NUR 1202 MODULE 8
A nurse assesses a client with Crohns disease and colonic strictures. Which clinical manifestation should alert the nurse to urgently contact the health care provider? a. Distended abdomen b. Temperature of 100.0 F (37.8 C) c. Loose and bloody stool d. Lower abdominal cramps
a. Distended abdomen
A nurse assesses a client with peritonitis. Which clinical manifestations should the nurse expect to find? (Select all that apply.) a. Distended abdomen b. Inability to pass flatus c. Bradycardia d. Hyperactive bowel sounds e. Decreased urine output
a. Distended abdomen b. Inability to pass flatus e. Decreased urine output
A nurse teaches a client who has viral gastroenteritis. Which dietary instruction should the nurse include in this clients teaching? a. Drink plenty of fluids to prevent dehydration. b. You should only drink 1 liter of fluids daily. c. Increase your protein intake by drinking more milk. d. Sips of cola or tea may help to relieve your nausea.
a. Drink plenty of fluids to prevent dehydration.
A nurse cares for a client who has a new colostomy. Which action should the nurse take? a. Empty the pouch frequently to remove excess gas collection. b. Change the ostomy pouch and wafer every morning. c. Allow the pouch to completely fill with stool prior to emptying it. d. Use surgical tape to secure the pouch and prevent leakage.
a. Empty the pouch frequently to remove excess gas collection.
A nurse assesses a client who has appendicitis. Which clinical manifestation should the nurse expect to find? a. Severe, steady right lower quadrant pain b. Abdominal pain associated with nausea and vomiting c. Marked peristalsis and hyperactive bowel sounds d. Abdominal pain that increases with knee flexion
a. Severe, steady right lower quadrant pain
After teaching a client who is prescribed adalimumab (Humira) for severe ulcerative colitis, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional teaching? a. I will avoid large crowds and people who are sick. b. I will take this medication with my breakfast each morning. c. Nausea and vomiting are common side effects of this drug. d. I must wash my hands after I play with my dog.
b. I will take this medication with my breakfast each morning.
A patient is being treated for an anal fissure. During a follow-up visit, the nurse finds improvement in the patient's condition. Which actions made by the patient are responsible for this positive finding? Select all that apply. a.) Limiting fluid intake b.) Taking warm sitz baths c.) Taking olsalazine regularly d.) Using hydrocortisone cream e.) Using psyllium hydrophilic mucilloid
b.) Taking warm sitz baths d.) Using hydrocortisone cream e.) Using psyllium hydrophilic mucilloid
A nurse teaches a client who is at risk for colon cancer. Which dietary recommendation should the nurse teach this client? a. Eat low-fiber and low-residual foods. b. White rice and bread are easier to digest. c. Add vegetables such as broccoli and cauliflower to your new diet. d. Foods high in animal fat help to protect the intestinal mucosa.
c. Add vegetables such as broccoli and cauliflower to your new diet.
A nurse assesses a client who is hospitalized with an exacerbation of Crohns disease. Which clinical manifestation should the nurse expect to find? a. Positive Murphys sign with rebound tenderness to palpitation b. Dull, hypoactive bowel sounds in the lower abdominal quadrants c. High-pitched, rushing bowel sounds in the right lower quadrant d. Reports of abdominal cramping that is worse at night
c. High-pitched, rushing bowel sounds in the right lower quadrant
A nurse cares for a teenage girl with a new ileostomy. The client states, I cannot go to prom with an ostomy. How should the nurse respond? a. Sure you can. Purchase a prom dress one size larger to hide the ostomy appliance. b. The pouch wont be as noticeable if you avoid broccoli and carbonated drinks prior to the prom. c. Lets talk to the enterostomal therapist about options for ostomy supplies and dress styles. d. You can remove the pouch from your ostomy appliance when you are at the prom so that it is less noticeable.
c. Lets talk to the enterostomal therapist about options for ostomy supplies and dress styles.
A nurse teaches a client who is recovering from a colon resection. Which statement should the nurse include in this clients plan of care? a. You may experience nausea and vomiting for the first few weeks. b. Carbonated beverages can help decrease acid reflux from anastomosis sites. c. Take a stool softener to promote softer stools for ease of defecation. d. You may return to your normal workout schedule, including weight lifting.
c. Take a stool softener to promote softer stools for ease of defecation.
Which question should the nurse ask while assessing a patient with ulcerative colitis (UC)? a.) "Did you eat street food in the last couple of days?" b.) "Have you undergone any surgeries in the past year?" c.) "Does anyone from your family have similar complaints?" d.) "Were you on antibiotic treatments in the past three months?"
d.) "Were you on antibiotic treatments in the past three months?"
Which factors should the nurse inquire about when taking the medical history of a patient with suspected appendicitis? a.) Abdominal pain that increases with cough b.) Abdominal pain before nausea and vomiting c.) Polyphagia followed by nausea and vomiting d.) Abdominal pain followed by nausea and vomiting
d.) Abdominal pain followed by nausea and vomiting
Which medication is helpful in patients who have fistulas associated with Crohn's disease? a.) Mesalamine b.) Sulfasalazine c.) Azithromycin d.) Metronidazole
d.) Metronidazole
A patient with hemorrhoids is being prepared for surgery the next day. Which therapy can help the patient in evacuating the bowels? a.) Enema b.) Dandelion c.) IV preparation d.) Potent laxatives
d.) Potent laxatives
A nurse assesses a client who is prescribed 5-fluorouracil (5-FU) chemotherapy intravenously for the treatment of colon cancer. Which assessment finding should alert the nurse to contact the health care provider? a. White blood cell (WBC) count of 1500/mm3 b. Fatigue c. Nausea and diarrhea d. Mucositis and oral ulcers
a. White blood cell (WBC) count of 1500/mm3
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? a.) "I should drink 2 to 3 cups of liquid every day." b.) "I should eat regular meals and chew food slowly." c.) "I should include 30 to 40 g of fiber in my diet every day." d.) "I should perform exercises regularly and manage stress."
a.) "I should drink 2 to 3 cups of liquid every day."
After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the clients understanding. Which menu selection indicates that the client correctly understands the dietary teaching? a. Ham sandwich on white bread, cup of applesauce, glass of diet cola b. Broiled chicken with brown rice, steamed broccoli, glass of apple juice c. Grilled cheese sandwich, small banana, cup of hot tea with lemon d. Baked tilapia, fresh green beans, cup of coffee with low-fat milk
b. Broiled chicken with brown rice, steamed broccoli, glass of apple juice
A nurse plans care for a client with Crohns disease who has a heavily draining fistula. Which intervention should the nurse indicate as the priority action in this clients plan of care? a. Low-fiber diet b. Skin protection c. Antibiotic administration d. Intravenous glucocorticoids
b. Skin protection
A nurse prepares a client for a colonoscopy scheduled for tomorrow. The client states, My doctor told me that the fecal occult blood test was negative for colon cancer. I dont think I need the colonoscopy and would like to cancel it. How should the nurse respond? a. Your doctor should not have given you that information prior to the colonoscopy. b. The colonoscopy is required due to the high percentage of false negatives with the blood test. c. A negative fecal occult blood test does not rule out the possibility of colon cancer. d. I will contact your doctor so that you can discuss your concerns about the procedure.
c. A negative fecal occult blood test does not rule out the possibility of colon cancer.
A nurse assesses a client who has ulcerative colitis and severe diarrhea. Which assessment should the nurse complete first? a. Inspection of oral mucosa b. Recent dietary intake c. Heart rate and rhythm d. Percussion of abdomen
c. Heart rate and rhythm
After teaching a client with diverticular disease, a nurse assesses the clients understanding. Which menu selection made by the client indicates the client correctly understood the teaching? a. Roasted chicken with rice pilaf and a cup of coffee with cream b. Spaghetti with meat sauce, a fresh fruit cup, and hot tea c. Garden salad with a cup of bean soup and a glass of low-fat milk d. Baked fish with steamed carrots and a glass of apple juice
d. Baked fish with steamed carrots and a glass of apple juice
A nurse plans care for a client who is recovering from an inguinal hernia repair. Which interventions should the nurse include in this clients plan of care? (Select all that apply.) a. Encouraging ambulation three times a day b. Encouraging normal urination c. Encouraging deep breathing and coughing d. Providing ice bags and scrotal support e. Forcibly reducing the hernia
a. Encouraging ambulation three times a day b. Encouraging normal urination d. Providing ice bags and scrotal support
A nurse assesses a client who is prescribed alosetron (Lotronex). Which assessment question should the nurse ask this client? a. Have you been experiencing any constipation? b. Are you eating a diet high in fiber and fluids? c. Do you have a history of high blood pressure? d. What vitamins and supplements are you taking?
a. Have you been experiencing any constipation?
After teaching a client who has a femoral hernia, the nurse assesses the clients understanding. Which statement indicates the client needs additional teaching related to the proper use of a truss? a. I will put on the truss before I go to bed each night. b. Ill put some powder under the truss to avoid skin irritation. c. The truss will help my hernia because I cant have surgery. d. If I have abdominal pain, Ill let my health care provider know right away.
a. I will put on the truss before I go to bed each night.
A nurse cares for a client with ulcerative colitis. The client states, I feel like I am tied to the toilet. This disease is controlling my life. How should the nurse respond? a. Lets discuss potential factors that increase your symptoms. b. If you take the prescribed medications, you will no longer have diarrhea. c. To decrease distress, do not eat anything before you go out. d. You must retake control of your life. I will consult a therapist to help.
a. Lets discuss potential factors that increase your symptoms.
A nurse cares for a client who states, My husband is repulsed by my colostomy and refuses to be intimate with me. How should the nurse respond? a. Lets talk to the ostomy nurse to help you and your husband work through this. b. You could try to wear longer lingerie that will better hide the ostomy appliance. c. You should empty the pouch first so it will be less noticeable for your husband. d. If you are not careful, you can hurt the stoma if you engage in sexual activity.
a. Lets talk to the ostomy nurse to help you and your husband work through this.
A nurse assesses a client with ulcerative colitis. Which complications are paired correctly with their physiologic processes? (Select all that apply.) a. Lower gastrointestinal bleeding Erosion of the bowel wall b. Abscess formation Localized pockets of infection develop in the ulcerated bowel lining c. Toxic megacolon Transmural inflammation resulting in pyuria and fecaluria d. Nonmechanical bowel obstruction Paralysis of colon resulting from colorectal cancer e. Fistula Dilation and colonic ileus caused by paralysis of the colon
a. Lower gastrointestinal bleeding Erosion of the bowel wall b. Abscess formation Localized pockets of infection develop in the ulcerated bowel lining d. Nonmechanical bowel obstruction Paralysis of colon resulting from colorectal cancer
A nurse reviews the chart of a client who has Crohns disease and a draining fistula. Which documentation should alert the nurse to urgently contact the provider for additional prescriptions? a. Serum potassium of 2.6 mEq/L b. Client ate 20% of breakfast meal c. White blood cell count of 8200/mm3 d. Clients weight decreased by 3 pounds
a. Serum potassium of 2.6 mEq/L
After teaching a client with an anal fissure, a nurse assesses the clients understanding. Which client actions indicate that the client correctly understands the teaching? (Select all that apply.) a. Taking a warm sitz bath several times each day b. Utilizing a daily enema to prevent constipation c. Using bulk-producing agents to aid elimination d. Self-administering anti-inflammatory suppositories e. Taking a laxative each morning
a. Taking a warm sitz bath several times each day c. Using bulk-producing agents to aid elimination d. Self-administering anti-inflammatory suppositories
The nurse is providing information to a patient about the treatment for hemorrhoids. Which statement by the patient indicates a need for further teaching? a.) "I will eat a low-fiber diet." b.) "I will avoid sitting for too long." c.) "I will avoid spicy foods and nuts." d.) "I will take docusate sodium every day."
a.) "I will eat a low-fiber diet."
Which are the most common types of abdominal hernias? Select all that apply. a.) Femoral hernia b.) Umbilical hernia c.) Reducible hernia d.) Direct inguinal hernia e.) Spermatic cord hernia f.) Indirect inguinal hernia
a.) Femoral hernia b.) Umbilical hernia d.) Direct inguinal hernia f.) Indirect inguinal hernia
Which complication is associated with Crohn's disease? a.) Fistula b.) Hemorrhage c.) Hypovolemia d.) Colorectal cancer
a.) Fistula
What is a common complication of Crohn's disease? a.) Fistulas b.) Tenesmus c.) Liquid stools d.) Bloody stools
a.) Fistulas
What are potential complications of Crohn's disease? Select all that apply. a.) Fistulas b.) Osteoporosis c.) Malabsorption d.) Stomach cancer e.) Abscess formation
a.) Fistulas b.) Osteoporosis c.) Malabsorption e.) Abscess formation
A patient with ulcerative colitis complains of severe diarrhea with exacerbations. What is the drug of choice in this condition? a.) Glucocorticoids b.) Aminosalicylates c.) Immunomodulators d.) Antidiarrheal drugs
a.) Glucocorticoids
Which laboratory parameters should the nurse assess in the patient who presents with symptoms of diverticulitis? Select all that apply. a.) Hematocrit b.) Hemoglobin c.) Serum albumin d.) Serum potassium e.) White blood cell (WBC) count
a.) Hematocrit b.) Hemoglobin e.) White blood cell (WBC) count
A patient reports an increased frequency of bloody stools. After reviewing the laboratory reports, the nurse suspects the patient has ulcerative colitis (UC). Which findings support the nurse's suspicion? Select all that apply. a.) Hematocrit value of 25 percent b.) Serum albumin of 2.5 g/dL c.) Hemoglobin value of 8 g/dL d.) White blood cell (WBC) count of 8000 cells/mcL e.) Erythrocyte sedimentation rate (ESR) of 18 mm/hr
a.) Hematocrit value of 25 percent b.) Serum albumin of 2.5 g/dL c.) Hemoglobin value of 8 g/dL
What symptoms are consistent with hemorrhoids? Select all that apply. a.) Pain b.) Polyps c.) Itching d.) Mucus discharge e.) Dark maroon blood
a.) Pain c.) Itching d.) Mucus discharge
What medications are used in patients diagnosed with diarrhea-predominant irritable bowel syndrome (IBS-D)? Select all that apply. a.) Rifaximin b.) Linaclotide c.) Loperamide d.) Lubiprostone e.) Psyllium hydrophilic mucilloid
a.) Rifaximin c.) Loperamide
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. a.) Use a belt to hold it in place. b.) Use light powder under the truss. c.) Assess the skin around the truss daily. d.) Put the truss on at night while sleeping. e.) Apply the truss after pushing in the protruding hernia.
a.) Use a belt to hold it in place. b.) Use light powder under the truss. c.) Assess the skin around the truss daily.
After teaching a client with perineal excoriation caused by diarrhea from acute gastroenteritis, a nurse assesses the clients understanding. Which statement by the client indicates a need for additional teaching? a. Ill rinse my rectal area with warm water after each stool and apply zinc oxide ointment. b. I will clean my rectal area thoroughly with toilet paper after each stool and then apply aloe vera gel. c. I must take a sitz bath three times a day and then pat my rectal area gently but thoroughly to make sure I am dry. d. I shall clean my rectal area with a soft cotton washcloth and then apply vitamin A and D ointment.
b. I will clean my rectal area thoroughly with toilet paper after each stool and then apply aloe vera gel.
After teaching a client who is recovering from a colon resection, the nurse assesses the clients understanding. Which statements by the client indicate a correct understanding of the teaching? (Select all that apply.) a. I must change the ostomy appliance daily and as needed. b. I will use warm water and a soft washcloth to clean around the stoma. c. I might start bicycling and swimming again once my incision has healed. d. Cutting the flange will help it fit snugly around the stoma to avoid skin breakdown. e. I will check the stoma regularly to make sure that it stays a deep red color. f. I must avoid dairy products to reduce gas and odor in the pouch.
b. I will use warm water and a soft washcloth to clean around the stoma. c. I might start bicycling and swimming again once my incision has healed. d. Cutting the flange will help it fit snugly around the stoma to avoid skin breakdown.
A patient is prescribed an esophagogastroduodenoscopy (EGD), which is a visualization of the esophagus, stomach, and duodenum. Which information would the nurse provide to the patient prior to the procedure? Select all that apply a.) "The entire series will take about 1 hour." b.) "You may have a dry mouth after the exam." c.) "You may take your medications on the morning of the exam." d.) "If you wear dentures, you may leave them in for the procedure" e.) "You must withhold foods and liquids for 6 to 8 hours before the test."
b.) "You may have a dry mouth after the exam." c.) "You may take your medications on the morning of the exam." e.) "You must withhold foods and liquids for 6 to 8 hours before the test."
The RN receives a change-of-shift report about four patients. Which patient does the nurse assess first? a.) 20-year-old with ulcerative colitis (UC) who had six liquid stools during the previous shift b.) 25-year-old who has just been admitted with possible appendicitis and has a temperature of 102°F c.) 56-year-old who had a colon resection earlier in the day and whose colostomy bag does not have any stool in it d.) 60-year-old admitted with acute gastroenteritis who is reporting severe cramping and nausea
b.) 25-year-old who has just been admitted with possible appendicitis and has a temperature of 102°F
Which clinical finding helped the nurse reach the conclusion that a patient with a hernia requires immediate surgical intervention? a.) Abdominal pain b.) Absence of bowel sounds c.) Increased intra-abdominal pressure d.) Presence of a lump in the stomach region
b.) Absence of bowel sounds
A nurse cares for a client who is prescribed mesalamine (Asacol) for ulcerative colitis. The client states, I am having trouble swallowing this pill. Which action should the nurse take? a. Contact the clinical pharmacist and request the medication in suspension form. b. Empty the contents of the capsule into applesauce or pudding for administration. c. Ask the health care provider to prescribe the medication as an enema instead. d. Crush the pill carefully and administer it in applesauce or pudding.
c. Ask the health care provider to prescribe the medication as an enema instead.
A nurse cares for a client with colon cancer who has a new colostomy. The client states, I think it would be helpful to talk with someone who has had a similar experience. How should the nurse respond? a. I have a good friend with a colostomy who would be willing to talk with you. b. The enterostomal therapist will be able to answer all of your questions. c. I will make a referral to the United Ostomy Associations of America. d. Youll find that most people with colostomies dont want to talk about them
c. I will make a referral to the United Ostomy Associations of America.
After teaching a client who has diverticulitis, a nurse assesses the clients understanding. Which statement made by the client indicates a need for additional teaching? a. Ill ride my bike or take a long walk at least three times a week. b. I must try to include at least 25 grams of fiber in my diet every day. c. I will take a laxative nightly at bedtime to avoid becoming constipated. d. I should use my legs rather than my back muscles when I lift heavy objects.
c. I will take a laxative nightly at bedtime to avoid becoming constipated.
A male patient with a long history of ulcerative colitis experienced massive bleeding and had emergency surgery for creation of an ileostomy. He is very concerned that sexual intercourse with his wife will be impossible because of his new ileostomy pouch. How does the nurse respond? a.) "What has your wife said about your pouch system?" b.) "Have you considered going to see a marriage counselor with your wife?" c.) "A change in position may be what is needed for you to have intercourse with your wife." d.) "You must get clearance from your health care provider before you attempt to have intercourse."
c.) "A change in position may be what is needed for you to have intercourse with your wife."
A patient has been newly diagnosed with ulcerative colitis. Which statement by the patient indicates a need for further teaching about the complications of the disease? a.) "I may have up to 20 liquid, bloody stools a day." b.) "I should monitor closely for gastrointestinal hemorrhage." c.) "I may have an increased risk of bladder infections caused by fistulas." d.) "I will have an increased risk of colorectal cancer, especially after 10 years."
c.) "I may have an increased risk of bladder infections caused by fistulas."
What is a clinical manifestation of Crohn's disease? a.) Nausea b.) Vomiting c.) Abdominal pain d.) Dryness of mucous membranes
c.) Abdominal pain
A patient with Crohn's disease is vomiting and sweating profusely after surgery. Which action should the nurse perform to assess the patient's condition? a.) Assisting the patient into full Fowler's position b.) Assessing redness and warmth on the extremities c.) Checking hydration status by assessing total input and output d.) Assessing the bowel sounds in all four abdominal quadrants
c.) Checking hydration status by assessing total input and output
Which complication is seen exclusively in patients with ulcerative colitis? a.) Cholelithiasis b.) Malabsorption c.) Colorectal cancer d.) Abscess formation
c.) Colorectal cancer
The nurse is teaching a patient with ulcerative colitis about ileostomy care. Which information does the nurse include in the plan of care? a.) "Consume a high-fiber diet regularly." b.) "Avoid taking enteric-coated medications." c.) "Empty your pouch when it is completely full." d.) "Change the entire pouch system every 2 to 3 weeks."
b.) "Avoid taking enteric-coated medications."
A nurse assesses clients at a community health center. Which client is at highest risk for the development of colorectal cancer? a. A 37-year-old who drinks eight cups of coffee daily b. A 44-year-old with irritable bowel syndrome (IBS) c. A 60-year-old lawyer who works 65 hours per week d. A 72-year-old who eats fast food frequently
d. A 72-year-old who eats fast food frequently
A patient with Crohn's disease reports numbness, tingling, and painful muscle contractions. After assessing the deep tendon reflexes of the patient, which intervention does the nurse perform next? a.) Intravenous administration of sodium b.) Intravenous administration of bicarbonate c.) Intravenous administration of phosphorus d.) Intravenous administration of magnesium sulfate
d.) Intravenous administration of magnesium sulfate
Which clinical findings in a patient indicate ulcerative colitis? a.) Bowel fistulas b.) Thickened bowel wall c.) Inflammation of the ileum and colon d.) Presence of blood and mucus in the stool
d.) Presence of blood and mucus in the stool
Which medication is used as the first line treatment for mild ulcerative colitis? a.) Infliximab b.) Prednisone c.) Loperamide d.) Sulfasalazine
d.) Sulfasalazine
A nurse assesses a client who is recovering from an ileostomy placement. Which clinical manifestation should alert the nurse to urgently contact the health care provider? a. Pale and bluish stoma b. Liquid stool c. Ostomy pouch intact d. Blood-smeared output
a. Pale and bluish stoma
A nurse cares for a client who had a colostomy placed in the ascending colon 2 weeks ago. The client states, The stool in my pouch is still liquid. How should the nurse respond? a. The stool will always be liquid with this type of colostomy. b. Eating additional fiber will bulk up your stool and decrease diarrhea. c. Your stool will become firmer over the next couple of weeks. d. This is abnormal. I will contact your health care provider.
a. The stool will always be liquid with this type of colostomy.
What does the nurse instruct the patient about barium elimination after a barium enema examination? Select all that apply. Select all that apply a.) "Take a mild laxative." b.) "Drink plenty of fluids." c.) "Report abdominal fullness or pain." d.) "Observe brown stools after 12 hours." e.) "Observe that the stool is chalky white."
a.) "Take a mild laxative." b.) "Drink plenty of fluids." e.) "Observe that the stool is chalky white."
Which treatment would be beneficial to an 85-year-old patient with an inguinal hernia? a.) A truss b.) Hernioplasty c.) Herniorrhaphy d.) Minimally invasive inguinal hernia repair
a.) A truss
A patient is admitted to the hospital with appendicitis. What signs/symptoms are consistent with this diagnosis? Select all that apply. a.) Anorexia b.) Nausea and vomiting c.) Rebound tenderness d.) Decreased white blood cell count e.) Abdominal pain relieved by coughing
a.) Anorexia b.) Nausea and vomiting c.) Rebound tenderness
A patient with Crohn's disease is learning about nutrition. Which type of food should the nurse teach the patient to avoid? a.) Wheat b.) Spinach c.) Lettuce d.) Bananas
a.) Wheat
A nurse assesses a client who is recovering from a hemorrhoidectomy that was done the day before. The nurse notes that the client has lower abdominal distention accompanied by dullness to percussion over the distended area. Which action should the nurse take? a. Assess the clients heart rate and blood pressure. b. Determine when the client last voided. c. Ask if the client is experiencing flatus.
b. Determine when the client last voided.
A nurse cares for a client who is recovering from a hemorrhoidectomy. The client states, I need to have a bowel movement. Which action should the nurse take? a. Obtain a bedside commode for the client to use. b. Stay with the client while providing privacy. c. Make sure the call light is in reach to signal completion. d. Gather supplies to collect a stool sample for the laboratory.
b. Stay with the client while providing privacy.
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? a.) "I will wake up with several small incisions." b.) "I need to avoid coughing after the procedure." c.) "I will be discharged within 5 hours of the procedure." d.) "I can have food and drinks up until an hour before my surgery."
b.) "I need to avoid coughing after the procedure."
Which behavior would be beneficial for a patient with constipation-predominant irritable bowel syndrome (IBS-C)? Select all that apply. a.) Chewing food minimally b.) Consuming regularly scheduled meals c.) Reducing the fiber content in the diet d.) Drinking 8 to 10 cups of liquid daily e.) Practicing meditation and yoga regularly
b.) Consuming regularly scheduled meals d.) Drinking 8 to 10 cups of liquid daily e.) Practicing meditation and yoga regularly
What should the nurse inquire about when taking the history of a patient suspected of irritable bowel syndrome? Select all that apply. a.) Any blood in the stools b.) Drugs the patient is taking c.) Family history of colon cancer d.) Any gastrointestinal infections e.) Weight change, fatigue, and malaise
b.) Drugs the patient is taking d.) Any gastrointestinal infections e.) Weight change, fatigue, and malaise
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. a.) Avoid caffeine. b.) Exercise regularly. c.) Take laxatives daily. d.) Increase fiber intake e.) Drink plenty of water
b.) Exercise regularly. d.) Increase fiber intake e.) Drink plenty of water
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? a.) Rifaximin b.) Linaclotide c.) Loperamide d.) Amitriptyline
b.) Linaclotide
What surgical techniques are involved in the treatment of Crohn's disease? a.) Minimal invasive surgery (MIS) and ileostomy b.) Minimal invasive surgery (MIS) and stricturoplasty c.) Ileostomy and natural orifice transluminal endoscopic surgery (NOTES) d.) Stricturoplasty and natural orifice transluminal endoscopic surgery (NOTES)
b.) Minimal invasive surgery (MIS) and stricturoplasty
After reviewing the case sheet of a patient experiencing severe abdominal pain and diarrhea, the nurse suspects ulcerative colitis. Which findings support the nurse's conclusion? Select all that apply. a.) Presence of bowel fistulas b.) Presence of blood in stools c.) Presence of multiple fractures d.) Intolerance to milk and milk products e.) Use of non-steroidal anti-inflammatory drugs for pain
b.) Presence of blood in stools d.) Intolerance to milk and milk products e.) Use of non-steroidal anti-inflammatory drugs for pain
A nurse is caring for a patient with a new diagnosis of moderate ulcerative colitis (UC). The nurse anticipates an order for which medication? a.) Azathioprine b.) Sulfasalazine c.) Mercaptopurine d.) Sulfamethoxazole
b.) Sulfasalazine
A nurse assesses a male client with an abdominal hernia. Which abdominal hernias are correctly paired with their physiologic processes? (Select all that apply.) a. Indirect inguinal hernia An enlarged plug of fat eventually pulls the peritoneum and often the bladder into a sac b. Femoral hernia A peritoneum sac pushes downward and may descend into the scrotum c. Direct inguinal hernia A peritoneum sac passes through a weak point in the abdominal wall d. Ventral hernia Results from inadequate healing of an incision e. Incarcerated hernia Contents of the hernia sac cannot be reduced back into the abdominal cavity
c. Direct inguinal hernia A peritoneum sac passes through a weak point in the abdominal wall d. Ventral hernia Results from inadequate healing of an incision e. Incarcerated hernia Contents of the hernia sac cannot be reduced back into the abdominal cavity
What diagnostic test is preferred to differentiate between ulcerative colitis and Crohn's disease? a.) Computed tomography (CT) scan b.) Colonoscopy c.) Magnetic resonance enterography d.) X-ray examination with barium enema
d.) X-ray examination with barium enema
A nurse assesses a client with irritable bowel syndrome (IBS). Which questions should the nurse include in this clients assessment? (Select all that apply.) a. Which food types cause an exacerbation of symptoms? b. Where is your pain and what does it feel like? c. Have you lost a significant amount of weight lately? d. Are your stools soft, watery, and black in color? e. Do you experience nausea associated with defecation?
a. Which food types cause an exacerbation of symptoms? b. Where is your pain and what does it feel like? e. Do you experience nausea associated with defecation?
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? a.) "I should get a colonoscopy every year after the age of 40." b.) "I should undergo a double-barrel contrast enema every 5 years." c.) "I should have a fecal occult blood test performed annually after the age of 50." d.) "I should have more frequent screening if a family member has had colorectal cancer."
a.) "I should get a colonoscopy every year after the age of 40."
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? a.) "I will need to eat a diet high in fiber." b.) "Limiting my fluids will help me with constipation." c.) "To help with the pain, I'll apply ice to the surgical area." d.) "I should take Ex-Lax after the surgery to 'keep things moving.'"
a.) "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? a.) "I will need to stay in the hospital overnight." b.) "I should not eat after midnight the day of the surgery." c.) "I may have trouble urinating immediately after the surgery." d.) "My chances of having complications after this procedure are slim."
a.) "I will need to stay in the hospital overnight."
A nurse cares for a client with a new ileostomy. The client states, I dont think my friends will accept me with this ostomy. How should the nurse respond? a. Your friends will be happy that you are alive. b. Tell me more about your concerns. c. A therapist can help you resolve your concerns. d. With time you will accept your new body.
b. Tell me more about your concerns.
A patient newly diagnosed with ulcerative colitis (UC) is started on sulfasalazine. Which explanation will the nurse give the patient about the reason for use of this drug? a.) "The medication will minimize your GI discomfort." b.) "The drug is used to stop the diarrhea and bloody stools." c.) "This medication causes intestinal inflammation to be reduced." d.) "With this medication, your cramping will be relieved."
c.) "This medication causes intestinal inflammation to be reduced."
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? a.) Reducible direct inguinal hernia b.) Irreducible direct inguinal hernia c.) Reducible indirect inguinal hernia d.) Irreducible indirect inguinal hernia
c.) Reducible indirect inguinal hernia
A patient with suspected appendicitis reports having abdominal pain around the umbilicus for the past 2 days, associated with decreased hunger and episodes of vomiting. Which nursing statement and patient response helps in confirming the diagnosis? a.) Nurse: "Have you eaten in restaurants within the past two days?" Patient response: "Yes, once at a fast-food restaurant." b.) Nurse: "Do you have an allergy toward milk and milk products?" Patient response: "Yes." c.) Nurse: "Were you traveling recently?" Patient response: "Yes, two week ago." d.) Nurse: "When did the pain and vomiting begin?" Patient response: "The pain started 2 days ago, and yesterday I started vomiting."
d.) Nurse: "When did the pain and vomiting begin?" Patient response: "The pain started 2 days ago, and yesterday I started vomiting."
An older patient is being evaluated for abdominal pain. After 2 days of pain, the patient began vomiting and now reports increased pain with coughing. The patient prefers to lie in a fetal position with the right hip and knee bent. The patient's white blood cell count is 25,000/mm 3. What does the nurse suspect in this patient? a.) Ulcerative colitis b.) Viral gastroenteritis c.) Appendicitis with a fecalith d.) Perforation of the appendix
d.) Perforation of the appendix
The nurse is assessing an older patient with diverticulitis. Which instructions given by the nurse will be beneficial to this patient? Select all that apply. a.) "Refrain from drinking alcohol." b.) "Use mild laxatives three times a day." c.) "Refrain from physical activities like bending." d.) "Add tomatoes and strawberries in your diet." e.) "Eat a high-fiber diet during severe abdominal pain."
a.) "Refrain from drinking alcohol." c.) "Refrain from physical activities like bending."
After teaching a client who has a new colostomy, the nurse provides feedback based on the clients ability to complete self-care activities. Which statement should the nurse include in this feedback? a. I realize that you had a tough time today, but it will get easier with practice. b. You cleaned the stoma well. Now you need to practice putting on the appliance. c. You seem to understand what I taught you today. What else can I help you with? d. You seem uncomfortable. Do you want your daughter to care for your ostomy?
b. You cleaned the stoma well. Now you need to practice putting on the appliance.
A nurse is teaching a patient about dietary methods to help manage exacerbations ("flare-ups") of diverticulitis. What does the nurse advise the patient? a.) "Be sure to maintain an exclusively low-fiber diet to prevent pain on defecation." b.) "Consume a low-fiber diet while your diverticulitis is active. When inflammation resolves, consume a high-fiber diet." c.) "Maintain a high-fiber diet to prevent the development of hemorrhoids that frequently accompany this condition." d.) "Make sure you consume a high-fiber diet while diverticulitis is active. When inflammation resolves, consume a low-fiber diet."
b.) "Consume a low-fiber diet while your diverticulitis is active. When inflammation resolves, consume a high-fiber diet."
Which pathophysiological finding is least likely to occur in ulcerative colitis? a.) The colon becomes narrowed. b.) Ulcers are seen in the intestine. c.) Intestinal mucosa becomes bluish. d.) Intestinal mucosa becomes reddened.
c.) Intestinal mucosa becomes bluish.
The nurse is assisting with an esophagogastroduodenoscopy (EGD) procedure on a patient who has symptoms of gastritis. The provider collects tissue samples and will test for H. pylori infection using which diagnostic test? a.) pH measurement b.) IgG or IgM testing c.) Rapid urease testing d.) Cytologic examination
c.) Rapid urease testing
A nurse cares for a middle-aged male client who has irritable bowel syndrome (IBS). The client states, I have changed my diet and take bulk-forming laxatives, but my symptoms have not gotten better. I heard about a drug called Amitiza. Do you think it might help? How should the nurse respond? a. This drug is still in the research phase and is not available for public use yet. b. Unfortunately, lubiprostone is approved only for use in women. c. Lubiprostone works well. I will recommend this prescription to your provider. d. This drug should not be used with bulk-forming laxatives.
b. Unfortunately, lubiprostone is approved only for use in women.
The health care provider has ordered a fecal occult blood test (FOBT) for a patient. What does the nurse instruct the patient to avoid for a few days before and during the sample collection? Select all that apply. a.) Milk b.) Warfarin c.) Vitamin C d.) Red meat e.) Vitamin B 12 f.) Nonsteroidal anti-inflammatory drugs (NSAIDs)
b.) Warfarin c.) Vitamin C d.) Red meat f.) Nonsteroidal anti-inflammatory drugs (NSAIDs)
The nurse is instructing a patient with recently diagnosed diverticular disease about diet. What food does the nurse suggest the patient include? a.) Strawberries (1 cup) b.) Tomato (1 medium) c.) A slice of 5-grain bread d.) Chuck steak patty (6 ounces)
c.) A slice of 5-grain bread
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? a.) Every 3 years b.) Every 5 years c.) Every 10 years d.) Every 15 years
c.) Every 10 years
A patient has a low-grade fever and tenesmus. Which other clinical manifestations may indicate ulcerative colitis? a.) Increase in appetite b.) Difficulty passing stools c.) Inflammation of the joints d.) Formation of lesions outside the mouth
c.) Inflammation of the joints
