Chapter 47 Coursepoint

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. Peritonitis C. Constipation D. Paralytic ileus

B

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"? A. two bowel movements daily B. stool consistency and client comfort C. one bowel movement every other day D. one bowel movement daily

B

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. Hemorrhoid B. Anal fissure C. Anal fistula D. Anorectal abscess

B

The nurse is teaching a client with constipation to increase dietary fiber intake to 25 g/day. Which recommendation would the nurse include? A. Limiting fluid intake to 5 to 6 glasses per day B. Adding fiber-rich foods to the diet gradually C. Avoiding bran cereals and beans in the diet D. Minimizing activity levels for at least 2 months

B

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

B

The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder? A. A loop of intestine adheres to an area that is healing slowly after surgery. B. The bowel protrudes through a weakened area in the abdominal wall. 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

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

D

The nurse working in the ED is evaluating a client for signs and symptoms of appendicitis. Which of the client's signs/symptoms should the nurse report to the physician? A. Pain when pressure is applied to the right lower quadrant B. Left lower quadrant pain C. High fever D. Nausea

D

A client reports 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? A. The client should take a fiber supplement along with the stimulant laxative. B. The laxative is safe to take with other medication the client is taking. C. If the client is drinking 8 glasses of water per day, it is all right to continue taking them. D. They can be habit forming and will require increasing doses to be effective.

D

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

D

Which is the most common presenting symptom of colon cancer? A. Change in bowel habits B. Fatigue C. Weight loss D. Anorexia

A

A client is being treated for diverticulosis. Which points should the nurse include in this client's teaching plan? Select all that apply. A. Do not suppress the urge to defecate. B. Avoid high-fiber foods C. Encourage an individualized exercise program D. Drink at least 8 to 10 large glasses of fluid every day. E. Use bulk-forming laxatives

A C D E

Post appendectomy, a nurse should assess the patient for abdominal rigidity and tenderness, fever, loss of bowel sounds, and tachycardia, all clinical signs of: A. Peritonitis B. An ileus. C. A pelvic abscess. D. An abscess under the diaphragm.

A

A client has a newly created colostomy. After participating in counseling with the nurse and receiving support from the spouse, the client decides to change the colostomy pouch unaided. Which behavior suggests that the client is beginning to accept the change in body image? A. The client touches the altered body part. B. The client closes his or her eyes when the abdomen is exposed. C. The client asks the spouse to leave the room. D. The client avoids talking about the recent surgery.

A

A client informs the nurse of having abdominal pain that is relieved when having a bowel movement. The health care provider diagnosed the client with irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder? A. Client is awakened from sleep due to abdominal pain. B. Chronic constipation with sporadic bouts of diarrhea C. Blood and mucus in the stool D. Weight loss due to malabsorption

B

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? A. Administer topical ointment to the rectal area to decrease bleeding. B. Test all stools for occult blood. C. Prepare the client for a gastrostomy tube placement. D. Administer morphine (Duramorph PF) routinely, as ordered.

B

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? A. "I don't understand this; I took the medication the doctor ordered and followed the diet." B. "I didn't eat anything I shouldn't have; I just ate roast beef on rye bread." C. "I don't like oatmeal, so it doesn't matter that I can't have it." D. "I don't understand why this happened again; I didn't travel out of the country."

B

A client who has undergone colostomy surgery is experiencing constipation. Which intervention should a nurse consider for such a client? A. Instruct the client to avoid prune or apple juice B. Suggest fluid intake of at least 2 L/day C. Instruct the client to keep a record of food intake D. Assist the client regarding the correct diet or to minimize food intake

B

A longitudinal tear or ulceration in the lining of the anal canal is termed a(n): A. anal fistula. B. hemorrhoid. C. anal fissure. D. anorectal abscess.

C

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

C

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

C

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

C

In women, which of the following types of cancer exceeds colorectal cancer? A. Liver B. Skin C. Breast D. Lung

C

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? A. Azotorrhea B. Tenesmus C. Borborygmus D. Diverticulitis

C

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 upper quadrant B. Left lower quadrant C. Right upper quadrant D. Right lower quadrant

D

A client realizes that regular use of laxatives has greatly improved bowel patterns. However, the nurse cautions this client against the prolonged use of laxatives for which reason? A. The client may develop arthritis or arthralgia. B. The client may develop inflammatory bowel disease. C. The client may lose his or her appetite. D. The client's natural bowel function may become sluggish.

D