N140A Prep U Exam 3

Change in bowel habits

Which is the most common presenting symptom of colon cancer? Fatigue Anorexia Weight loss Change in bowel habits

Chronic constipation with sporadic bouts of diarrhea

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

The consistency of stool and comfort when passing stool

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

Peritonitis

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? Constipation Peritonitis Paralytic ileus Accumulation of gas

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

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

Low residue

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

Drink 8 to 10 glasses of fluid daily.

The nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching? Avoid daily exercise. Drink 8 to 10 glasses of fluid daily. Use laxatives weekly. Avoid unprocessed bran.

The clusters of ulcers take on a cobblestone appearance.

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

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

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

Clamp the tubing and allow client to rest.

The nurse is irrigating a client's colostomy when the client begins to report cramping. What is the appropriate action by the nurse? Increase the rate of administration. Clamp the tubing and allow client to rest. Change irrigation fluid to normal saline. Discontinue the irrigation immediately.

Ulcerative colitis

The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition? Ulcerative colitis Intestinal malabsorption Small-bowel disease Disorders of the colon

high-fiber diet.

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

Metamucil

Which of the following is considered a bulk-forming laxative?

They can be habit forming and will require increasing doses to be effective.

A client informs the nurse that he is taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about taking a stimulant laxative? The laxative is safe to take with other medication the client is taking. As long as the client is drinking 8 glasses of water per day, he can continue to take them. They can be habit forming and will require increasing doses to be effective. The client should take a fiber supplement along with the stimulant laxative.

Test all stools for occult blood.

A client is admitted to the hospital for diagnostic testing to rule out colorectal cancer. Which intervention should the nurse include on the plan of care? Administer topical ointment to the rectal area to decrease bleeding. Test all stools for occult blood. Prepare the client for a gastrostomy tube placement. Administer morphine (Duramorph PF) routinely, as ordered.

Right lower quadrant

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? Right lower quadrant Right upper quadrant Left upper quadrant Left lower quadrant

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

A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult? "I don't understand why this happened again; I didn't travel out of the country." "I don't understand this; I took the medication the doctor ordered and followed the diet." "I don't like oatmeal, so it doesn't matter that I can't have it." "I didn't eat anything I shouldn't have; I just ate roast beef on rye bread."

Increasing fluid intake to prevent dehydration

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

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

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

severe abdominal pain with direct palpation or rebound tenderness

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? jaundice and vomiting rectal bleeding and a change in bowel habits tenderness and pain in the right upper abdominal quadrant severe abdominal pain with direct palpation or rebound tenderness

Intestinal malabsorption.

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 small bowel disorder. Inflammatory colitis. A disorder of the large bowel. Intestinal malabsorption.

Broiled chicken with low-fiber pasta

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

lack of free water intake

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? lack of exercise increased fiber lack of solid food lack of free water intake

Loperamide

After teaching a group of students about irritable bowel syndrome (IBS) and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an antidiarrheal agent commonly administered for IBS? Loperamide Lubiprostone Peppermint oil Dicyclomine

Hypokalemia

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

stool consistency and client comfort

An older adult client in a long-term care facility is concerned about bowel regularity. During a client education session, the nurse reinforces the medically acceptable definition of "regularity." What is the actual measurement of "regular"? stool consistency and client comfort one bowel movement daily one bowel movement every other day two bowel movements daily

Mucosal disorders causing generalized malabsorption

Celiac disease (celiac sprue) is an example of which category of malabsorption? Luminal problems causing malabsorption Infectious diseases Postoperative malabsorption Mucosal disorders causing generalized malabsorption

Adding fiber-rich foods to the diet gradually

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

Breast

In women, which of the following types of cancer exceeds colorectal cancer? Breast Skin Liver Lung

Peritonitis

The nurse is monitoring a client's postoperative course after an appendectomy. The nurse's assessment reveals that the client has vomited, has abdominal tenderness and rigidity, and has tachycardia. The nurse reports to the physician that the client has signs/symptoms of which complication? Hemorrhage Pelvic abscess Ileus Peritonitis

0.9% NS

Medical management of a patient with peritonitis includes fluid, electrolyte, and colloid replacement. The nurse knows to prepare the initial, most appropriate intravenous solution. Which of the following is the correct solution? 0.9% NS D10W 0.45% of NS D5W

usual pattern of elimination.

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

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

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

usual pattern of elimination.

The nurse is caring for a patient who has malabsorption syndrome with an undetermined cause. What procedure will the nurse assist with that is the best diagnostic test for this illness? Pancreatic function tests Endoscopy with mucosal biopsy Ultrasound Stool specimen for ova and parasites

Anal fissure

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? Anal fissure Anal fistula Anorectal abscess Hemorrhoid

Borborygmus

The nurse is performing and documenting the findings of an abdominal assessment. When the nurse hears intestinal rumbling and the client then experiences diarrhea, the nurse documents the presence of which condition? Diverticulitis Azotorrhea Tenesmus Borborygmus

Dry skin thoroughly after washing

The nurse is teaching a client with an ostomy how to change the pouching system. Which information should the nurse include when teaching a client with no peristomal skin irritation? Apply triamcinolone acetonide spray Dry skin thoroughly after washing Dust with nystatin powder Apply barrier powder

Metabolic alkalosis

Vomiting results in which of the following acid-base imbalances? Metabolic alkalosis Respiratory alkalosis Metabolic acidosis Respiratory acidosis

Dilated pits of hair follicles in the cleft

What would the nurse identify as a characteristic finding when assessing a client for pilonidal sinus? Abdominal pain Pain in the perianal area Dilated pits of hair follicles in the cleft Purulent drainage from the gluteal fold

Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage. The appendix may develop gangrene and rupture, especially in a middle-aged client. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

presents with a rigid, board-like abdomen.

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

Diarrhea

Which is one of the primary symptoms of irritable bowel syndrome (IBS)? Abdominal distention Diarrhea Pain Bloating