Prep U- Chapter 47: Management of Patients With Intestinal & Rectal Disorders

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

Assist client to increase dietary fiber.

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

Breast

Which of the following is the diagnostic of choice if the suspected diagnosis is diverticulitis? - Computed tomography scan -Magnetic resonance imaging -Barium enema -Colonoscopy

Computed tomography scan

A nurse is reviewing the history and physical of a client admitted for a hemorrhoidectomy. Which predisposing condition does the nurse expect to see? -Lactic acidosis -Hyperkalemia -Hypoglycemia -Constipation

Constipation

What information should the nurse include in the teaching plan for a client being treated for diverticulosis? -Avoid daily exercise; indulge only in mild activity -Use laxatives or enemas at least once a week -Avoid unprocessed bran in the diet -Drink at least 8 to 10 large glasses of fluid every day

Drink at least 8 to 10 large glasses of fluid every day

The nurse is performing a community screening for colorectal cancer. Which characteristic should the nurse include in the screening? -Age younger than 40 years -History of skin cancer -Familial polyposis -Low-fat, low-protein, high-fiber diet

Familial polyposis

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

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

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

Hypokalemia

The nurse is caring for a patient diagnosed with abdominal perforation. Which of the following is a clinical manifestation of this disease process? -Bradycardia -Subnormal temperature -Hypotension -Normal erythrocyte sedimentation rate (ESR)

Hypotension :Clinical manifestations include hypotension, increased temperature, tachycardia, and elevated ESR.

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

Metabolic alkalosis :Vomiting results in loss of hydrochloric acid (HCl) and potassium from the stomach, leading to a reduction of chlorides and potassium in the blood and to metabolic alkalosis.

Clients with irritable bowel disease (IBS) are at significantly increased risk for which condition? - Osteoporosis -DVT -Pneumonia -Hypotension

Osteoporosis

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? - Pancreatic insufficiency - Celiac disease - Lactose intolerance - Ileal dysfunction

Pancreatic insufficiency

The nurse in an extended-care facility reports that a resident has clinical manifestations of fecal incontinence. The health care provider orders a diagnostic study to rule out inflammation. Which study will the nurse prepare the client for? -Peritonitis -A pelvic abscess. -An ileus. -An abscess under the diaphragm.

Peritonitis :Peritonitis is inflammation of the peritoneum, the serous membrane lining the abdominal cavity and covering the viscera. Peritonitis is typically a life-threatening emergency that requires prompt surgical intervention, and typically involves postoperative critical care monitoring due to the risk of sepsis, organ failure, and subsequent infections.

The nurse is reviewing the laboratory test results of a client with Crohn disease. Which of the following would the nurse most likely find? -Increased albumin levels -Decreased white blood cell count -Stool cultures negative for microorganisms or parasite -Decreased erythrocyte sedimentation rate

Stool cultures negative for microorganisms or parasite

A client presents to the emergency department with complaints of acute GI distress, bloody diarrhea, weight loss, and fever. Which condition in the family history is most pertinent to the client's current health problem? - Appendicitis -Gastroesophageal reflux disease -Ulcerative colitis -Hypertension

Ulcerative colitis

A longitudinal tear or ulceration in the lining of the anal canal is termed a(n):

anal fissure.

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

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

The nurse in an extended-care facility reports that a resident has clinical manifestations of fecal incontinence. The health care provider orders a diagnostic study to rule out inflammation. Which study will the nurse prepare the client for? - Anorectal manometry -Transit study -Flexible sigmoidoscopy -Barium enema

Flexible sigmoidoscopy

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 -Consuming a low-protein, high-fiber diet -Taking only enteric-coated medications -Wearing an appliance pouch only at bedtime

Increasing fluid intake to prevent dehydration :Because stool forms in the large intestine, an ileostomy typically drains liquid waste. To avoid fluid loss through ileostomy drainage, the nurse should instruct the client to increase fluid intake.

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

Low residue

Which of the following is the most common symptom of a polyp? -Abdominal pain -Anorexia -Rectal bleeding -Diarrhea

Rectal bleeding

Which of the following will the nurse observe as symptoms of perforation in a patient with intestinal obstruction? - Decreased urine output -Decreased blood pressure -Purulent drainage from the gluteal fold - Sudden, sustained abdominal pain

Sudden, sustained abdominal pain :Sudden, sustained pain, abdominal distention, and fever are symptoms of perforation in a client with intestinal obstruction

A patient arrives in the emergency department with complaints of right lower abdominal pain that began 4 hours ago and is getting worse. The nurse assesses rebound tenderness at McBurney's point. What does this assessment data indicate to the nurse? -Appendicitis -Diverticulitis -Crohn's disease -Ulcerative colitis

Appendicitis

A client has symptoms suggestive of peritonitis. Nursing management would not include: -inserting a nasogastric tube. -accurate recording of input and output. -limiting analgesics to avoid the formation of paralytic ileus. -inserting a urinary retention catheter.

limiting analgesics to avoid the formation of paralytic ileus.

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? -severe abdominal pain with direct palpation or rebound tenderness -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 :Peritonitis decreases intestinal motility and causes intestinal distention. A classic sign of peritonitis is a sudden, diffuse, severe abdominal pain that intensifies in the area of the underlying causative disorder

Which of the following would a nurse expect to assess in a client with peritonitis? - Board-like abdomen -Decreased pulse rate -Hyperactive bowel sounds -Deep slow respirations

Board-like abdomen :The client with peritonitis would typically exhibit a rigid, board-like abdomen, with absent bowel sounds, elevated pulse rate, and rapid, shallow respirations.

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

Anal fissure :Fissures are usually caused by the trauma of passing a large, firm stool or from persistent tightening of the anal canal secondary to stress or anxiety (leading to constipation).

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? -Abdominal cramping when having a bowel movement -Excess gas -Daily bowel movements -Change in bowel habits

Change in bowel habits

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

Change in bowel habits

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 barrier powder =Dry skin thoroughly after washing -Apply triamcinolone acetonide spray -Dust with nystatin powder

Dry skin thoroughly after washing

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. -The incidence of colorectal cancer decreases with age. -It is the third most common cancer in the United States. -Colorectal cancer has no hereditary component.

It is the third most common cancer in the United States. :The lifetime risk of developing colorectal cancer is 1 in 20. The incidence increases with age (the incidence is highest in people older than 85).

When interviewing a client with internal hemorrhoids, what would the nurse expect the client to report? -Pain -Itching -Rectal bleeding -Soreness

Rectal bleeding :Internal hemorrhoids cause bleeding but are less likely to cause pain External hemorrhoids may cause few symptoms, or they can produce pain, itching, and soreness of the anal area.

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

The consistency of stool and comfort when passing stool

The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation? -Current medications -Usual pattern of elimination -Alcohol consumption -Activity levels

Usual pattern of elimination

A client is admitted to the emergency department with reports right lower quadrant pain. Blood specimens are drawn and sent to the laboratory. Which laboratory finding should be reported to the health care provider immediately? - White blood cell (WBC) count 22.8/mm3 -Serum sodium 135 mEq/L -Serum potassium 4.2 mEq/L -Hematocrit 42%

White blood cell (WBC) count 22.8/mm3

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

Chronic constipation with sporadic bouts of diarrhea