Med Surg 1: Chapter 57 Study guide
What is the nature of pain associated with diverticulitis? a. Intermittent becoming progressively steady b. Sharp and continuous c. Localized to the right upper quadrant d. Severe and incapacitating
a
Which statements does the nurse include while providing discharge instructions for a patient with giardiasis? (Select all that apply.) a. "Avoid contact with stool from dogs and beavers." b. "All household and sexual partners should have stool examinations for parasites." c. "Treatment will most likely consist of metronidazole (Flagyl)." d. "The infection can be transmitted to others until the amebicides kill the parasites." e. "Stools are examined 6 days after treatment to assess for eradication."
a, b, c, d
Which interventions are useful in preventing spread of gastroenteritis? (Select all that apply.) a. Careful handwashing b. Sanitize all surfaces that may be contaminated c. Prophylactic use of antibiotics d. Easily accessible hand sanitizers e. Test all food preparation employees
a, b, d
Which statements about peritonitis are true? (Select all that apply.) a. Peritonitis is caused by contamination of the peritoneal cavity by bacteria or chemicals. b. Continuous ambulatory peritoneal dialysis (CAPD) can cause peritonitis. c. White blood cell counts are often decreased with peritonitis. d. Abdominal wall rigidity is a classic finding in patients with peritonitis. e. Chemical peritonitis is caused by leakage of pancreatic enzymes or gastric acids.
a, b, d
The patient has been diagnosed with acute appendicitis. Based on this diagnosis, which intervention does the nurse perform? a. Start a bowel cleansing program. b. Prepare the patient for surgery. c. Apply a heating pad to the lower abdomen. d. Assess the patient's knowledge about dietary modifications.
b
The patient with gastroenteritis due to infection with the norovirus asks the nurse how this illness occurred. Which statement by the patient indicates correct understanding of the nurse's teaching? a. "I got this infection from being around my grandchildren when they had respiratory illnesses." b. "It is likely that I got this illness from either contaminated water or food." c. "I may have gotten sick when I was travelling last month." d. "It's really important that everything I eat is cooked until it is well done."
b
The nurse is providing teaching for a patient with an anal fissure as a complication of CD. Which statement by the patient indicates the need for further teaching? a. "I will use warm sitz baths." b. "A diet that is low in bulk-producing agents is best for me." c. "Hydrocortisone cream may be helpful to decrease discomfort." d. "Topical antiinflammatory agents will help if I am uncomfortable."
b
What is the priority nursing concern for a patient with gastroenteritis? a. Nutrition therapy b. Fluid replacement c. Skin care d. Drug therapy
b
Which statement is true about the medical treatment of UC? a. Infliximab (Remicade) is approved as a first-line therapy. b. Immunomodulators are not thought to be effective; however, in combination with steroids, they may offer a synergistic effect. c. When a therapeutic level of glucocorticoids is reached, the dosage of the drug stays the same to maintain the therapeutic effect. d. The method of action for the aminosalicylates is interruption of the pain pathway.
b
Which are common manifestations in a 28-year-old patient with dehydration secondary to gastroenteritis? (Select all that apply.) a. Peripheral edema b. Elevated temperature c. Dry mucous membranes d. Hypertension e. Oliguria
b ,c, e
Which interventions does the nurse expect to implement when caring for a patient with diverticulitis? (Select all that apply.) a. Laxative and enemas as ordered b. IV fluids to prevent dehydration c. Broad-spectrum antibiotics d. Teach the patient to refrain from lifting or straining e. Keep the patient NPO if symptoms are severe
b, c, d, e
The nurse on the surgical unit is expecting to admit the patient who has had an appendectomy with abscess. What does the nurse anticipate care for this patient will include? (Select all that apply.) a. Clear liquids b. Wound drains c. IV antibiotics d. Nonsteroidal antiinflammatory drugs (NSAIDs) for pain control e. Nasogastric (NG) tube care
b, c, e
Which characteristics pertain to Crohn's disease (CD)? (Select all that apply.) a. Begins in the rectum and proceeds in a continuous manner toward the cecum b. Fistulas commonly develop c. Five to six soft, loose stools per day that are nonbloody d. Increased risk of colon cancer e. Some patients experience extraintestinal manifestations such as migratory polyarthritis, ankylosing spondylitis, and erythema nodosum f. Cobblestone appearance of the internal intestine
b, c, f
The fluid shift that occurs in peritonitis may result in which of the following? a. Intracellular fluid moving into the peritoneal cavity b. Significant increase in circulatory volume c. Decreased circulatory volume and hypovolemic shock d. Increased bowel motility caused by increased fluid volume
c
The nurse is caring for a patient with gastroenteritis who has frequent stools. Which task is best to delegate to the UAP? a. Teach the patient to avoid toilet paper and harsh soaps. b. Instruct the patient on how to take a sitz bath. c. Use a warm washcloth to remove stool from the skin. d. Dry the skin with absorbent cotton.
c
A patient with CD has a fistula. Which assessment finding indicates possible dehydration? a. Weight gain of 2 pounds in one day b. Abdominal pain c. Foul-smelling urine d. Decreased urinary output
d
As part of the routine treatment plan for a patient with bacterial gastroenteritis, which drugs does the nurse anticipate the patient will most likely be prescribed? a. Anticholinergics b. Antiemetics c. Antiperistaltic drugs d. Antibiotics
d
The nurse is assessing a patient with viral gastroenteritis. Which symptom is the nurse most concerned about? a. Orthostatic blood pressure changes b. Poor skin turgor c. Dry mucous membranes d. Rebound tenderness
d
The nurse is assessing an older adult patient with abdominal pain. Assessment findings include generalized abdominal pain with rigidity, nausea and vomiting, elevated temperature (101.2°F), increased heart rate (122/minute) and chills. The patient is also somewhat confused and does not know where he is. What does the nurse suspect with this patient? a. Crohn's disease b. Ulcerative colitis c. Diverticulitis d. Peritonitis
d
Which drug is often used in older patients for pain management of moderate to severe diverticulitis? a. Ibuprofen (Motrin) b. Acetaminophen (Tylenol) c. Aspirin (Anacin) d. Morphine sulfate (Duramorph)
d
Which type of diet has been implicated in the formation of diverticula? a. High-fat diet b. Low-protein diet c. High-cholesterol diet d. Low-fiber diet
d
What are the cardinal signs of peritonitis? a. Fever and headache b. Dizziness with nausea and vomiting c. Abdominal pain, distention, and tenderness d. Nausea and loss of appetite
c
Which is a preventive measure for diverticular disease? a. Excluding whole-grain breads from the diet b. Avoiding fresh apples, broccoli, and lettuce c. Taking bulk agents such as psyllium hydrophilic mucilloid (Metamucil) d. Taking routine anticholinergics to reduce bowel spasms
c
Which statement is true about drug therapy for CD? a. Budesonide (Entocort EC) is a rapidrelease compound that delivers low local glucocorticoid concentrations to the terminal ileum for patients with CD. b. Methotrexate (Rheumatrex) is contraindicated in the treatment of CD. c. Metronidazole (Flagyl) has been helpful in patients with fistulas and CD. d. Adalimumab (Humira) is a glucocorticoid approved for the treatment of CD
c
Which type of stoma will a patient with diverticulitis most likely have postoperatively? a. Ileostomy b. Jejunostomy c. Colostomy d. Cecostomy
c
A patient is prescribed sulfasalazine (Azulfidine) for the treatment of UC. Which patient statement indicates the patient is experiencing a side effect of this drug? a. "My skin is covered with a rash." b. "My knees hurt." c. "My appetite has increased." d. "I wake up at night sweating sometimes."
a
A patient is suspected to have ulcerative colitis (UC). Which definitive diagnostic test does the nurse expect the patient to undergo in order to confirm the diagnosis? a. Colonoscopy b. C-reactive protein c. Albumin levels d. Erythrocyte sedimentation rate
a
The ED nurse is assessing a patient admitted with frequent, liquid, foul-smelling stools containing mucus and blood. Assessment findings include temperature 103.8° F, tenesmus, abdominal tenderness, and vomiting. Which additional laboratory tests does the nurse expect to collect? a. Serial stool samples b. Urine culture c. Throat culture d. Sputum culture
a
The respiratory problems that may accompany peritonitis are a result of which factor? a. Associated pain interfering with ventilation b. Decreased pressure against the diaphragm c. Fluid shifts to the thoracic cavity d. Decreased oxygen demands related to the infectious process
a
Which description best defines an anal fissure? a. Perianal tear that can be very painful b. Duct obstruction and infection c. Communicating tract d. Localized area of induration with pus
a
Which intervention does the nurse delegate to the unlicensed assistive personnel (UAP) when caring for a postoperative patient with peritonitis? a. Measure intake and output. b. Assess wound drainage. c. Administer IV antibiotics. d. Teach patient about wound care.
a
Which statement about diverticular disease is true? a. Most diverticula occur in the sigmoid colon. b. Diverticula are uncomfortable even when not inflamed. c. High-fiber diets contribute to diverticula occurrence. d. Diverticula form where intestinal wall muscles are weak.
a
The nurse is caring for the patient with acute appendicitis. Which interventions will the nurse perform? (Select all that apply.) a. Maintain the patient on NPO status. b. Administer IV fluids as prescribed. c. Apply warm compresses to the right lower abdominal quadrant. d. Maintain the patient in the supine position. e. Administer laxatives.
a, b
A patient with UC who has had an ileostomy is being discharged home. The nurse has provided discharge teaching. Which statements by the patient indicate the teaching has been effective? (Select all that apply.) a. "I will avoid foods that cause gas." b. "I will call the health care provider if I have a fever over 101° F." c. "I will change the adhesive for the appliance daily." d. "I know the pouch needs emptying when I feel pain in that area." e. "I will call the health care provider if I feel like my heart is beating fast."
a, b ,e
In caring for a patient with CD, the nurse observes for which complications? (Select all that apply.) a. Peritonitis b. Small bowel obstruction c. Nutritional and fluid imbalances d. Presence of fistulas e. Appendicitis f. Severe nausea and vomiting
a, b, c, d
Which nursing intervention is part of nonsurgical management for a patient with peritonitis? a. Monitor weekly weight and intake and output. b. Insert a nasogastric tube to decompress the stomach. c. Order a breakfast tray when the patient is hungry. d. Administer NSAIDs for pain.
b
The patient comes to the emergency department (ED) with right lower quadrant pain. What does the ED nurse suspect? a. Gastroenteritis b. Ulcerative colitis c. Appendicitis d. Crohn's disease
c
The nurse is instructing a patient about home care after an exploratory laparotomy for peritonitis. Which statement by the patient indicates that teaching has been effective? a. "It is normal for the incision site to be warm." b. "I will stop taking the antibiotics if diarrhea develops." c. "I will call the health care provider for a temperature greater than 101° F." d. "I will resume activity with my bowling league this week for exercise."
c
Which laboratory finding does the nurse expect may occur with a diagnosis of appendicitis? a. Decreased hematocrit and hemoglobin b. Increased coagulation time c. Decreased potassium d. Increased WBC count
d
Which surgical procedure involves removal of the colon, rectum, and anus with surgical closure of the anus? a. Restorative proctolectomy with ileo pouch-anal anastomosis (RPC-IPAA) b. Natural orifice transluminal endoscopic surgery (NOTES) c. Sigmoid colostomy d. Total proctocolectomy with a permanent ileostomy
d
