Medical-Surgical Week 7 Part 2

A patient with colorectal cancer (CRC) was started on 5-fluorouracil (5-FU) and is experiencing fatigue, diarrhea, and mouth ulcers. A relatively new chemotherapeutic agent, oxaliplatin, has been added to the treatment regimen. What does the nurse tell the patient about the diarrhea and mouth ulcers?

"5-FU cannot discriminate between your cancer and your healthy cells."

Which instruction would the nurse provide to a patient who is advised to use a truss to treat an inguinal hernia?

"Apply a light layer of powder beneath the truss."

Which instructions should the nurse provide regarding postoperative care for a patient who has had minimally invasive inguinal hernia repair (MIIHR) and is ready for discharge? Select all that apply.

"Avoid coughing." "Report lingering pain immediately." "Observe incisions for redness and swelling." "Take stool softeners to prevent constipation."

A patient complains of diarrhea, abdominal distention, and bloating that gets worse and then goes away. What response by the nurse is most appropriate?

"Do you have any pain in the left lower abdomen?"

The nurse is caring for a patient who is to be discharged after a bowel resection and the creation of a colostomy. Which patient statement demonstrates that additional instruction from the nurse is needed?

"I can drive my car in about 2 weeks."

Which statement made by the patient who has undergone minimally invasive inguinal hernia repair (MIIHR) indicates a need for further teaching?

"I can remove the Steri-Strips."

After assessing a patient who presents with abdominal pain, the nurse suspects colon cancer. Which statements by the patient may support the nurse's suspicion? Select all that apply.

"I have difficulty in passing stools." "I have incomplete bowel movements."

A patient who was scheduled for a bowel resection and colostomy for treatment of colorectal cancer tells the nurse that he does not know how he will go on like this. What statement by the nurse is most appropriate?

"I know this has to be very hard for you. Why don't you tell me a little bit about how you feel?"

The nurse is explaining preoperative and postoperative care to a patient scheduled for a conventional open herniorrhaphy. Which statement made by the patient demonstrates a correct understanding of the instructions given?

"I need to avoid coughing after the procedure."

The home health nurse is teaching a patient about the care of a new colostomy. Which patient statement demonstrates a correct understanding of the instructions?

"I need to check for leakage underneath my colostomy."

A patient with irritable bowel syndrome (IBS) is constipated. The nurse instructs the patient about a management plan. Which patient statement shows an accurate understanding of the nurse's teaching?

"I need to go for a walk every evening."

The nurse is teaching a patient about skin care around a colostomy. Which statement made by the patient indicates effective learning?

"I should apply a skin sealant and allow it to dry before applying the pouch."

The nurse is teaching a patient about perineal wound care. Which patient statement indicates a need for further teaching?

"I should avoid sitz baths."

The nurse teaches an older patient about preventing fecal impaction. Which statement made by the patient indicates effective learning?

"I should consume bulk-forming products."

The nurse is teaching a patient with irritable bowel syndrome about self-management. Which statement made by the patient indicates the need for further teaching?

"I should drink 2 to 3 cups of liquid every day."

A nurse is educating people at a health fair regarding colorectal cancer screening. Which statement made by a participant indicates a need for further teaching?

"I should get a colonoscopy every year after the age of 40."

The nurse is teaching an older adult patient who is undergoing screening for colorectal cancer. Which statement by the patient indicates that the teaching has been effective?

"I should have a colonoscopy every 10 years."

A patient is prescribed alosetron for irritable bowel syndrome (IBS). Which statement by the patient indicates a need for further teaching?

"I should not take antihistamines while I'm on this medicine."

A nursing instructor is teaching a student about interventions for a patient who has low-volume voiding postoperatively. Which statement indicates that the student understands the information?

"I should provide 1500 to 2500 mL of fluids every day."

The nurse is providing information to a patient about the treatment for hemorrhoids. Which statement by the patient indicates a need for further teaching?

"I will eat a low-fiber diet."

The Certified Wound, Ostomy, and Continence Nurse (CWOCN) is teaching a patient with colorectal cancer how to care for a newly created colostomy. Which patient statement reflects a correct understanding of the necessary self-management skills?

"I will make certain that I always have an extra bag available."

The nurse is providing discharge instructions to a patient who has just had a hemorrhoidectomy. Which statement by the patient indicates the teaching was effective?

"I will make sure someone is with me the first time I have a bowel movement."

The nurse is teaching a patient who has undergone a hemorrhoidectomy about a follow-up plan of care. Which patient statement demonstrates a correct understanding of the nurse's instructions?

"I will need to eat a diet high in fiber."

A 24-year-old male is scheduled for a minimally invasive inguinal hernia repair (MIIHR). Which patient statement indicates a need for further teaching about this procedure?

"I will need to stay in the hospital overnight."

A patient suspected of having irritable bowel syndrome (IBS) is scheduled for a hydrogen breath test. What does the nurse tell the patient about this test?

"If you have IBS, hydrogen levels will be increased in your breath samples."

The nurse is caring for a 56-year-old patient who has no familial adenomatous polyposis (FAP) or other risk factors related to colorectal cancer. When the nurse teaches the patient about cancer screenings, what does the nurse advise?

"It is recommended you get a colonoscopy every 10 years."

A patient with a history of polyps is preparing to undergo a colonoscopy. The patient tells the nurse, "I'm really scared that I could have colorectal cancer." What is the most appropriate response by the nurse?

"It is understandable to be scared. Tell me what worries you the most."

A patient with malabsorption syndrome asks the nurse, "What did I do to cause this disorder to develop?" How does the nurse respond?

"Nothing you did could have caused it; it is the result of flattening of the mucosa of your small intestine."

Which statement made by the student nurse indicates effective learning about polyps?

"Polyps are formed in the intestinal tracts as small growths."

The nurse is explaining postoperative care to a patient scheduled for a hemorrhoidectomy. What teaching does the nurse include?

"Sitz baths should be given three to four times each day."

A patient with colorectal cancer (CRC) is scheduled for colostomy surgery. Which comment from the nurse is most therapeutic for this patient?

"Tell me what worries you the most about this procedure."

A male patient's sister was recently diagnosed with colorectal cancer (CRC), and his brother died of CRC 5 years ago. He asks the nurse whether he will inherit the disease too. How does the nurse respond?

"The only way to know whether you are predisposed to CRC is by genetic testing."

The registered nurse provides education to a group of student nurses about perineal wound care. Which statement made by a student nurse indicates the need for further teaching?

"The patient should assume a straight position in the bed."

A patient is scheduled for a hydrogen breath test to rule out irritable bowel syndrome (IBS). Which statement by the patient indicates a need for further teaching?

"The test will take about 3 to 4 hours."

Which statement will the nurse include in the teaching plan about postoperative care for a patient who underwent a hernia repair?

"You should apply ice packs to the surgical area."

The advanced practice nurse is examining a patient for the presence of an inguinal hernia. In what order does the nurse perform the assessment?

1. Ask the patient to lie down for inspection of the abdomen. 2. Ask the patient to stand up for examination of the groin. 3. Observe for any bulging while the patient performs the Valsalva maneuver. 4. Auscultate for the presence of active bowel sounds. 5. Gently insert a finger in the inguinal ring and ask the patient to cough. Correct

Which patient does the nurse suspect to have femoral hernia?

2

The nurse is working at a community health fair and speaks with a group of individuals about the risk factors for colorectal cancer (CRC). Which individual does the nurse identify as most at risk for developing CRC?

33-year-old who has Crohn disease

Which figure indicates a sigmoid colostomy?

4

Which patient does the medical-surgical unit charge nurse assign to an LPN/LVN?

47

Which statement is most accurate about colorectal cancer (CRC)?

A palpable mass in the lower right quadrant is common in CRC of the ascending colon.

Which treatment would be beneficial to an 85-year-old patient with an inguinal hernia?

A truss

Which factor increases the risk for hernia?

Abdominal distension

Which clinical finding helped the nurse reach the conclusion that a patient with a hernia requires immediate surgical intervention?

Absence of bowel sounds

A patient is admitted to the hospital for hernia repair. Which assessment finding does the nurse report immediately to the health care provider?

Absent bowel sounds

What are risk factors for colorectal cancer? Select all that apply.

Age >50 years Family history of cancer History of Crohn's disease Heavy alcohol consumption

The nurse is planning care for a male patient who has undergone a hernia repair. The patient reports difficulty voiding. What does the nurse instruct the patient to do?

Allow water to run when attempting to void.

What antidiarrheal drug prescribed for a patient with diarrhea-predominant irritable bowel syndrome should not be taken with psychoactive or antihistamines drugs?

Alosetron

What medication could be prescribed for a patient to treat pain associated with irritable bowel syndrome (IBS)?

Amitriptyline

Aside from chemotherapeutic agents, what other medications does the nurse expect to administer to a patient with advanced colorectal cancer for relief of symptoms?

Analgesics and antiemetics

What is a behavioral illness that is known to relate to irritable bowel syndrome (IBS)?

Anxiety

What teaching should be provided to a patient with chronic diarrhea?

Apply a coat of medicated protective barrier to the skin.

How does the nurse provide special skin care for the patient with chronic diarrhea?

Apply a thin coat of aloe vera after each stool.

A patient has a new colostomy after a partial colectomy for colon cancer in which the surgeon was able to completely remove the colorectal tumor. The patient is crying and keeps saying, "Nothing will ever be the same." Which action by the nurse is best?

Ask the patient to describe feelings about having a colostomy.

The nurse is assessing a patient in the outpatient clinic. Which assessments will the nurse perform if he or she suspects the patient has malabsorption syndrome? Select all that apply.

Asking if the patient feels bloated Requesting to check the patient's iron levels Discussing the many bruises on the patient's skin Asking the patient if there have been any changes in sexual activity or interest lately

A male patient in a long-term care facility is 2 days postoperative after an open repair of an indirect inguinal hernia. Which nursing action does the RN delegate to unlicensed assistive personnel (UAP)?

Assisting the patient to stand to void

The nurse is caring for a patient who presents with a bulging area from the umbilicus. What action by the nurse is priority?

Auscultate the bowel sounds.

Which interventions should be performed to assess for hernia in an overweight patient who reports abdominal pain while lifting heavy objects?

Auscultating for absence of bowel sounds

A patient underwent minimally invasive inguinal hernia repair surgery (MIIHR). What does the nurse include in the discharge teaching? Select all that apply.

Avoiding lifting more than 10 pounds Checking the incision site for redness Resting for several days after the surgery

What findings are consistent with the diagnosis of irritable bowel syndrome (IBS)? Select all that apply.

Belching Diarrhea

Which factors cause malabsorption syndrome? Select all that apply.

Bile salt deficiencies Presence of bacteria

Which symptoms reported by a patient are consistent with irritable bowel syndrome (IBS)? Select all that apply.

Bloating Anorexia Left lower quadrant pain

Which parameters would the nurse plan to monitor on an ongoing basis for a patient who has undergone polypectomy? Select all that apply.

Blood in stool Abdominal distention Colonoscopic changes

Which complication occurs due to increasing growth of the colorectal tumor in a patient?

Bowel obstruction or perforation with resultant peritonitis

An adult patient arrives at the health care provider's office reporting a bump where there is a painful section of the abdomen. Which abnormal assessment finding indicates the patient may have obstruction or strangulation?

Bowel sounds are absent upon auscultation.

What does the nurse advise a patient diagnosed with irritable bowel syndrome (IBS) to take during periods of constipation?

Bulk-forming laxatives

The nurse case manager is discussing community resources with a patient who has colorectal cancer (CRC) and is scheduled for a colostomy. Which referral is of greatest value to this patient initially?

Certified Wound, Ostomy, and Continence Nurse (CWOCN)

The nurse is caring for a patient diagnosed with familial adenomatous polyposis. What procedure should the nurse prepare the patient for?

Colectomy

Which surgery may be performed on a patient with regional lymph node involvement in colon cancer?

Colon resection

A patient with a bowel obstruction is ordered a nasogastric (NG) tube. After the nurse inserts the tube, which nursing intervention is the highest priority for this patient?

Connecting the tube to intermittent low suction

A patient recently diagnosed with irritable bowel syndrome (IBS) asks the nurse what dietary changes will help with IBS. What does the nurse suggest?

Consuming 30-40 g of fiber per day

Which behavior would be beneficial for a patient with constipation-predominant irritable bowel syndrome (IBS-C)? Select all that apply.

Consuming regularly scheduled meals Drinking 8 to 10 cups of liquid daily Practicing meditation and yoga regularly

The nurse is caring for a patient who is 2 days postoperative for a colostomy placement. Which assessment finding does the nurse report to the health care provider?

Dark red and firm stoma

Which assessment finding should the nurse report immediately when caring for a patient who has undergone herniorrhaphy?

Decreased urine output

What should the nurse inquire about when taking the history of a patient suspected of irritable bowel syndrome? Select all that apply.

Drugs the patient is taking Any gastrointestinal infections Weight change, fatigue, and malaise

A 50-year-old patient comes to an outpatient clinic for a colonoscopy and asks how often the procedure needs to be performed. What does the nurse tell the patient?

E

The patient reports constipation and bloating. Which self-management measure will the nurse teach to help prevent fecal impaction?

Eat whole-grain products.

A patient with a family history of colorectal cancer (CRC) regularly sees a health care provider for early detection of any signs of cancer. Which laboratory result may be an indication of CRC in this patient?

Elevated carcinoembryonic antigen

The nurse is providing postoperative care to a patient who underwent a colostomy. Which action made by the nurse requires correction?

Emptying the pouch when it is three-fourths full of stool

A patient with CRC had colostomy surgery performed yesterday. The patient is very anxious about caring for the colostomy and states that the health care provider's instructions "seem overwhelming." What does the nurse do first for this patient?

Encourages the patient to look at and touch the colostomy stoma

A patient's stool sample showed microscopic amounts of blood content. After assessing the patient's history, the nurse concludes that the patient may have tumors in the colon. Which finding in the patient's history enabled the nurse to reach this conclusion?

Endometrial cancer

What are the priority assessments a primary health care provider should perform for a patient who complains about a protrusion in the abdominal region? Select all that apply.

Examining the ring and its contents Auscultating for active bowel sounds Asking the patient to perform the Valsalva maneuver

The nurse is performing discharge teaching with a patient with hemorrhoids. Which instructions does the nurse include in the teaching plan? Select all that apply.

Exercise regularly. Increase fiber intake. Drink plenty of water.

A patient who reports unintentional weight loss, dark or bright-colored red stools, and a family history of colorectal cancer is admitted to the hospital. Which information should the nurse obtain from this patient? Select all that apply.

Experiencing fatigue Use of tobacco or alcohol Experiencing abdominal fullness

What risk factors are associated with the development of colorectal cancer? Select all that apply.

Family history Crohn's disease Physical inactivity

Which symptoms are consistent with a diagnosis of irritable bowel syndrome (IBS)? Select all that apply.

Fatigue Abdominal pain Weight changes

What laboratory test is indicated for a patient who is being evaluated for malabsorption disorders?

Fecal fat analysis

Which are the most common types of abdominal hernias? Select all that apply.

Femoral hernia Umbilical hernia Direct inguinal hernia Indirect inguinal hernia

What symptoms should a patient prescribed alosetron for irritable bowel syndrome (IBS) report immediately? Select all that apply.

Fever Darkened urine

What signs are consistent with strangulation of a hernia? Select all that apply.

Fever Nausea Abdominal distention

A 51-year-old female patient receives an annual wellness check. The patient does not have a personal or family history of colorectal cancer, but the nurse plans to discuss screening recommendations with the patient. What will the nurse include in the teaching?

Get a colonoscopy every 10 years.

The nurse observes the student nurse care for a patient who is at risk for fecal impaction. Which action made by the student nurse causes the nurse to intervene?

Having the patient use the bedpan during elimination

The nurse is assessing a patient who presents with unexplained weight loss, abdominal fullness, and a change in bowel elimination patterns. What lab values are priorities when assessing this patient? Select all that apply.

Hemoglobin Red blood cells

Which laboratory test may be used to identify bacterial overgrowth and malabsorption of nutrients in the small intestine?

Hydrogen breath test

Which statement about irritable bowel syndrome (IBS) is most accurate?

IBS is associated with both primary and secondary mental health disorders.

What is the most accurate statement about the incidence of intestinal regions affected by colorectal cancer (CRC)?

Incidence in the sigmoid colon is 25%.

Which other complication might develop in a patient who underwent abdominal surgery and developed an infection of the surgical wound in the postoperative period?

Incisional hernias

The nurse is caring for a patient diagnosed with malabsorption syndrome and macrocytic anemia. What lab value is consistent with this diagnosis?

Increased mean corpuscular volume space (MCV)

A 46-year-old man comes to the emergency department (ED) with a large bulge in his lower abdomen that descends into the scrotum. What type of hernia is this patient likely experiencing?

Indirect inguinal

The nurse receives a call from a patient who underwent an abdominoperineal resection five weeks ago. The patient reports drainage from the perineal wound that is serosanguineous. What action by the nurse is appropriate?

Inform the patient this is a normal finding.

A patient presents to the emergency department with pain in the left lower quadrant of the abdomen. The patient reports nausea after eating, diarrhea, and abdominal bloating. What diagnosis does the nurse suspect?

Irritable bowel syndrome (IBS)

What is the mechanism of action for the chemotherapeutic drug cetuximab?

It blocks factors that promote cancer cell growth.

Which statements are true regarding a hernia? Select all that apply.

It is caused by acquired muscle weakness. It is a weakness in the abdominal muscle wall. It is caused by increased intra-abdominal pressure.

A patient presents to the emergency department with a protrusion from the umbilicus, abdominal distention, nausea, and pain. The patient's vital signs are: blood pressure 140/80, pulse 112, temperature 100.8°F. What action by the nurse is priority?

Keep the patient NPO.

A patient is diagnosed with constipation-predominant irritable bowel syndrome. What medication does the nurse anticipate will be prescribed by the primary health care provider?

Linaclotide

What medications are used in patients diagnosed with constipation-predominant irritable bowel syndrome (IBS-C)? Select all that apply.

Linaclotide Lubiprostone Psyllium hydrophilic mucilloid

A patient has undergone a resection of the ileum. What laboratory findings of the patient indicate malabsorption of proteins? Select all that apply.

Low serum iron Low serum albumin

What type of nutrition therapy is indicated for patients diagnosed with severe steatorrhea?

Low-fat

A patient has been admitted with a large-bowel obstruction. What assessment finding is consistent with a diagnosis of large-bowel obstruction?

Lower abdominal distention

A patient reports pain in the left lower quadrant of the abdomen. On assessment, the nurse finds hypersensitivity of internal organs and hypoactive bowel sounds. Which medication would be beneficial to the patient?

Lubiprostone

Which drug does the primary health care provider prescribe to a patient with irritable bowel syndrome complaining of abdominal pain and constipation?

Lubiprostone

While assessing a patient with colorectal cancer, the primary health care provider finds some masses when palpating the abdomen. Which assessment test would be used to confirm if there are masses in the abdomen?

Magnetic resonance imaging

A patient underwent a colostomy formation. What instructions should the nurse provide to the patient and family members about home care management? Select all that apply.

Measure the size of the stoma regularly. Refrain from eating asparagus, broccoli, eggs, fish, and garlic. Include buttermilk, cranberry juice, parsley, and yogurt in the diet.

Which is a key feature of large-bowel obstruction?

Minimal or no vomiting

What instructions should the nurse provide when educating a group of people about risk factors for preventing colorectal cancer? Select all that apply.

Modify your dietary habits. Undergo colorectal diagnostic testing regularly. Be informed about the hazards of smoking, excessive alcohol, and physical inactivity.

What side effects should be assessed for in patients receiving chemotherapy for metastatic colorectal cancer? Select all that apply.

Mucositis Leukopenia

A patient diagnosed with irritable bowel syndrome (IBS) is discharged home with a variety of medications for IBS symptoms. Upon returning to the clinic, the patient states, "Most of my symptoms have improved, except for the diarrhea." What does the nurse anticipate will be prescribed for this patient?

Muscarinic receptor agonist

The nurse is assigned to care for a patient with a small bowel obstruction. What clinical manifestations would the nurse expect to find during the admission assessment? Select all that apply.

Nausea Vomiting Electrolyte imbalances

Which patients have the highest risk for diagnosis of an umbilical hernia? Select all that apply.

Obese patients Newborn babies Pregnant women

The nurse is assessing a patient for signs and symptoms of an obstruction in the small intestine. What does the nurse expect to find? Select all that apply.

Obstipation Abdominal distention Early and profuse vomiting

What patient population is more susceptible to direct inguinal hernias?

Older adults

Which chemotherapy medications may be prescribed to a patient after surgery for colorectal cancer? Select all that apply.

Oxaliplatin Leucovorin Capecitabine

A nurse is developing a plan of care for a patient who is admitted for surgery immediately. The patient has a history of malabsorption syndrome related to a Whipple procedure for cancer in the duodenum 2 years ago. Which order from the health care provider should the nurse question?

Pancreatic enzymes QID

What key points should the nurse specialist consider during a psychosocial assessment of a patient prior to ostomy surgery? Select all that apply.

Patient's employment Financial concerns regarding purchase of ostomy supplies

Which interventions should the nurse provide during the postoperative care of a patient who underwent a colostomy formation? Select all that apply.

Place a colostomy pouch over the stoma. Establish and maintain an intravenous line. Assess the color and integrity of the stoma frequently.

Small growths that are covered with mucosa and are attached to the surface of the intestine are known as what?

Polyps

Which statement is true regarding polyps?

Polyps may be hereditary.

What finding is consistent with a diagnosis of irritable bowel syndrome (IBS)?

Positive hydrogen breath test

A patient with an intestinal obstruction has pain that changes from a "colicky" intermittent type to constant discomfort. What does the nurse do first?

Prepares the patient for emergency surgery

A patient with irritable bowel syndrome (IBS) has a stool culture positive for Pseudomonas aeruginosa. Which statement about this finding is correct?

Probiotics may be ordered to help alleviate GI symptoms.

A patient who was being treated for a hernia is diagnosed with small-bowel obstruction. The nurse expects what assessment findings? Select all that apply.

Profuse vomiting Severe fluid imbalance Upper abdominal distention

Which is a functioning stoma?

Proximal stoma

Which assessment finding in a patient with a new colostomy causes the nurse to notify the health care provider immediately?

Purplish stoma

After an abdominoperineal resection, a 75-year-old patient is referred to a home health agency. Which staff member does the nurse manager assign to perform the initial assessment on this patient?

RN who is new to the agency with 5 years experience in the emergency department (ED)

A patient is in the first postoperative day after a partial colectomy with colostomy. The nurse notes that the stoma is reddish-pink and moist with edema and a small amount of bleeding. Which nursing action is correct?

Recognize these as normal, early postoperative findings.

What may be a cause of colon polyps?

Rectal bleeding

The primary health care provider prescribes alosetron to a patient with irritable bowel syndrome. What complications should the nurse instruct the patient to report immediately? Select all that apply.

Rectal bleeding Darkened urine Bloody diarrhea

The primary health care provider prescribes bevacizumab for a patient who underwent surgical resection for colorectal cancer. Which is an expected outcome of this medication?

Reduce blood flow to the growing tumor cells, thereby depriving the nutrients for growth

A 67-year-old male patient reports pain in the inguinal area that occurs when he coughs. A bulge that can be pushed back into the abdomen is found in his inguinal area. What type of hernia does he have?

Reducible

The primary health care provider observes a hernia pushing downward at an angle into the inguinal canal and disappears when the patient lies in a supine position. What condition does the primary health care provider conclude the patient has?

Reducible indirect inguinal hernia

The nurse is planning the care of a female patient with severe diarrhea-predominant irritable bowel syndrome (IBS-D). Which nursing invention is most appropriate for the patient?

Report symptoms of constipation early if taking alosetron.

The nurse is assessing a patient diagnosed with a paralytic ileus. The patient has a nasogastric (NG) tube in place, is complaining of nausea, and has increased abdominal distention. What action by the nurse is priority?

Reposition the nasogastric (NG) tube.

A patient with a rectal tumor is scheduled for surgery. Which surgical procedure does the nurse anticipate the surgeon will perform?

Resection with anastomosis

What symptoms are consistent with a large-bowel obstruction? Select all that apply.

Ribbon-like stool Metabolic acidosis Lower abdominal distention

What medications are used in patients diagnosed with diarrhea-predominant irritable bowel syndrome (IBS-D)? Select all that apply.

Rifaximin Loperamide

A patient has a nasogastric (NG) tube for decompression after a small bowel obstruction. What position should a patient be encouraged to use?

Semi-Fowler's

The nurse is teaching a male patient about proper perineal wound care and comfort measures. What does the nurse include in the teaching? Select all that apply.

Sitting on soft pillows or foam pads Assuming a side-lying position in bed Avoiding sitting for long periods of time

A patient who reports several days of abdominal pain has abdominal distention with visible peristaltic waves in the mid-abdomen. The patient has nausea and vomiting and has been unable to pass stool. Laboratory studies reveal fluid and electrolyte imbalances and metabolic alkalosis. Which condition does the nurse suspect in this patient?

Small-bowel obstruction

A patient has been educated about nutrition and colorectal cancer. What selections by the patient demonstrate an understanding of the importance of brassica vegetables? Select all that apply.

Sprouts Broccoli Cabbage

What instruction should be included for a patient who has undergone inguinal hernia repair? Select all that apply.

Stand to void. Ambulate early. Report signs of infection

A patient asks the nurse, "Can you tell me some foods to include in my diet so that I can reduce my chances of getting colorectal cancer?" Which dietary selection does the nurse suggest?

Steamed broccoli with turkey

Which of the following is a common sign of malabsorption syndrome?

Steatorrhea

A patient is diagnosed with irritable bowel syndrome (IBS). What factors does the nurse suspect as possible causes of the patient's problem? Select all that apply.

Stress Anxiety Caffeinated drinks

The patient is prescribed amitriptyline for irritable bowel syndrome (IBS). What should the patient be told when taking this medication?

Take it 30 minutes before a meal.

What teaching should be included for a patient who has prescribed lubiprostone for irritable bowel syndrome (IBS)?

Take medication with food.

A patient who is taking alosetron reports dark amber urine. What action by the nurse is priority?

Tell the patient not to take the medication again.

The nurse is caring for a patient with a suspected diagnosis of pernicious anemia. What test does the nurse anticipate being ordered for this patient?

The Schilling test

What is characteristic of mechanical obstruction?

The bowel is physically blocked.

The nurse sees a note in a patient's medical record that the patient has IBS-M. What does this mean?

The patient has IBS with a mix of diarrhea and constipation.

The nurse is caring for a patient who has experienced two days of obstipation. What does the nurse understand about this patient?

The patient has not passed stool in two days.

Which describes internal hemorrhoids?

They cannot be seen upon inspection.

In home colostomy care, what is the purpose of stoma paste?

To prevent the adjacent skin from becoming raw

The patient is prescribed a tricyclic antidepressant for treatment of irritable bowel syndrome (IBS). What is the reason behind administration of this medication?

Treating pain

The nurse is teaching a patient ways to prevent fecal impaction with a heathy diet. Which menu selection made by the patient indicates to the nurse that teaching was effective?

Turkey sandwich on whole wheat bread with an apple

Which kind of hernia is common in infants?

Umbilical

While assessing an obese patient, the primary health care provider observes the condition depicted in the figure and indicated by the X. Which condition does the primary health care provider expect?

Umbilical hernia

A patient underwent a colostomy formation and was discharged from the hospital. Which complications should the patient be aware of and immediately report to the primary health care provider? Select all that apply.

Unusual bleeding Unusual bleeding

A patient is being evaluated in the emergency department (ED) for a possible small-bowel obstruction. Which signs and/or symptoms does the nurse expect to assess?

Upper abdominal distention, metabolic alkalosis, and great amount of vomiting

An older adult patient is unable to have a surgical repair of an inguinal hernia. The patient has been prescribed a truss. What teaching for this patient is appropriate? Select all that apply.

Use a belt to hold it in place. Use light powder under the truss. Assess the skin around the truss daily.

What information about intestinal polyps is most accurate?

Villous adenomas pose a greater cancer risk than tubular adenomas.