal fistula

C) Anal fissure

A client informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The client states that the physician told him he has irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder? A) Weight loss due to malabsorption B) Client is awakened from sleep due to abdominal pain C) Blood and mucus in the stool D) Chronic constipation with sporadic bouts of diarrhea

D) Chronic constipation with sporadic bouts of diarrhea

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? A) Consuming a low-protein, high-fiber diet B) Taking only enteric-coated medications C) Wearing an appliance pouch only at bedtime D) Increasing fluid intake to prevent dehydration

D) Increasing fluid intake to prevent dehydration

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) Inflammatory colitis B) A disorder of the large bowel C) A small bowel disorder D) Intestinal malabsorption

D) Intestinal malabsorption

Celiac sprue is an example of which category of malabsorption? A) Infectious diseases causing generalized malabsorption B) Luminal problems causing malabsorption C) Mucosal disorders causing generalized malabsorption D) Postoperative malabsorption

C) Mucosal disorders causing generalized malabsorption

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

A) Assist client to increase dietary fiber.

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? A) Borborygmus B) Tenesmus C) Diverticulitis D) Azotorrhea

A) Borborygmus

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? A) The consistency of stool and comfort when passing stool B) That the client has a bowel movement daily C) That the stool is formed and soft D) The client is able to fully evacuate with each bowel movement

A) The consistency of stool and comfort when passing stool

The etiology of cancer of the colon and rectum is predominantly _____, a malignancy arising from the epithelial lining of the intestine.

Adenocarcinoma

Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes: A) Caffeinated products B) Spicy foods C) High-fiber diet D) Fluids with meals

C) High-fiber diet

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

C) Steatorrhea

Which client requires immediate nursing intervention? The client who: A) Complains of anorexia and periumbilical pain B) Complains of epigastric pain after eating C) Present with ribbonlike stools D) Presents with a rigid, board-like abdomen

D) Presents with a rigid, board-like abdomen

The nurse is assessing a client for constipation. To identify the cause of constipation, the nurse should begin by reviewing the client's: A) Activity levels B) Alcohol consumption C) Current medications D) Usual pattern of elimination

D) Usual pattern of elimination

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? A) Lack of free water intake B) Lack of solid food C) Increased fiber D) Lack of exercise

A) Lack of free water intake

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? A) Accumulation of gas B) Peritonitis C) Paralytic ileus D) Constipation

B) Peritonitis

The nurse is conducting a community education program on colorectal cancer. Which statement should the nurse include in the program? A) The lifetime risk of developing colorectal cancer is 1 in 10. B) The incidence of colorectal cancer decreases with age. C) It is the third most common cancer in the United States. D) Colorectal cancer has no hereditary component.

C) It is the third most common cancer in the United States.

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

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

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

C) Suggest fluid intake of at least 2 L/day