Bowel Discussion Questions
A patient is caring for a 70 year old male patient after a colectomy. The patient has received chemotherapy prior to surgery and has hypertension and DM. Which factors put this patient at risk for sepsis? (Select all that apply). 1-Age 2-Abdominal surgery 3-Gender 4-DM 5-Weight
1,2,4- Age, Abdominal surgery, DM
The nurse should instruct the patient to avoid which drug while taking metoclopramide hydrochloride? 1-Antacides 2-Antihypertensives 3-Anticoagulants 4-Alcohol
4-Alcohol
A nurse is delegating activities to unlicensed assistive personnel. Which activities can be appropriately delegated? (Select all that apply). 1-Assist client with oral care prior to breakfast. 2-Ask about location, quality, and radiation of pain. 3-Observe and document effect of medication after given by the nurse. 4-Measure and record intake and output throughout the shift. 5-Determine if the patient is oriented to person, place and time and report to nurse. 6-Change a simple dry dressing on a patient's coccyx while bathing.
1,4- Assist with oral care, Measure and record intake and output
The nurse is caring for a patient who has just had an upper GI endoscopy. The patient's vital signs must be taken every 30 minutes for 2 hours after the procedure. The nurse assigns an unlicensed assistive personnel to take the vital signs. One hour later, the UAP reports the patient, who was previously afebrile, has developed a temperature of 101.8. the nurse should: 1-Promptly assess the patient for potential perforation. 2-Tell the assistant to change thermometers and retake the temp. 3-Plan to give the patient acetaminophen to lower the temp. 4-Ask the UAP to bathe the patient in tepid water.
1- Promptly assess the patient for potential perforation
The nurse is obtaining a health history from a patient who has a sliding hiatal hernia associated with reflux. The nurse should ask the patient about the presence of which symptoms? 1-Heartburn 2-Jaundice 3-Anorexia 4-Stomatitis
1-Heartburn
The nurse instructs the patient who has had a hemorrhoidectomy not to use sitz baths until at least 12 hours postoperatively to avoid inducing which complication? 1-Hemorrhage 2-Rectal spasm 3-Urine retention 4-Constipation
1-Hemorrhage
The nurse should assess the patient who is being admitted to the hospital with upper GI bleeding for which finding? (Select all that apply). 1-Dry, flushed skin 2-Decreased urine output 3-Tachycardia 4-Widening pulse pressure 5-Rapid respirations 6-Thirst
2,3,5,6- Decreased urine output, Tachycardia, Rapid respirations, Thirst
While changing the patient's colostomy bag and dressing, the nurse determines that the patient is ready to participate in self care when the patient: 1-Asks if the healthcare provider will change the dressing soon. 2-Asks about the supplies used during the dressing change 3-talks about the news on the television 4-Is upset about the way the night nurse changed the dressing.
2- Asks about supplies used during the dressing change
The nurse has been assigned to provide care for 4 patients. In what order, from first to last, should the nurse assess these patients? All options must be used. 1-A patient awaiting surgery for a hiatal hernia repair at 1100. 2-A patient with suspected gastric cancer who is on nothing by mouth status for tests 3-A patient with peptic ulcer disease experiencing a sudden onset of acute stomach pain 4-A patient who is requesting pain medication 2 days after surgery to repair a fractured jaw.
3,4,2,1
When obtaining a nursing history from a patient with a suspected gastric ulcer, which signs and symptoms should the nurse assess? (Select all that apply). 1-Epigastric pain at night 2-Relief of epigastric pain after ------Eating 3-Vomiting 4-Weight loss 5-Melena
3,4,5-Vomiting, Weight Loss and Melena
What observation should the nurse instruct the patient with an ileostomy to report immediately? 1-Passage of liquid stool from the stoma. 2-Occasional presence of undigested food in the effluent. 3-Absence of drainage from the ileostomy for 6 or more hours. 4-Temperature of 99.8 F.
3- Absence of drainage from the ileostomy for 6 or more hours
A patient had a colon resection yesterday. The patient's hemoglobin was 14.1 g/dL yesterday and today it is 7.2 g/dL. The patient's oxygen saturation is 87%. After reviewing the chart and notifying the healthcare provider, the nurse should first: Orders: 1000 mL NS every 8 hours at 125 gtts/hour Morphine sulfate 10 mg IV every 4 hours as needed for pain Nothing by mouth Oxygen 2-4 L/min per mask\ 1-Take the vital signs every hour. 2-Increase the saline infusion to 150 gtts/hour. 3-Administer oxygen at 2 L/min. 4-Determine when last pain medication was administered.
3- Administer oxygen at 2 L/min
A patient has had an exacerbation of ulcerative colitis with cramping and diarrhea persisting longer than 1 week. The nurse should assess the patient for which complications? 1-Heart failure 2-Deep vein thrombosis 3-Hypokalemia 4-Hypocalcemia
3- Hypokalemia
A patient refuses to look at or care for her colostomy. Which statement by the nurse would be most appropriate? 1-"It has been 4 days since your surgery, and you will soon be discharged. You have to learn to care for your colostomy before you leave the hospital." 2-"I think we will need to teach your husband to care for your colostomy if you are not going to be able to do it." 3-"I understand how you are feeling. It is important for you to feel attractive, and you think having a colostomy changes your attractiveness." 4-"I can see that you are upset. Would you like to share your concerns with me?"
4- "I can see that you are upset. Would you like to share your concerns with me?"
The patient with gastroesophageal reflux disease (GERD) has a chronic cough. This symptom may indicate: 1-Development of laryngeal cancer. 2-Irritation of the esophagus. 3-Esophageal scar tissue formation. 4-Aspiration of gastric content.
4- Aspiration of gastric content
A patient with peptic ulcer disease is taking ranitidine. What is the expected outcome of this drug? 1-Heal the ulcer 2-Protect the ulcer surface from acids 3-Reduce acid concentration 4-Limit gastric acid secretion.
4- Limit gastric acid secretion
A patient with a well managed ileostomy has sudden onset of abdominal cramps, vomiting, and watery discharge from the ileostomy. The nurse should: 1-Tell the patient to take an antiemetic. 2-Encourage the patient to increase fluid intake to 3 L/day to replace fluid lost through vomiting. 3-Instruct the patient o take 30 mL of milk of magnesia to stimulate a bowel movement. 4-Notify the healthcare provider.
4- Notify the healthcare provider
Within 6 hours following a subtotal gastrectomy, the drainage from the patient's NG tube is bright red. The nurse should first: 1-Clamp the NG tube. 2-Remove the existing NG tube. 3-Irrigate the NG tube with iced saline. 4-Chart the finding in the patient's medical record.
4-Chart it first
A patient was admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The patient develops a sudden, sharp pain in the midepigastric region along with a rigid, board like abdomen. After obtaining he patient's vital signs, what should the nurse do next? 1-Administer pain medication as prescribed. 2-Raise the head of the bed. 3-Prepare to insert a nasogastric tube. 4-Notify the healthcare provider.
4-Notify the healthcare provider
Amoxicillin trihydrate 300 mg po has been prescribed for a patient with an oral infection. The medication is available in a liquid suspension that is available as 250 mg/5 mL. How many mL should the nurse administer:
6 mL
The nurse is developing a care management plan with a patient who has been diagnosed with gastroesophageal reflux disease (GERD). What should the nurse instruct the patient ot do: (Select all that apply). 1-Avoid a diet high in fatty foods. 2-Avoid beverages that contain caffeine. 3-Eat 3 meals a day, with the largest meal being at dinner in the evening. 4-Avoid all alcoholic beverages. 5-Lie down after consuming each meal for 30 minutes. 6-Use OTC antisecretory agents rather than RX.
1,2,4- Avoid high fats, Avoid Caffeine, Avoid alcohol
A nurse is assessing a patient who has been admitted with a diagnosis of an obstruction in the small intestine. The nurse should assess the patient for which signs and symptoms? (Select all that apply). 1-Projectile vomiting 2-Significant abdominal distention 3-Copious diarrhea 4-Rapid onset of dehydration 5-Increased bowel sounds
1,3,4- Projectile vomiting, Rapid onset of dehydration, Copious diarrhea
A patient with colon cancer has developed ascites. The nurse should conduct a focused assessment for which signs and symptoms? (Select all that apply). 1-Respiratory distress 2-Bleeding 3-Fluid and electrolyte imbalance 4-weight gain 5-infection
1,3-Respiratory distress, Fluid and Electrolyte imbalance
A patient newly diagnosed with ulcerative colitis who has been placed on steroids asks the nurse why steroids are prescribed. The nurse should tell the patient. 1-"Ulcerative colitis can be cured by the use of steroids." 2-"Steroids are used insevere flare ups because they can decrease the incidence of bleeding." 3-"Long term use of steroids will prolong periods of remission." 4-"The side effects of steroids outweigh their benefits to patients with ulcerative colitis."
2- "Steroids are used in severe flare-ups because they can decrease the incidence of bleeding."
A patient has been placed on long term sulfasalazine therapy for treatment of ulcerative colitis. The nurse should encourage the patient to eat which foods to help avoid the nutrient deficiencies that may develop as a result of this medication? 1-Citrus fruits 2-Green, leafy vegetables 3-eggs 4-milk products
2- Green, leafy vegetables
Which diet would be most appropriate for the client with ulcerative colitis? 1-High calorie, low protein 2-High protein, low residue 3-low fat, high fiber 4-how sodium, high carbohydrate
2-High protein, low residue
Which goal for the patient's care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis? 1-Promoting self care and independence 2-Managing diarrhea 3-Maintaining adequate nutrition 4-Promoting rest and comfort.
2-Managing diarrhea
Postoperative nursing care for a patient after an appendectomy should include: 1-Administering sitz baths 4x/day 2-Noting the first bowel movement after surgery 3-Limiting the patient's activity to bathroom privileges. 4-Measuring abdominal girth every 2 hours.
2-Nothing first bowel movement after surgery
When a patient has an acute attack of diverticulitis, the nurse should first: 1-Prepare the patient for a colonoscopy. 2-Encourage the patient to eat a high fiber diet. 3-Assess the patient for signs of peritonitis. 4-Encourage the patient to drink a glass of water every 2 hours.
3- Assess the patient for signs of peritonitis
A patient who has been diagnosed with gastroesophageal reflux disease (GERD) has heartburn. To decrease the heartburn, the nurse should instruct the patient o eliminate which item from the diet? 1-Lean beef 2-Air popped popcorn 3-Hot chocolate 4-Raw vegetables
3- Hot chocolate
A patient with peptic ulcer disease is admitted ot the hospital for a gastric resection. The patient reports a sudden sharp pain in the midepigastric area that radiates to the shoulder. The nurse should first: 1-Establish an IV line 2-Administer pain medication. 3-Notify the surgeon 4-Call for a stat ECG
3- Notify the surgeon
The patient is taking cimetidine to treat a hiatal hernia. The nurse should evaluate the paitent to determine that the drug has been effective in preventing which health problem? 1-Esophageal reflux 2-Dysphagia 3-Esophagitis 4-Ulcer formation
3-Esophagitis
A patient has a NG tube inserted at the time of abdominal perineal resection with permanent colostomy for colon cancer. This tube will most likely be removed when the patient demonstrates: 1-Absence of nausea and vomiting 2-Passage of mucus from the rectum. 3-Passage of flatus and feces from the colostomy. 4-Absence of stomach drainage for 24 hours.
3-Passage of flatus and feces from the colostomy
The nurse is teaching the patient with stomatitis about mouth care. Which instruction is most appropriate? 1-Drink hot tea at frequent intervals. 2-Gargle with antiseptic mouthwash. 3-Use an electric toothbrush. 4-Eat a soft, bland diet.
3-Use an electric toothbrush
A patient is taking an antacid for treatment of a peptic ulcer. Which statement best indicates that the patient understands how to correctly take the antacid? 1-"I should take my antacid before I take my other medications." 2-" I need to decrease my intake of fluids so that I do not dilute the effects of my antacids" 3-"My antacid will be most effective if I take it whenever I experience stomach pains." 4-"It is best for me to take my antacid 1-3 hours after meals."
4 -It is best for me to take my antacids 1-3 hours after meals
