309 Gastro 2 quiz

A client is scheduled for a colonoscopy, and the healthcare provider orders a tap water enema. In which position should the nurse place the client during the enema? 1. Left sims 2. Back lying 3. Knee chest 4. Mid-Fowler

1. left sims

A nurse teaches a client with G.I. irritability to minimize the intake of dietary irritants. Which products did the nurse teach the client to avoid? Select all that apply 1. Rice 2. Milk 3. Cheese 4. Table salt 5. Chocolate candy

2. Milk 3. Cheese 5. Chocolate candy

For which classic clinical findings should the nurse assess the stool of clients with malabsorption syndrome? 1. Melena 2. Frank blood 3. Fat globules 4. Currant jelly consistency

3. Fat globules

You are caring for a client who was recently admitted for severe diverticulitis. Which task is appropriate to delegate for the care of this client? 1. Tell the unit secretary to call radiology and schedule a barium enema 2. Instruct the LPN/LVN to give PRN laxatives when the client reports constipation 3. Advise the nursing student to help the client ambulate up and down the hall 4. Tell the UAP that a stool specimens must be saved to test for occult blood

4. tell the UAP that a stool specimen must be saved to test for occult blood

Which drug is often used in older patients for pain management of moderate to severe diverticulitis? a. Ibuprofen (Motrin) b. Acetaminophen (Tylenol) c. Aspirin (Anacin) d. Morphine sulfate (Duramorph)

Which drug is often used in older patients for pain management of moderate to severe diverticulitis? d. morphine sulfate (Duramorph)

A patient is prescribed sulfasalazine (Azulfidine) for the treatment of ulcerative colitis. Which patient statement indicates the patient is experiencing a side effect of this drug? a. "My skin is covered with a rash" b. "My knees hurt." c. "My appetite has increased." d. "I wake up at night sweating sometimes."

a. " my skin is covered with a rash"

A patient with ulcerative colitis who has had an ileostomy is being discharged home. The nurse has provided discharge teaching. Which statements by the patient indicate the teaching has been effective? Select all that apply a. "I will avoid foods that cause gas" b. "I will call the health care provider if I have a fever over 101°F" c. "I will change the adhesive for the appliance daily." d. "I know the pouch needs emptying when I feel pain in that area." e. "I will call the healthcare provider if I feel like my heart is beating fast"

a. "I will avoid foods that cause gas" b. "I will call the health care provider if I have a fever over 101°F" e. "I will call the healthcare provider if I feel like my heart is beating fast"

Which NG tube can be connected to low continuous suction? a. Salem sump b. Levin c. Anderson d. Carney

a. Salem sump

Which findings for a patient with a new colostomy will the nurse report to the surgeon? Select all that apply a. a dark-red, dry stoma b. Stoma protruding about 2 cm from the abdominal wall c. Mucocutaneous seperation d. A slight amount of edema in the initial postoperative period e. Large amount of bleeding

a. a dark-red, dry stoma c. mucocutaneous separation e. large amount of bleeding

Which interventions are useful in preventing the spread of gastroenteritis? Select all that apply a. Careful handwashing b. Sanitize all surfaces that may be contaminated c. Prophylactic use of antibiotics d. Easily accessible hand sanitizers e. Test all food preparation employees

a. careful handwashing b. Sanitize all surfaces that may be contaminated d. Easily accessible hand sanitizers

Which intervention is contraindicated in the nonsurgical management of hemorrhoids? a. Diets low in fiber and fluids b. Dibucaine (Nupercainal) ointment c. Warm sitz baths three or four times a day d. Cleansing the anal area with moistened cleaning tissues

a. diets low in fiber and fluids

Which discharge information does the nurse include for the patient who has had an intestinal obstruction caused by fecal impaction? a. Encourage the patient to report abdominal distention, nausea, or vomiting, and constipation b. Provide the patient a written description of a low-fiber diet c. Remind the patient to limit activity d. Remind the patient to decrease fluid intake

a. encourage the patient to report abdominal distention, nausea, or vomiting, and constipation

Which key features does the nurse most likely find when performing a physical assessment on a patient with a small bowel obstruction? a. Visible peristaltic waves in the upper and middle abdomen b. Minimal or no vomiting c. No major fluid and electrolyte imbalances d. Metabolic acidosis

a. visible peristaltic waves in the upper and middle abdomen

Which interventions does the nurse expect to implement when caring for a patient with diverticulitis? Select all that apply a. Laxatives and enemas are ordered b. IV fluids to prevent dehydration c. Broad spectrum antibiotics d. Teach the patients to refrain from lifting or straining e. Keep the patient NPO if symptoms are severe

b. IV fluids to prevent dehydration c. Broad spectrum antibiotics d. Teach the patients to refrain from lifting or straining e. Keep the patient NPO if symptoms are severe

A patient with a colostomy may safely include which food item into the diet? a. Burritos b. Yogurt c. Cabbage d. Carbonated beverages

b. yogurt

What are the cardinal signs of peritonitis? a. Fever and headache b. Dizziness and nausea and vomiting c. Abdominal pain, distention, and tenderness d. Nausea and loss of appetite

c. Abdominal pain, distention, and tenderness

The patient with IBS reports abdominal distention and feeling bloated to the nurse. The patient states she had a bowel movement that morning. What drug treatment does the nurse expect the healthcare provider to order? a. loperamide (Imodium) b. Psyllium hydrophilic mucilloid (Metamucil) c. Lubiprostone (amitiza) d. rifaximin (Xifaxan)

d. Rifaximin (Xifaxan)

The patient has an abdominal hernia with a sac that can be replaced into the abdominal cavity by gentle pressure. Which type of hernia does the nurse recognize? a. incisional b. irreducible c. indirect inguinal d. reducible

d. reducible

Which surgical procedure involves removal of the colon, rectum, and anus with surgical closure of the anus? a. Restorative proctolectomy with oleo pouch-anal anastomosis (RPC-IPAA) b. Natural orifice transluminal endoscopic surgery (NOTES) c. Sigmoid colostomy d. Total proctocolectomy with a permanent ileostomy

d. total proctocolectomy with a permanent ileostomy

A self-help group of clients with irritable bowel syndrome have invited a nurse to present a program on nutrition. Which substance should the nurse teach the clients to minimize in the diet to decrease G.I. irritability? 1. Cola drinks 2. Amino acids 3. Rice products 4. Sugar products

1. Cola drinks

Which food selections by a client with malabsorption syndrome indicate that the nurses dietary teaching was successful? Select all that apply 1. Green beans 2. Baked potato 3. Noodle pudding 4. Turkey sandwich 5. Whole wheat cereal

1. Green beans 2. Baked potato

You are caring for an obese post operative client who underwent surgery for bowel resection. As the client is moving in bed, he comments "something popped open". Upon examination you note wound evisceration. Place in order the steps for handling this complication. 1. Cover the intestine with sterile moistened gauze 2. Stay calm and stay with the client 3. Check the vital signs, especially blood pressure and pulse 4. Have a colleague gather supplies and contact the physician 5. Put the client into semi-Fowler position with knees slightly flexed 6. Prepare the client for surgery as ordered

1. Stay calm and stay with the patient 2. Put the clients into semi Fowler position with knees slightly flexed 3. Check the vital signs especially blood pressure and pulse 4. Have a colleague gather sterile supplies and contact the physician 5. Cover the intestine with sterile moisten gauze 6. Prepare the client for surgery as ordered

A nurse is reviewing the laboratory results of and collecting a health history from client with a diagnosis of colitis. Which common clinical manifestation of colitis should the nurse expect? 1. Weight loss 2. Hemoptysis 3. Increased red blood cells 4. Decreased white blood cells

1. Weight loss

A client who had surgery for a ruptured appendix develops peritonitis. What clinical findings related to peritonitis should the nurse expect the client to exhibit? Select all that apply 1. Fever 2. Hyperactivity 3. Extreme hunger 4. Urinary retention 5. Abdominal muscle rigidity

1. fever 5. Abdominal muscle rigidity

You are teaching the client and family how to perform colostomy irrigation. Place the following information in the correct order. 1. Hang the container at about shoulder height 2. Allow the solution to flow slowly and steadily for 5 to 10 minutes 3. Put 500 to 1000mL of lukewarm water in the container 4. Clip the irrigation sleeve and have the client walk for 30 to 45 minutes for secondary evacuation 5. Lubricate the stoma cone and gently inset the tubing tip into the stoma 6. Clean, rinse, and dry the skin, and apply a new drainage pouch 7. Put on a pair of clean gloves 8. Allow 15 to 20 minutes for the initial evacuation

1. put on a pair of clean gloves 2. Put 500 to 1000 mL of lukewarm water in the container 3. Hang the container at about shoulder height 4. Lubricate the stoma cone and gently insert the tubing tip into the stoma 5. Allow the solution to flow slowly and steadily for 5 to 10 minutes 6. Allowed 15 to 20 minutes for the initial evacuation 7. Clip the irrigation sleeve and have the client walk for about 30 to 45 minutes for a secondary evacuation 8. Clean, rinse, and dry the skin, and apply a new drainage pouch

Neomycin 1g is prescribed preoperatively for a client with a diagnosis of cancer of the colon. The client asks why neomycin is being given. Which is the best response by the nurse? 1. "It will decrease your kidney function and lesson urine production during surgery." 2. It will kill the bacteria in your bowel and decrease the risk of infection after surgery." 3. "It is used to alter the body flora, which reduces the spread of the tumor to the adjacent organs." 4. "It is used to prevent you from getting an infection, particularly a bladder infection, before surgery."

2. "It will kill the bacteria in your bowel and decrease the risk of infection after surgery"

An exploratory laparotomy is performed on a client with melena, and gastric cancer is discovered. A partial gastrectomy is performed, and a jejunostomy tube is surgically implanted. A nasogastric tube to suction is in place. What should the nurse expect regarding the clients nasogastric tube drainage during the first 24 hours after surgery? 1. Green and viscid 2. Contain some blood and clots 3. Contain large amounts of frank blood 4. Similar to coffee grounds in color and consistency

2. Contain some blood and clots

After many years of coping with colitis, a patient makes a decision to have a colectomy as advised by the healthcare provider. Which is most likely the significant factor that impacted on the clients decision? 1. It is temporary until the colon heals 2. Surgical treatment cures ulcerative colitis 3. Ulcerative colitis can progress to Crohn's disease 4. Without surgery, eating table food is contraindicated

2. Surgical treatment cures ulcerative colitis

A nurse is teaching a client who has a full time job how to care for a new colostomy. At which time should the nurse suggest scheduling the colostomy irrigations? 1. When it is most convenient for the client 2. Approximately a half hour after breakfast 3. Halfway between the two largest meals of the day 4. At the time the client had bowel movements before surgery

2. approximately a half hour after breakfast

For clients coming to the ambulatory care G.I. clinic, which tasks would be most appropriate to assign to an LPN? 1. Teaching a client self-care measures for an ulcer 2. Assisting the physician in incision and drainage of a pilonidal cyst 3. Evaluating a client's response to sitz baths for an anorectal abscess 4. Describing the basic pathophysiology of an anal fistula to a client

2. assisting the physician in incision and drainage of a pilonidal cyst

A client is diagnosed as having colitis. Which clinical findings should the nurse expect the client to report? Select all that apply 1. Fever 2. Diarrhea 3. Gain in weight 4. Spitting up blood 5. Abdominal cramps

2. diarrhea 5. Abdominal cramps

A nurse is teaching a client with an acute exacerbation of colitis about the most appropriate diet. Which food selected by the client indicates that the dietary teaching is effective? 1. Orange juice 2. Scrambled eggs 3. Vanilla milkshake 4. Creamed potato soup

2. scrambled eggs

A client is diagnosed with malabsorption syndrome. Which foods should the nurse teach the client to avoid? Select all that apply 1. Corn 2. Cheese 3. Oatmeal 4. Rye bread 5. Fruit juice

3. Oatmeal 4. Rye bread

A client with cancer of the colon had surgery for a resection of the tumor and the creation of a colostomy. During the six week post operative check up, the nurse teaches the client about nutrition. The nurse evaluates that learning has taken place when the client states, "I should follow a diet that is: 1. Rich in protein." 2. Low in fiver content." 3. As close to usual as possible." 4. Higher in calories that before."

3. as close to usual as possible"

What should the nurse do when caring for a client with an ileostomy? 1. Teach the client to eat foods high in residue 2. Explain that drainage can be controlled with daily irrigations 3. Expect the stoma to start draining on the third postoperative day 4. Anticipate that any emotional stress can increase intestinal peristalsis

4. anticipate that any emotional stress can increase intestinal peristalsis

Which information does the nurse include when teaching a patient with new onset hemorrhoids about prevention of hemorrhoid flare-up? Select all that apply a. "Increase the fiber in your diet to prevent constipation." b. "Do not participate in any physical exercise." c. "Maintain a healthy weight." d. "Increase your amount of fluid intake." e. "Prolonged sitting or standing will not affect the development of hemorrhoids."

a. " increase the fiber in your diet to prevent constipation" c. "Maintain a healthy weight" d. "Increase your amount of fluid intake"

In caring for patients with Crohn's disease, the nurse observes for which complications? Select all that apply a. Peritonitis b. Small bowel obstruction c. Nutritional and fluid imbalances d. Presence of fistulas e. Appendicitis f. Severe nausea and vomiting

a. Peritonitis b. Small bowel obstruction c. Nutritional and fluid imbalances d. Presence of fistulas

The respiratory problems that may accompany peritonitis are a result of which factor? a. Associated pain interfering with ventilation b. Decreased pressure against the diaphragm c. Fluid shifts to the thoracic cavity d. Decreased oxygen demands related to the infectious process

a. associated pain interfering with ventilation

What are the major focus areas for interventions aimed at treating malabsorption syndromes? Select all that apply a. Avoiding substances that aggravate malabsorption b. Use of complementary and alternative therapies c. Supplementation of nutrients d. Assessment and supplementation of coping strategies e. Curative radiation therapy

a. avoiding substances that aggravate malabsorption c. Supplementation of nutrients

Which are the most common signs of colorectal cancer (CRC)? Select all that apply a. change in stool consistency b. absent bowel sounds c. abdominal cramping d. anemia e. rectal bleeding

a. change in stool consistency d. anemia e. rectal bleeding

A patient is suspected to have ulcerative colitis. Which definitive diagnostic test does the nurse expect the patient to undergo in order to confirm the diagnosis? a. Colonoscopy b. C-reactive protein c. Albumin levels d. Erythrocyte sedimentation rate

a. colonoscopy

The nurse is assessing a patient newly admitted with constipation and failure to pass flatus. Which condition is the most likely cause of this patient's symptoms? a. Complete bowel obstruction b. Partial obstruction c. Colorectal cancer d. Crohn's disease

a. complete bowel obstruction

What is the nature of pain associated with diverticulitis? a. Intermittent becoming progressively steady b. Sharp and continuous c. Localized to the right upper quadrant d. Severe and incapacitating

a. intermittent becoming progressively steady

Which findings does the nurse expect for a post operative colostomy patient? Select all that apply a. Reddish-pink, moist stoma b. Small amount of bleeding c. Large amount of stoma swelling d. Mucocutaneous separation e. Smooth, intact peristomal skin

a. reddish-pink, moist stoma b. small amount of bleeding e. smooth, intact peristomal skin

The nurse is teaching a patient about what to expect after a descending colon colostomy. The nurse tells the patient to expect this stool to have what kind of form? a. Similar to that of stool expelled from the rectum b. Think and paste-like c. Thin and gelatin-like d. Watery

a. similar to that of stool expelled from the rectum

The patient with gastroenteritis due to infection with the Norovirus asked the nurse how this illness occurred. Which statement by the patient indicates correct understanding of the nurses teaching? a. "I got this infection from being around my grandchildren when they had respiratory illnesses." b. "It is likely that I got this illness from either contaminated water or food." c. "I may have gotten sick when I was traveling last month." d. "It's really important that everything I eat is cooked until it is well done."

b. "It is likely that I got this illness from either contaminated water or food"

Which are common manifestation in a 28-year-old patient with dehydration secondary to gastroenteritis? Select all that apply a. Peripheral edema b. Elevated temperature c. Dry mucous membranes d. Hypertension e. Oliguria

b. Elevated temperature c. Dry mucous membranes e. Oliguria

What is the priority nursing concern for a patient with gastroenteritis? a. Nutrition therapy b. Fluid replacement c. Skin care d. Drug therapy

b. Fluid replacement

Which diagnostic test measures urinary excretion of vitamin B12 for diagnosis of pernicious anemia and other malabsorption syndromes? a. Bile acid breath test b. Schilling test c. Hydrogen breath test d. D-xylose absorption test

b. Schilling test

Which characteristics pertain to Crohn's disease? Select all that apply a. Begins in the rectum and proceeds in a continuous manner toward the cecum b. Fistulas commonly develop c. Five to six soft, loose stools per day that are nonbloody d. Increased risk of colon cancer e. Some patients experience extra intestinal manifestations such as migratory polyarthritis. ankylosing spondylitis, and erythema nodosum f. Cobblestone appearance of the internal intestine

b. fistulas commonly develop c. 5-6 soft, loose stools per day that are nonbloody f. Cobblestone appearance of the internal intestine

Which nursing intervention is part of nonsurgical management for a patient with peritonitis? a. Monitor weekly weight and intake and output b. Insert a nasogastric tube to decompress the stomach c. Order a breakfast tray when the patient is hungry d. Administer NSAIDS for pain

b. insert a nasogastric tube to decompress the stomach

The trauma patient has ecchymosis in the shape and distribution of a seatbelt. What is the nurses best first action? a. Start a third large-bore IV b. Notify the health care provider c. Insert a urinary catheter d. Get a 12-lead electrocardiogram

b. notify the healthcare provider

Which nursing care actions should the nurse delegate to the unlicensed assistant personnel for an older patient with a bowel obstruction? Select all that apply a. Administer analgesics as needed b. Provide mouth care every 2 hours c. Assess abdomen for distention d. Teach the patient about surgical procedures e. Provide the patient with a few ice chips

b. provide mouth care every 2 hours e. provide the patient with a few ice chips

Emergency care of a patient with abdominal trauma includes which interventions? Select all that apply a. Insertion of at least two large-bore IV catheters in the lower extremities b. Type and cross-matching of 4 to 8 units of blood c. Measurement of arterial blood gases d. Continuous hemodynamic monitoring e. Insertion of a foley catheter

b. type and cross matching of 4-8 units of blood c. Measurement of arterial blood gases d. Continuous hemodynamic monitoring e. insertion of a foley catheter

Which parasitic infection is manifested by diarrhea and occurs most commonly in immunosuppressed patients, especially those with human immunodeficiency virus? a. Entamoeba histolytica b. Cryptosporidium c. Giardia lamblia d. Escherichia coli

c. Giardia lamblia

Which test may be used in diagnosing IBS? a. erythrocyte sedimentation rate b. stool sample for ova and parasites c. hydrogen breath test d. blood cultures for infection

c. Hydrogen breath test

Which is a preventative measure for diverticular disease? a. Excluding whole-grain breads from the diet b. Avoiding fresh apples, broccoli, and lettuce c. Taking bulk agents such as psyllium hydrophilic mucilloid (Metamucil) d. Taking routine anticholinergics to reduce bowel spasms

c. Taking bulk agents such as psyllium hydrophilic mucilloid (Metamucil)

Which observation of a patient with an intestinal obstruction does the nurse report immediately? a. Urinary output of 1000 mL in an 8-hour period b. The patient's request for something to drink c. Abdominal pain changing from colicky to constant discomfort d. The patient is changing positions frequently

c. abdominal pain changing from colicky to constant discomfort

The fluid shifts that occurs in peritonitis may result in which of the following? a. Intracellular fluid moving into the peritoneal cavity b. Significant increase in circulatory volume c. Decreased circulatory volume and hypovolemic shock d. Increased bowel motility caused by increased fluid volume

c. decreased circulatory volume and hypovolemic shock

The nurse assesses a patient with a hernia and finds that the patient's symptoms include abdominal distention, nausea, vomiting, and pain. The patient's heart rate is 118 bpm and temperature is 101°F. Which type of hernia does the nurse suspect? a. incisional b. incarcerated c. strangulated d. umbilical

c. strangulated

The nurses caring for a patient with gastroenteritis who has frequent stools. Which task is best to delegate to the UAP? a. Teach the patient to avoid toilet paper and harsh soaps b. Instruct the patient on how to take a sitz bath c. Use a warm washcloth to remove stool from the skin d. Dry the skin with absorbent cotton

c. use a warm washcloth to remove stool from the skin

As part of the routine treatment plan for a patient with bacterial gastroenteritis, which drugs does the nurse anticipates the patient will most likely be prescribed? a. Anticholinergics b. Antiemetics c. Antiperistaltic drugs d. Antibiotics

d. antibiotics

The nurse is teaching a patient about colostomy care. Which information does the nurse include in the teaching plan? a. The stoma will enlarge within 6 to 8 weeks of surgery. b. Use a moisturizing soap to cleanse the area around the stoma. c. Place the colostomy bag on the skin when the skin sealant is still damp. d. An antifungal cream or powder can be used if a fungal rash develops.

d. antifungal cream or powder can be used if a fungal rash develops

Which intervention applies to the nursing care of an older patients with heart failure and hypovolemia related to an intestinal obstruction? a. Provide frequent mouth care with lemon glycerin swabs b. Offer ice chips to suck on before surgery c. Offer a small glass of water d. Assess for crackles in the lungs

d. assess for crackles in the lungs

What is the classic symptom of malabsorption syndrome? a. Unintentional weight loss b. Decreased libido c. Bloating with flatus d. Chronic diarrhea

d. chronic diarrhea

Which type of diet has been implicated in the formation of diverticula? a. High-fat diet b. Low-protein diet c. High-cholesterol diet d. Low-fiber diet

d. low-fiber diet

The nurse is assessing an older adult patient with abdominal pain. Assessment findings include generalized abdominal pain with ridigity, nausea, and vomiting, elevated temperature (101.2F), increased HR (122/min), and chills. The patient is also somewhat confused and does not know where he is. What does the nurse suspect with this patient? a. Crohn's disease b. Ulcerative colitis c. Diverticulitis d. Peritonitis

d. peritonitis

Place the steps for performing colostomy care in the correct order. 1. Fit the pouch snuggly around the stoma 2. Assess the color and appearance of the stoma 3. Wash the skin with mild soap and rinse with warm water 4. Apply a skin barrier to protect the peristomal skin 5. Dry the skin carefully 6. Don a pair of gloves and remove the old pouch

1. Don a pair of clean gloves and remove the old pouch 2. Assess the color and appearance of the stoma 3. Wash the skin with mild soap and rinse with warm water 4. Dry the skin carefully 5. Apply a skin barrier to protect the peristomal skin 6. Fit the pouch snugly around the stoma

When advising a college student about dietary choices the nurse should consider the caloric value of the most commonly ordered fast foods eaten by active young adults. List the following foods in order from the one with the least number of calories to the one with the most number of calories. 1._______Frech fries 2_______Garden salad 3_______Whooper with cheese 4._______One slice of French toast 5._______Six pieces of chicken tenders

1. Garden salad 2. French toast 3. Six pieces of chicken tenders 4. French fries 5. Whopper with cheese

A female client with the diagnosis of Crohn's disease tells the nurse that her boyfriend dates other women. She believes that this behavior causes an increase in her symptoms. What should the nurse do first when counseling this client? 1. Help the client explore attitudes about herself 2. Educate the client's boyfriend about her illness 3. Suggest the client should not see her new boyfriend for awhile 4. Schedule the client and her boyfriend for a counseling session

1. Help the client explore attitudes about herself

A client hospitalized with ulcerative colitis reports 10 to 20 small diarrhea stools per day, with abdominal pain before defecation. The client appears depressed and underweight and is uninterested in self-care or suggested therapies. What is the priority nursing diagnosis? 1. Diarrhea related to irritated bowel 2. Imbalanced Nutrition: Less than Body Requirements related to nutrition loss 3. Acute Pain related to increased GI motility 4. Ineffective Self-Health Management related to treatment plan

1. diarrhea related to irritated bowel

An active adolescent is admitted to the hospital for surgery for an ileostomy. When planning a teaching session about self-care, the nurse includes sports that should be avoided by a client with an ileostomy. Which should be included on the list of sports to be avoided? Select all that apply 1. Football 2. Swimming 3. Ice hockey 4. Track events 5. Cross-country skiing

1. football 3. Ice hockey

A nurse obtains daily's stool specimens for a client with chronic bowel inflammation. The nurse concludes that these stool examinations were ordered to determine: 1. Fat content 2. Occult blood 3. Ova and parasites 4. Culture and sensitivity

2. Occult blood

A nurse is educating a client with a colostomy of the ascending colon about using a colostomy appliance. Which instruction should the nurse provide to help prevent leakage of stool from the appliance? 1. Irrigate the colostomy to establish an expected pattern of elimination 2. Empty the appliance when it is approximately one half full with feces 3. Use an antiseptic to clean the peristomal skin before applying the appliance 4. Select an appliance with a pouch opening of at least 5 cm larger than the stoma

2. empty the appliance when it is approximately one half full with feces

A nurse is caring for a client with a new colostomy. Which client outcome is most important for achievement of long-range goals associated with adjusting to a new colostomy? 1. Mastery of techniques of colostomy care 2. Readiness to accept an altered body function 3. Awareness of available community resources 4. Knowledge of the necessary dietary modifications

2. readiness to accept an altered body function

When a client is being prepared for a colonoscopy procedure, which task is most suitable to delegate to the UAP? 1. Explaining the need for clear liquid diet 1 to 2 days before the procedure. 2. Reinforcing "nothing by mouth" status 8 hours before the procedure 3. Administering laxatives 1 to 3 days before the procedure 4. Administering an enema the night before the procedure

2. reinforcing NPO status eight hours before the procedure

A client had part of the ileum surgically removed. Why is it necessary for the nurse to monitor the client for clinical indicators of anemia? 1. Folic acid is absorbed in the ileum 2. The hemopoietic factor is absorbed in the ileum 3. Iron absorption is dependent on simultaneous bile salt absorption in the ileum 4. The trace elements copper, cobalt, and nickel, required for hemoglobin synthesis, are absorbed in the ileum

2. the hemopoietic factor is absorbed in the ileum

A nurse is teaching a client with a permanent colostomy about self-care in preparation for discharge from the hospital. Which intervention should the nurse discuss with the client? 1. Limiting activity 2. Wearing special clothing 3. Dilating the stoma periodically 4. Maintaining a low-residue diet

3. Dilating the stoma periodically

A nurse is evaluating a client who has been receiving medical intervention for the diagnosis of Crohn's disease. Which expected outcome is most important for this client? 1. Does skin care 2. Takes oral fluids 3. Gains a half pound per week 4. Experiences less abdominal cramping

3. Gains a half pound per week

You are planning a treatment intervention program for chronic fecal incontinence for an elderly client. Which intervention should you try first? 1. Administer a glycerin suppository 15 minutes before evacuation time 2. Insert a rectal tube at specified intervals each day 3. Assist the client to the bedpan or toilet 30 minutes after meals 4. Use incontinence briefs or adult-sized diapers

3. assist the client to the bedpan or toilet 30 minutes after meals

Two hours after a subtotal gastrectomy, the nurse identifies that the drainage from the clients nasogastric tube is bright red. What should the nurse do first? 1. Notify the health care provider 2. Clamp the nasogastric tube for one hour 3. Determine that this is an expected finding 4. Irrigate the nasogastric tube with iced saline

3. determine that this is an expected finding

You are caring for a client with a nasal gastric tube. Which task can be delegated to an experienced UAP? 1. Removing the NG tube per physician order 2. Securing the tape if the client accidentally dislodges the tube 3. Disconnecting the suction to allow ambulation to the toilet 4. Reconnecting the suction after the client has ambulated

3. disconnecting the suction to allow ambulation to the toilet

An 18-year-old is admitted with an acute onset of right lower quadrant pain at McBurney's point. Appendicitis is suspected. For which clinical indicator should the nurse assess the client to determine if the pain is secondary to appendicitis? 1. Urinary retention 2. Gastric hyperacidity 3. Rebound tenderness 4. Increased lower bowel motility

3. rebound tenderness

A client with ulcerative colitis has experienced frequent severe exacerbations over the past several years. The client is admitted to the hospital with intense pain, severe diarrhea, and cachexia. Which therapeutic course should the nurse expect the healthcare provider to explore with this client? 1. Intensive psychotherapy 2. Continued medical therapy 3. Surgical therapy (colectomy) 4. Diet therapy (low-residue, high-protein diet)

3. surgical therapy (colectomy)

Which explanation is most accurate when the nurse teaches a client about intussusception of the bowel? 1. Kinking of the bowel onto itself 2. A band of connective tissue compressing the bowel 3. Telescoping of a proximal loop of bowel into a distal loop 4. A protrusion of an organ or part of an organ through the wall that contains it

3. telescoping of a proximal loop of bowel into a distal loop

A nurse is admitting a client with the diagnosis of malabsorption syndrome to the medical unit at lunchtime. Which foods can be included on the clients ordered diet? 1. Breaded veal cutlet with cheese 2. Roast beef sandwiches with pickles 3. Chicken noodle soup with crackers 4. Cheese omelet with chopped spinach

4. cheese omelet with chopped spinach

A nurse is assessing two clients. One client has ulcerative colitis and the other client has Crohn's disease. Which is more likely to be identified in the client with ulcerative colitis than the client with Crohn's disease? 1. Inclusion of transmural involvement of the small bowel wall 2. Correlation with increased malignancy because of malabsorption syndrome 3. Pathology beginning proximally with intermittent plaques found along the colon 4. Involvement starting distally with rectal bleeding that spreads continuously up the colon

4. involvement starting distally with rectal bleeding that spreads continuously up the colon

Which statements does the nurse include while providing discharge instructions for a patient with giardiasis? Select all that apply a. "Avoid contact with stool from dogs and beavers" b. "All household and sexual partners should have stool examinations for parasites" c. "Treatment will most likely consist of metronidazole (Flagyl)" d. "Infection can't be transmitted to others until the amebicides kill the parasites" e. "Stools are examined 6 days after treatment to asses for eradication."

a. "Avoid contact with stool from dogs and beavers" b. "All household and sexual partners should have stool examinations for parasites" c. "Treatment will most likely consist of metronidazole (Flagyl)" d. "Infection can't be transmitted to others until the amebicides kill the parasites"

Which discharge instructions does the nurse include for a patient after abdominoperitoneal resection? a. use a soft pillow to sit on whenever you sit down b. Lie on your back when you are resting in bed c. use a rubber doughnut device for sitting on when in the car d. sit in a chair for at least 4 consecutive hours a day

a. "use a soft pillow to sit on whenever you sit down"

Which drug is the drug of choice for the treatment of IBS when pain is the predominant symptom? a. Amitriptlyine (Elavil) b. Fesoterodine (Toviaz) c. Loperamide (Imodium) d. psyllium hydrophilic mucilloid (Metamucil)

a. Amitriptyline (Elavil)

The patient has a diagnosis of irritable bowel syndrome. What forms can IBS take? select all that apply a. diarrhea (IBS-D) b. constipation (IBS-c) c. Bloating (IBS-B) d. alternating diarrhea and constipation (IBS-A) e. mix of constipation and diarrhea (IBS-M)

a. Diarrhea (IBS-D) b. Constipation (IBS-C) d. Alternating diarrhea and constipation (IBS-A) e. Mix of constipation and diarrhea (IBS-M)

Which are potential complications of polyps? Select all that apply a. Gross rectal bleeding b. Colorectal cancer c. Intestinal obstruction d. Septic shock e. Intussusception

a. Gross rectal bleeding c. Intestinal obstruction e. Intussusception

The nurse is to administer alvimopan (Entereg) to a patient with postoperative ileus (POI). What is the action of this drug? a. Increases gastrointestinal (GI) motility b. Laxative for bowel movement c. Antibiotic to prevent infection d. Prevents nausea and vomiting

a. Increases gastrointestinal (GI) motility

Darifenacin (Enablex) is an example of a new group of drugs that may be used to manage IBS. What action of this drug would make it suitable for treatment of IBS? a. inhibits intestinal motility b. decreases abdominal distention c. Eliminates constipation d. increases fluid in the intestines

a. Inhibits intestinal motility

Which laboratory results are expected with malabsorption syndrome resulting in hypochromic microcytic anemia? Select all that apply a. Low mean corpuscular hemoglobin (MCH) b. High serum vitamin A level c. Elevated fecal fat content d. Increased mean corpuscular volume (MCV) e. Decreased serum cholesterol level f. Low mean corpuscular hemoglobin concentration (MCHC)

a. Low mean corpuscular hemoglobin (MCH) f. Low mean corpuscular hemoglobin concentration (MCHC)

The nurse is caring for the patient with acute appendicitis. Which interventions will the nurse perform? Select all that apply a. Maintain the patient on NPO status b. Administer IV fluids as prescribed c. Apply warm compresses to the right lower abdominal quadrant d. Maintain the patient in supine position e. Administer laxatives

a. Maintain the patient on NPO status b. Administer IV fluids as prescribed

Which intervention does the nurse delegate to the unlicensed assistive personnel (UAP) when caring for a post operative patients with peritonitis? a. Measure intake and output b. Assess wound drainage c. Administer antibiotics d. Teach patient about wound care

a. Measure intake and output

Which statement about diverticular disease is true? a. Most diverticula occur in the sigmoid colon b. Diverticula are uncomfortable even when not inflamed c. High-fiber diets contribute to diverticula d. Diverticula form where intestinal wall muscles are weak

a. Most diverticula occur in the sigmoid colon

The nurse is teaching a patient about how to control gas in odor from a colostomy. Which information does the nurse include? a. Do not chew gum b. Place an aspirin in the colostomy c. Do not consume buttermilk d. Do not eat parsley

a. do not chew gum

The emergency department nurse is assessing a patient with abdominal trauma after a motor vehicle accident. The patient has become somewhat confused, his skin is pale, cool, and moist and he has had only 20 mL of urine output during the past hour. What does the nurse suspect? a. Hypovolemic shock b. Head injury c. Liver laceration d. Large bowel injury

a. hypovolemic shock

The nurse is providing teaching about ways to reduce the risk for colorectal cancer. Which dietary suggestions will the nurse be sure to include? Select all that apply a. low fat b. low protein c high fiber d. high in red meat e. low in refined carbohydrates

a. low fat c. high fiber e. low in refined carbohydrates

Which description best defines an anal fissure? a. Perianal tear that can be very painful b. Duct obstruction and infection c. Communicating tract d. Localized area of induration with pus

a. perianal tear that can be very painful

Which statements about peritonitis are true? Select all that apply a. Peritonitis is caused by contamination of the peritoneal cavity by bacteria or chemicals b. Continuous ambulatory peritoneal dialysis (CAPD) can cause peritonitis c. White blood cell counts are often decreased with peritonitis d. Abdominal wall rigidity is a classic finding in patients with peritonitis e. Chemical peritonitis is caused by leakage of pancreatic enzymes or gastric acids

a. peritonitis is caused by contamination of the peritoneal cavity by bacteria or chemicals b. continuous ambulatory peritoneal dialysis (CAPD) can cause peritonitis d. abdominal wall rigidity is a classic finding in patients with peritonitis

The emergency department nurse is assessing a patient admitted with frequent, liquid, foul-smelling stools containing mucus and blood. Assessment findings include a temperature of the 103.8°F, tenesmus, abdominal tenderness, and vomiting. Which additional laboratory tests does the nurse expect to collect? a. Serial stool samples b. Urine culture c. Throat culture d. Sputum culture

a. serial stool samples

Why does the nurse place a patient with a bowel obstruction in semi Fowler's position? Select all that apply a. To promote increased peristalsis b. To alleviate the pressure of abdominal distention on the chest c. To decrease the likelihood of nausea and vomiting d. To facilitate breathing e. To prevent aspiration

a. to promote increased peristalsis b. To alleviate the pressure of abdominal distention on the chest d. to facilitate breathing

The nurse is teaching a patient with IBS about complementary and alternative therapies for the disease. Which patient statements indicate that teaching has been effective? Select all that apply a. Hydrotherapy may help decrease symptom b. probiotics can help decrease bacteria and decrease my IBS symptoms c. peppermint oil has been used to expel gas and relax spastic intestinal muscles d. fish oil can be used to ease constipation e. Ginkgo can be used for abdominal discomfort and to expel gas

b. "Probiotics can help decrease bacteria and decrease my IBS symptoms" c. "Peppermint oil has been used to expel gas and relax spastic intestinal muscles"

The nurse is providing teaching for a patient with an anal fissure as a complication of Crohn's disease. Which statement by the patient indicates the need for further teaching? a. "I will use warm sits baths." b. "A diet that is low in bulk-producing agents is best for me." c. "Hydrocortisone cream may be helpful to decrease discomfort." d. " Topical antiinflammatory agents will help if I am uncomfortable."

b. "a diet that is low in bulk producing agents is best for me"

Which statement by a patient indicates an understanding of surgical management of hemorrhoids? a. "It will take 10 to 14 days for the rubber band used on the hemorrhoid to fall off." b. "My first bowel movement after the surgery may be very painful." c. "After surgery, I will need to eat a low-fiber, low -fiber diet." d. "Stool softeners and laxatives are avoided after hemorrhoid surgery."

b. "my first bowel movement after the surgery may be very painful"

The nurse on the surgical unit is expecting to admit the patient who has had an appendectomy with abscess. What does the nurse anticipates care for this patient will include? Select all that apply a. Clear liquids b. Wound drains c. IV antibiotics d. Nonsteroidal anti-inflammatory drugs (NSAIDS) for pain control e. Nasogastric (NG) tube care

b. Wound drains c. IV antibiotics e. Nasogastric tube care

Which are examples of mechanical bowel obstructions? Select all that apply a. Paralytic ileus b. Adhesions c. Tumors d. Absent peristalsis e. Fecal impaction

b. adhesions c. Tumors e. Fecal impaction

After colostomy surgery, which intervention does the nurse employ? a. cover the stoma with a dry, sterile dressing b. applying a pouch system as soon as possible c. make a hole in the pouch for gas to escape d. watch for the colostomy to start functioning on day 1

b. apply a pouch system as soon as possible

What do post operative measures for a male patient who has had an inguinal herniorrhaphy include? a. applying a warm pack to the scrotum b. elevating the scrotum on a pillow c. encouraging use of a bedpan to void d. decreasing fluid intake to decrease bladder emptying

b. elevating the scrotum on a pillow

What statement is true about the medical treatment of ulcerative colitis? a. Infliximab (Remicade) is approved as a first-line therapy b. Immunomodulators are not thought to be effective, however, in combination with steroids, they may offer a synergistic effect. c. When a therapeutic level of glucocorticoids is reached, the dosage of the drug stays the same to maintain the therapeutic effect d. The method of action for the aminosalicylates is interruption of the pain pathway

b. immunomodulators are not thought to be effective, however, in combination with steroids, they may offer a synergistic effect.

What nursing care does a patient with a nasogastric tube require? select all that apply a. Assessment of proper placement at least every 12 hours b. Keep patient in a semi-Fowler's position c. Confirmation of NG tube placement by x-ray if it is repositioned d. Monitor contents of the NG tube e. Irrigation of the tube with 30 mL of normal saline as ordered f. Questioning the patient about the passage of flatus

b. keep the patient in a semi Fowler's position c. Confirmation of NG tube placement by x-ray if it is repositioned d. Monitor contents of the NG tube e. Irrigation of the tube with 30 mL of normal saline as ordered

The nurses providing care for a patient with a bowel obstruction notes that the patient has started passing flatulence and had a small bowel movement. What has occurred with this patient? a. Blockage is complete b. Peristalsis has returned c. Peritonitis has occurred d. The patient is rehydrated

b. peristalsis has returned

The patient has been diagnosed with acute appendicitis. Based on this diagnosis, which intervention does the nurse perform? a. Start a bowel cleansing program b. Prepare the patient for surgery c. Apply a heating pad to the lower abdomen d. Assess the patient's knowledge about dietary modifications.

b. prepare the patient for surgery

The nurse is instructing a patient about home care after an exploratory laparotomy for peritonitis. Which statement by the patient indicates that teaching has been effective? a. "It is normal for the incision site to be warm." b. " I will stop taking the antibiotics if diarrhea develops." c. "I will call the health care provider for a temperature greater than 101°F" d. "I will resume activity with my bowling league this week for exercise."

c. "I will call the healthcare provider for a temperature greater than 101°F"

Which statement is true about drug therapy for crohn's disease? a. Budesonide (Entocort EC) is a rapid-release compound that delivers low local glucocorticoid concentrations to the terminal ileum for patients with crohn's disease b. Methrotrexate (Rheumatrex) is contraindicated in the treatment ofncrohn's disease c. Metronidazole (Flagyl) has been helpful in patients with fistulas and crohn's disease d. Adalimumab (Humira) is a glucocorticoid approved for the treatment of crohn's disease

c. Metronidazole (Flagyl) has been helpful in patients with fistulas and crohn's disease

Which are true statements about caring for a patient with a truss? Select all that apply a. a surgical binder holds the truss in place b. the truss is removed only for bathing c. the truss is only used after the hernia is reduced by the physician d. the truss is applied before the hernia is reduced to decrease the pain e. powder should be applied to the skin under the truss daily

c. The truss is only used after the hernia has been reduced by the physician e. Powder should be applied to the skin under the truss daily

The patient comes to the emergency department with lower right quadrant pain. What does the ED nurse suspect? a. Gastroenteritis b. Ulcerative colitis c. Appendicitis d. Crohn's disease

c. appendicitis

Which test is definitive for the diagnosis of CRC? a. carcinoembryonic antigen (CEA) b. barium swallow c. colonoscopy with biopsy d fecal occult blood test (FOBT)

c. colonoscopy with biopsy

Which type of stoma will a patient with diverticulitis most likely have postoperatively? a. Ileostomy b. Jejunostomy c. Colostomy d. Cecostomy

c. colostomy

Which sign/symptom is a patient who had an AP resection instructed to report to healthcare provider immediately? a. Serosanguineous drainage from the wound b. Sensations of having a bowel movement c. Constant perineal odor and pain d. Occasional perineal pain and itching

c. constant perineal odor and pain

Which activity does the nurse tell the patient to avoid after surgery for a hernia repair? a. ambulating b. turning c. coughing d. deep-breathing

c. coughing

Which statement about intra-abdominal pressure (IAP) monitoring is correct? a. The normal IAP for adults is 15 to 20 mm Hg b. Patients with high IAP have bradycardia c. High IAP leads to increased afterload and decreased preload d. Patients with high IAP are hypertensive

c. high IAP leads to increased afterload and decreased preload

The nurse is performing an abdominal assessment on a patient suspected of having an abdominal hernia. The nurse auscultates the abdomen and determines the absence of bowel sounds. What does the nurse suspect in this patient? a. peritonitis b. IBS c. obstruction and strangulation d. low intraabdominal pressure

c. obstruction and strangulation

Which description best defines intussusception of the intestine? a. Twisting of the intestine b. Fecal constipation or impaction c. Telescoping of a segment of the intestine within itself d. Adhesions forming scar tissue

c. telescoping of a segment of the intestine within itself

A patient with Crohn's disease has a fistula. Which assessment findings indicates possible dehydration? a. Weight gain of 2 pounds in one day b. Abdominal paoin c. Foul-smelling urine d. decreased urinary output

d. decreased urinary output

Which laboratory finding does the nurse expect may occur with a diagnosis of appendicitis? a. Decreased hematocrit and hemoglobin b. Increased coagulation time c. Decreased potassium d. Increased WBC count

d. increased white blood cell count

Which acid-base abnormality results from a bowel obstruction high in the small intestine? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis

d. metabolic alkalosis

The nurse is assessing a patient with viral gastroenteritis. Which symptom is the nurse most concerned about? a. Orthostatic blood pressure changes b. Poor skin turgor c. Dry mucous membranes d. Rebound tenderness

d. rebound tenderness