MLQ Ch. 47

A client reports severe pain and bleeding while having a bowel movement. Upon inspection, the health care provider notes a linear tear in the anal canal tissue. The client is diagnosed with a: A. hemorrhoid. B. fissure. C. fistula. D. pilonidal cyst.

B

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

D

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

D

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client? A. diverticulitis B. inflammatory bowel disease (IBD) C. colorectal cancer D. liver failure

B

A nurse is caring for a client with cardiac disease. The client asks the nurse which medication is best for help with regular bowel movements. What is the best response by the nurse? A. Bisacodyl B. Docusate C. Mineral oil D. Magnesium hydroxide

B

What is the primary nursing diagnosis for a client with a bowel obstruction? A. Deficient knowledge B. Acute pain C. Deficient fluid volume D. Ineffective tissue perfusion

C

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

D

A client underwent a continent ileostomy. Within which time frame should the client expect to empty the reservoir? A. At least once every 2 days B. Three or four times daily C. At least once a day D. Every 4 to 6 hours

D

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

D

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

D

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

D

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

B

A nurse is teaching an older adult client about good bowel habits. Which statement by the client indicates to the nurse that additional teaching is required? A. "I should eat a fiber-rich diet with raw, leafy vegetables, unpeeled fruit, and whole grain bread." B. "I need to use laxatives regularly to prevent constipation." C. "I need to drink 2 to 3 liters of fluids every day." D. "I should exercise four times per week."

B

A nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. What else would the nurse expect to find? A. tenderness and pain in the right upper abdominal quadrant B. severe abdominal pain with direct palpation or rebound tenderness C. jaundice and vomiting D. rectal bleeding and a change in bowel habits

B

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

C

A resident at a long-term care facility lost the ability to swallow following a stroke 4 years ago. The client receives nutrition via a PEG tube, has adapted well to the tube feedings, and remains physically and socially active. Occasionally, the client develops constipation that requires administration of a laxative to restore regular bowel function. What is the most likely cause of this client's constipation? A. lack of exercise B. lack of solid food C. increased fiber D. lack of free water intake

D

A client is scheduled to undergo rhinoplasty in the morning, and reports medications used on a daily basis, which the nurse records on the client's chart. Which daily medications have the potential to result in constipation? A. acetaminophen B. multivitamin without iron C. NSAIDs D. laxative

D

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

C

A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of? A. Irritable bowel syndrome B. Diverticulitis C. Crohn's disease D. Ulcerative colitis

C

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and board-like. What complication does the nurse determine may be occurring at this time? A. Accumulation of gas B. Paralytic ileus C. Peritonitis D. Constipation

C

A patient with IBD would be encouraged to increase fluids, use vitamins and iron supplements, and follow a diet designed to reduce inflammation. Select the meal choice that would be recommended for a low-residue diet. A. A fruit salad with yogurt B. A peanut butter sandwich and fruit cup C. Broiled chicken with low-fiber pasta D. Salami on whole grain bread and V-8 juice

C

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

B

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

B

Which is one of the primary symptoms of irritable bowel syndrome (IBS)? A. Diarrhea B. Bloating C. Abdominal distention D. Pain

A

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

A

The nurse is assessing a client for constipation. To identify the cause of constipation, the nurse should begin by reviewing the client's: A. usual pattern of elimination. B. activity levels. C. alcohol consumption. D. current medications.

A

Which drug is considered a stimulant laxative? A. Bisacodyl B. Magnesium hydroxide C. Mineral oil D. Psyllium hydrophilic mucilloid

A

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

C

A patient visited a nurse practitioner because he had diarrhea for 2 weeks. He described his stool as large and greasy. The nurse knows that this description is consistent with a diagnosis of: A. A disorder of the large bowel. B. Intestinal malabsorption. C. Inflammatory colitis. D. A small bowel disorder.

B

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

A

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and board-like. What complication does the nurse determine may be occurring at this time? A. Peritonitis B. Accumulation of gas C. Constipation D. Paralytic ileus

A

A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder? A. A change in bowel habits B. Abdominal distention C. Frank blood in the stool D. Abdominal pain

A

A surgeon is discussing surgery with a client diagnosed with colon cancer. The client is visibly shaken over the possibility of a colostomy. Based on the client's response, the surgeon should collaborate with which health team member? A. Enterostomal nurse B. Clinical educator C. Social worker D. Staff nurse

A

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

A

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

B

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

B

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

C

A nurse is interviewing a client about past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? A. Duodenal ulcers B. Weight gain C. Polyps D. Hemorrhoids

C

Which term refers to a protrusion of the intestine through a weakened area in the abdominal wall? A. Adhesion B. Tumor C. Hernia D. Volvulus

C

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

D

A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location? A. Left lower quadrant B. Left upper quadrant C. Right upper quadrant D. Right lower quadrant

D