Chapter 51: Concepts of Care for Patients with Noninflammatory Intestinal Disorders

The nurse is teaching a client with a newly created colostomy about foods to limit or avoid because of flatulence or odors. Which foods should be avoided? (Select all that apply.) A. Mushrooms B. Peas C. Onions D. Broccoli E. Buttermilk F. Yogurt

A, B, C, D

The nurse is teaching a group of clients with irritable bowel syndrome (IBS) about complementary and alternative therapies. What does the nurse suggest as possible treatment modalities? (Select all that apply.) A. Yoga B. Acupuncture C. Peppermint oil capsules D. Decreasing physical activities E. Meditation

A, B, C, E

The nurse is caring for a client with a complete large bowel obstruction. What assessment findings would the nurse expect? Select all that apply. A. Obstipation B. Dehydration C. Metabolic alkalosis D. Abdominal distention E. Abdominal pain F. Profuse vomiting

A, D, E

A client had an open partial colectomy and colostomy placement 6 hours ago. Which assessment would concern the nurse? A. Purple, moist stoma B. Stoma edema C. Liquid stool collecting in the drainage bag D. Serosanguineous fluid draining from the drain(s)

A. Purple, moist stoma

A nurse cares for a patient who is recovering from a hemorrhoidectomy. The patient states, "I need to have a bowel movement." Which safety action would the nurse take? A. Stay with the patient while providing privacy. B. Obtain a bedside commode for the patient to use. C. Make sure the call light is in reach to signal completion. D. Gather supplies to collect a stool sample for the laboratory.

A. Stay with the patient while providing privacy.

An abdominoperineal resection is planned for a patient diagnosed with rectal cancer. The nurse understands that which of the following will NOT be surgically removed during this procedure? A. The transverse colon B. The sigmoid colon C. The rectum D. The anus

A. The transverse colon

The nurse is teaching a client with irritable bowel syndrome (IBS) who has frequent constipation. Which statement by the client shows an accurate understanding of the nurse's teaching? A. "Maintaining a low-fiber diet will manage my constipation." B. "I need to go for a walk every day if possible." C. "Limiting the amount of fluid that I drink with meals is very important." D. "A cup of caffeinated coffee with cream & sugar at dinner is OK for me."

B. "I need to go for a walk every day if possible."

A client has a nasogastric tube (NGT) connected to low continuous suction. What is the nurse's priority to ensure client safety? A. Assess for peristalsis at least once every 8 to 12 hours. B. Assess placement of the NGT for placement every 4 hours. C. Measure the gastric drainage every 8 to 12 hours and document. D. Monitor the nasal skin and membranes around the tube for irritation.

B. Assess placement of the NGT for placement every 4 hours.

What symptom does the nurse expect the client with intussusception to exhibit? A. Decrease in pulse B. Singultus (hiccups) C. Frequent bloody stools D. Extremely elevated body temperature

B. Singultus (hiccups)

A client has a new diagnosis of irritable bowel syndrome (IBS) with diarrhea. What health teaching by the nurse is appropriate for this client? A. "Avoid high-fiber foods in your diet." B. "Take a stool softener every day to ease defecation." C. "Avoid dairy products and caffeinated beverages." D. "Ask your primary health care provider for an antidepressant."

C. "Avoid dairy products and caffeinated beverages."

A nurse provides discharge teaching for a male client who had a minimally invasive hernia repair this morning. Which statement by the client indicates a need for further teaching? A. "I should avoid coughing if at all possible." B. "I can shower in a day or two after I remove my surgical bandage." C. "I can't go back to work for at least 6 weeks." D. "I should use an ice pack to help relieve my pain."

C. "I can't go back to work for at least 6 weeks."

The Certified Wound, Ostomy, and Continence Nurse (CWOCN) is teaching a client with colorectal cancer how to care for a newly created colostomy. Which statement by the client indicates a correct understanding of the necessary self-management skills? A. "If I have any leakage, I'll put a towel over it." B. "I can put aspirin tablets in the pouch in order to reduce odor" C. "I will apply a nonalcoholic skin sealant and let it dry before applying the bag." D. "I will have my spouse change the bag for me."

C. "I will apply a nonalcoholic skin sealant and let it dry before applying the bag."

The nurse is teaching an older client how to prevent a stool impaction that can obstruct the intestines. Which statement by the client indicates a need for further teaching? A. "I will drink lots of fluids every day, especially water." B. "I will increase my exercise, especially walking, every day." C. "I will be sure to take a laxative every night to keep my bowels moving." D. "I will try to eat more high-fiber foods, such as raw vegetables and whole grains."

C. "I will be sure to take a laxative every night to keep my bowels moving."

The home health nurse is teaching a client about the care of a new colostomy. Which statement by the client demonstrates a correct understanding of the health teaching? A. "If the skin around the stoma is red or scratched, it will heal soon." B. "I need to strive for a very tight fit when applying the barrier around the stoma." C. "A dark or purplish-looking stoma is normal and would not concern me." D. "I need to check for leakage underneath my colostomy."

D. "I need to check for leakage underneath my colostomy."

The nurse is caring for a client who has a nonmechanical intestinal obstruction. Which of the following likely contributed to this condition? A. Fibroids B. Adhesions C. Fecal impaction D. Abdominal surgery

D. Abdominal surgery

What action would be LEAST likely to achieve the desired outcomes for the client diagnosed with intestinal obstruction? A. IV hydration to achieve fluid balance B. Supplement potassium as needed based on electrolyte panel. C. Administer IV opioids to decrease pain to 2-3/10 D. Administer stimulant laxatives to increase GI elimination

D. Administer stimulant laxatives to increase GI elimination

The nurse is caring for a client who had an anterior-posterior surgical resection for colorectal cancer this morning. What will the nurse anticipate as the client's priority problem at this time? A. Intestinal obstruction B. Nausea and vomiting C. Severe pain D. Constipation

C. Severe pain

A client with an intestinal obstruction has pain that changes from a "colicky" intermittent type to constant discomfort. After a complete assessment, what action would the nurse plan implement at this time? A. Change the nasogastric suction level from "intermittent" to "continuous." B. Administer medication for pain based on the client's pain level. C. Position the client in a semi- or high-Fowler position. D. Notify the surgeon immediately

D. Notify the surgeon immediately

The nurse is teaching a client who has undergone a hemorrhoidectomy about a follow-up plan of care. Which statement by the client demonstrates a correct understanding of the nurse's instructions? A. "I will take laxatives after the surgery to 'keep things moving?0'." B. "To help with the pain, I'll apply ice to the surgical area." C. "I will need to eat a diet high in fiber, including raw vegetables." D. "Limiting my fluids will help me with constipation."

C. "I will need to eat a diet high in fiber, including raw vegetables."

A male client is scheduled for a minimally invasive inguinal hernia repair (MIIHR). Which statement by the client indicates a need for further teaching about this procedure? A. "I may have trouble urinating immediately after the surgery." B. "My chances of having complications after this procedure are slim." C. "I will need to stay in the hospital overnight." D. "I will not eat after midnight the day of the surgery."

C. "I will need to stay in the hospital overnight."

A client who has colorectal cancer is scheduled for a colostomy. Which referral is initially the most important for this client? A. Home health nursing agency B. Social worker C. Certified Wound, Ostomy, and Continence Nurse (CWOCN) D. Hospital chaplain

C. Certified Wound, Ostomy, and Continence Nurse (CWOCN)

A client with an intestinal obstruction has pain that changes from a "colicky" intermittent type to constant discomfort. After a complete assessment, what action would the nurse plan implement at this time? A. Change the nasogastric suction level from "intermittent" to "continuous." B. Administer medication for pain based on the client's pain level. C. Position the client in a semi- or high-Fowler position. D. Prepare the client for emergency surgery in collaboration with the health team.

D. Prepare the client for emergency surgery in collaboration with the health team.