NURS 321 Practice Questions for Lower GI Disorders

A nurse is preparing to instill 840mL of enteral nutrition via a client's gastrostomy tube over 24hr using an infusion pump. The nurse should set the infusion pump to deliver how many mL/hr? (Round the answer to the nearest whole number)

35 mL/hr

A nurse is assessing a client who reports frequent vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect? (Select all that apply) a. Poor skin turgor b. Bradycardia c. Hypotension d. Pale yellow urine e. Flat neck veins

A,C,E rationale: C: Frequent V/D cause dehydration, which manifests as postural hypotension D: which manifests as flat neck veins when client is lying supine

A nurse is teaching a client who has constipation about a high-fiber diet. Which of the following goods should be included as source of fiber? (Select all that apply) a. Kidney beans b. Blackberries c. Refined cereals d. Whole wheat bread e. Lean turkey

AB,D

A nurse admits a client to the emergency department who reports nausea and vomiting that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following laboratory test results should the nurse expect to see? a. Decreased WBC b. Increased serum amylase c. Decreased serum lipase d. Increased serum calcium

B

A nurse is caring for a client who has diverticular disease. When palpating the client's abdomen, in which of the following locations should the nurse expect the client to report abdominal pain? a. Lower left quadrant b. Upper left quadrant c. Lower right quadrant d. Upper right quadrant

A

A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include? a. Both are inflammatory b. Both begin in the rectum c. Both manifest fistula formation d. Both require frequent surgery

A

A nurse is developing a teaching plan for a client who has an ileostomy and will require stoma care. Which of the following information should the nurse include? a. Empty the pouch when it is 1/2 full b. Hold pressure on the skin barrier for 10 to 15 sec to secure the seal c. Clean the peristomal skin four times a day d. Expect firm fecal content

A

A nurse is reviewing the medication list for a client who has a new diagnosis of a small bowel obstruction. The nurse should withhold which of the following medications? a. Senna b. Ibuprofen c. Omeprazole d. Zolpidem

A rationale: Laxatives are contraindicated in clients who have fecal impaction, bowel obstruction, and acute abdominal surgery to prevent perforation. Because the bowel does not allow for any passage of stool with a complete small bowel obstruction, laxatives will cause increased abdominal cramping and discomfort

A nurse is teaching a client who has constipation. Which of the following should the nurse discuss as causes of constipation? (Select all that apply) a. Excessive laxative use b. Ignoring the urge to defecate c. Inadequate fluid intake d. Increased fiber in the diet e. Increased activity

A,B,C rationale: A: Chronic use of laxatives causes the large intestine to lose muscle tone and become less responsive to stimulation by laxatives

A nurse is caring for an older adult client who has had surgery for an intestinal obstruction and has an NG tube to wall suction. Which of the following interventions should the nurse include int he client's postoperative plan of care? (Select all that apply) a. Discontinue suction when assessing for peristalsis b. Irrigate the NG tube with 0.9% sodium chloride irrigation solution c. Place sequential compression devices on the bilateral lower extremities d. Reposition the client from side to side every 2 hrs e. Encourage the use of an incentive spirometer every 2 hr while the client is awake

A,B,C,D rationale: A: the nurse should turn off suction while auscultating the abdomen to determine the return of peristalsis because the suction masks any present bowel sounds

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following manifestations of peritonitis? a. Hyperactive bowel sounds b. Nausea and vomiting c. Bradycardia d. Increased urinary output

B

A nurse is planning care for client who has a decreased level of consciousness. The client is receiving continuous enteral feedings via a gastrostomy tube due to an inability to swallow. Which of the following is the priority action by the nurse? a. Observe client's respiratory status b. Elevate the head of the client's bed 30° to 45° c. Monitor intake and output every 8 hr d. Check residual volume every 4 to 6 hr

B

A nurse is assessing a client who has a colostomy. Which of the following findings should the nurse report to the provider? a. The stool is yellow-green b. The ostomy is draining frequently c. The stoma is pale in color d. The skin around the stoma is red

C

A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect? a. Hyperactive bowel sounds b. Increased urinary output c. Rigid abdomen d. Frequent bowel movements

C

A nurse is teaching an older adult client who reports constipation. Which of the following instructions should the nurse include in the teaching? a. Bear down hard when defecating b. Drink four to five glasses of water daily c. Increase dietary intake of raw vegetables d. Limit activity

C

A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric obstruction. Which of the following rationales for the use of the nasogastric tube should the nurse include in the teaching? a. Determine the pH of the gastric secretions b. Supply nutrients via tube feedings c. Decompress the stomach d. Administer medications

C rationale: A pyloric obstruction is caused by edema, scarring, or spasm, often the result of gastritis or PUD. The nurse should inform the client that because the stomach is dilated and may cause undigested food, it must be decompressed, necessitating the placement of an NG tube

A nurse is a PACU is assessing a client who has a newly created colostomy. Which of the following findings should the nurse report to the provider? a. Stoma oozing red drainage b. Shiny, moist stoma c. Purplish-colored stoma d. Rosebud-like stoma orifice

C rationale: A stoma that is purplish in color indicates ischemia. The nurse should notify the provider immediately

A nurse is assessing a client who has hypokalemia as a result of nausea, vomiting, and diarrhea. Which of the following findings should the nurse expect? a. Hyperactive reflexes b. Extreme thirst c. Weak, irregular pulse d. Paresthesia

C rationale: Common manifestations of potassium depletion include a weak and irregular pulse, muscle weakness, fatigue, and ventricular dysrhythmias

A nurse is creating a plan of care to maintain the skin integrity of a client who experiences frequent diarrhea due to ulcerative colitis. Which of the following interventions should the nurse include in the plan? a. Soak in a sitz bath for 20 min after each stool b. Administer a soap-suds edema to cleanse the colon c. Cleanse with antimicrobial scrub and vigorously dry d. Wipe perianal area with warm water and apply a barrier cream

D rationale: to decrease skin breakdown when in contact with fecal material

A nurse is admitting a client with suspected appendicitis. Identify where the nurse will palpate to assess for pain at McBurney's point. (Selectable areas, or "Hot Spots" are outlined in the artwork below. Select only the outlined area that corresponds to your answer)

LLQ box