Med Surg Chapter 24: Nursing Management: Patients With Intestinal and Rectal Disorders: PREPU

A patient diagnosed with IBS is advised to eat a diet that is: A. High in fiber. B. Restricted to 1,200 calories/day. C Low in residue. D. Sodium-restricted.

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

D

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

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. Increased intestinal bacteria C. Decreased production of hydrochloric acid D. Increased intestinal motility

A

After undergoing a total cystectomy and urinary diversion, a client has a Kock pouch (continent internal reservoir) in place. Which statement by the client indicates a need for further teaching? A. "I'll have to wear an external collection pouch for the rest of my life." B. "I should eat foods from all the food groups." C. "I'll need to drink at least eight glasses of water a day." D. "I'll have to catheterize my pouch every 2 hours."

A An internal collection pouch, such as the Kock pouch, allows the client to perform self-catheterization for ileal drainage. This pouch is an internal reservoir, eliminating the need for an external collection pouch

It is important for the nurse to monitor serum electrolytes in a patient with acute diarrhea. Select the electrolyte result that should be immediately reported. A. Potassium of 2.8 mEq/L B. Sodium of 136 mEq/L C. Calcium of 9 mg/dL D. Chloride of 100 mEq/L

A

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

B. The presence of mucus and pus in the stools suggests ulcerative colitis. Watery stools are characteristic of small-bowel disease. Loose, semisolid stools are associated more often with disorders of the colon. Voluminous, greasy stools suggest intestinal malabsorption.

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. colorectal cancer C.liver failure D. inflammatory bowel disease (IBD)

D.

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? A. Chronic constipation with sporadic bouts of diarrhea B. Weight loss due to malabsorption C. Blood and mucus in the stool D. Client is awakened from sleep due to abdominal pain.

A.

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 avoid exercise. B. Encourage the client to follow diet and medication instructions. C. Instruct the client to cleanse perianal area with warm water. D.Teach the client how to do sitz baths at home using warm water three to four times each day.

A

The nurse observes the physician palpating the abdomen of a client that is suspected of having acute appendicitis. When the abdomen is pressed in the left lower quadrant the client complains of pain on the right side. What does the nurse understand this assessment technique is referred to? A. Rovsing sign B. Referred pain C. Cremasteric reflex D. Rebound pain

A When an examiner deeply palpates the left lower abdominal quadrant and the client feels pain in the right lower quadrant, this is referred to as a positive Rovsing sign and suggests acute appendicitis.

A nurse caring for a patient with regional enteritis knows to assess for this most serious systemic complication. What is that complication? A. Nephrolithiasis B. Small bowel obstruction C. Pyelonephritis D. Megacolon

B

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? A.Ultrasound B. Endoscopy with mucosal biopsy C. Pancreatic function tests D. Stool specimen for ova and parasites

B

A client is diagnosed with Zollinger-Ellison syndrome. The nurse knows to assess the client for which characteristic clinical feature of this syndrome? A. Folate deficiency B. Steatorrhea C. Decreased intestinal lactose D. Lymphadenopathy

B STEATORRHEA- EXCESSIVE FAT IN THE STOOL

A 58-year-old with a longstanding diagnosis of diverticulitis has been admitted to the hospital due to an acute exacerbation in her symptoms. The care team has deemed surgery unnecessary, but is pursuing aggressive medical treatment. What pathophysiological process is contributing to this woman's health problem? A. Stenosis of the ileocecal valve has created an infected obstruction. B. Proliferation of bacteria in the woman's large bowel has eliminated her normal flora. C. Food and bacteria have accumulated in a herniated area of the patient's colon. D. Uncoordinated peristalsis has resulted in irritation of the colon and stagnation of the bowel's contents.

C

What is the most common cause of small-bowel obstruction? A. Neoplasms B. Volvulus C. Hernias D. Adhesions

D

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

D. Bowel sounds are hypoactive or absent in a client with a paralytic ileus. Clients with Crohn's disease and gastroenteritis have hyperactive bowel sounds because of increased intestinal motility. A complete bowel obstruction causes absent bowel sounds below the obstruction and hyperactive sounds above the obstruction.

Which of the following is a term used to describe intestinal rumbling? A. Borborygmus B. Malabsorption C. Atony D. Tenesmus

A

A client presents to the emergency room with a possible diagnosis of appendicitis. The health care provider asks the nurse to assess for tenderness at McBurney's point. The nurse knows to palpate which area? A. In the left periumbilical area B. Between the umbilicus and the left iliac crest C. Between the umbilicus and the anterior superior iliac spine D. In the upper right quadrant slightly below the diaphragm

C

A patient is suspected to have diverticulosis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling? A. Flexible sigmoidoscopy B. Barium enema C. Colonoscopy D. CT scan

C

During assessment of a client for a malabsorption disorder, the nurse notes a history of abdominal pain and weight loss, marked steatorrhea, azotorrhea, and frequent glucose intolerance. Based on these clinical features, what diagnosis will the nurse suspect? A. Celiac disease B. Ileal dysfunction C. Pancreatic insufficiency D. Lactose intolerance

C

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

D