Prep-U Intestinal and rectal disorders
What is the most common cause of small-bowel obstruction? Hernias Neoplasms Adhesions Volvulus
Adhesions
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? Anorectal abscess Anal fistula Hemorrhoid Anal fissure
Anal fissure
Which drug is considered a stimulant laxative? Magnesium hydroxide Bisacodyl Mineral oil Psyllium hydrophilic mucilloid
Bisacodyl is a stimulant laxative. Magnesium hydroxide is a saline agent. Mineral oil is a lubricant. Psyllium hydrophilic mucilloid is a bulk-forming agent.
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 Blood and mucus in the stool Chronic constipation with sporadic bouts of diarrhea Client is awakened from sleep due to abdominal pain.
Chronic constipation with sporadic bouts of diarrhea
A client who has undergone colostomy surgery is experiencing constipation. Which intervention should a nurse consider for such a client? Suggest fluid intake of at least 2 L/day Instruct the client to avoid prune or apple juice Assist the client regarding the correct diet or to minimize food intake Instruct the client to keep a record of food intake
Suggest fluid intake of at least 2 L/day
The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation? Alcohol consumption Activity levels Usual pattern of elimination Current medications
Usual pattern of elimination
In addition to teaching a client with constipation to increase dietary fiber intake to 25 g/day, which of the following would the nurse include as important? Avoiding bran cereals and beans in the diet. Adding fiber-rich foods to the diet gradually. Limiting fluid intake to 5 to 6 glasses per day. Minimizing activity levels for at least 2 months.
Adding fiber-rich foods to the diet gradually.
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? Borborygmus Tenesmus Azotorrhea Diverticulitis
Borborygmus
Vomiting results in which of the following acid-base imbalances? Metabolic alkalosis Metabolic acidosis Respiratory acidosis Respiratory alkalosis
Metabolic alkalosis
A client with Crohn's disease is to receive prednisone as part of the treatment plan. Which of the following instructions would be appropriate? "Take the drug on an empty stomach to avoid upsetting your stomach." "Once your symptoms improve, you can stop taking the drug." "Make sure to increase your salt intake to compensate for the loss of fluid." "Avoid contact with other people who might have an infection."
"Avoid contact with other people who might have an infection." Clients taking corticosteroids may not experience a normal immune response to infection.
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? "I don't understand this; I took the medication the doctor ordered and followed the diet." "I didn't eat anything I shouldn't have; I just ate roast beef on rye bread." "I don't understand why this happened again; I didn't travel out of the country." "I don't like oatmeal, so it doesn't matter that I can't have it."
"I didn't eat anything I shouldn't have; I just ate roast beef on rye bread."
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 eat a fiber-rich diet with raw, leafy vegetables, unpeeled fruit, and whole grain bread." "I need to use laxatives regularly to prevent constipation." "I need to drink 2 to 3 liters of fluids every day." "I should exercise four times per week."
"I need to use laxatives regularly to prevent constipation."
A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder? Abdominal distention Frank blood in the stool A change in bowel habits Abdominal pain
A change in bowel habits
A community health nurse is performing a home visit to a 53-year-old patient who requires twice-weekly wound care on her foot. The patient mentions that she is currently having hemorrhoids, a problem that she has not previously experienced. What treatment measure should the nurse recommend to this patient? Daily application of topical antibiotics Decreased fluid intake Bathing, rather than showering, once per day A high-fiber diet with increased fruit intake
A high-fiber diet with increased fruit intake
What is the most common cause of small-bowel obstruction? Hernias Neoplasms Adhesions Volvulus
Adhesions
In women, which of the following types of cancer exceeds colorectal cancer? Breast Lung Skin Liver
Breast
Which is the most common presenting symptom of colon cancer? Fatigue Change in bowel habits Anorexia Weight loss
Change in bowel habits
Which statement provides accurate information regarding cancer of the colon and rectum? Colorectal cancer is the third most common site of cancer in the United States. Rectal cancer affects more than twice as many people as colon cancer. The incidence of colon and rectal cancer decreases with age. Colon cancer has no hereditary component.
Colorectal cancer is the third most common site of cancer in the United States.
The nurse is caring for a 77-year-old patient diagnosed with Crohn's disease. What would be especially important to monitor this patient for? Pain Fluid overload Fatigue Dehydration
Dehydration
What information should the nurse include in the teaching plan for a client being treated for diverticulosis? Avoid unprocessed bran in the diet Avoid daily exercise; indulge only in mild activity Drink at least 8 to 10 large glasses of fluid every day Use laxatives or enemas at least once a week
Drink at least 8 to 10 large glasses of fluid every day
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? Dry skin thoroughly after washing Apply barrier powder Apply triamcinolone acetonide spray Dust with nystatin powder
Dry skin thoroughly after washing The nurse should teach the client without peristomal skin irritation to dry the skin thoroughly after washing. Barrier powder, triamcinolone acetonide spray, and nystatin powder are used when the client has peristomal skin irritation and/or fungal infection.
The nurse is performing a community screening for colorectal cancer. Which characteristic should the nurse include in the screening? Age younger than 40 years Low-fat, low-protein, high-fiber diet History of skin cancer Familial polyposis
Familial polyposis
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 Wearing an appliance pouch only at bedtime Consuming a low-protein, high-fiber diet Taking only enteric-coated medications
Increasing fluid intake to prevent dehydration
A patient visited a nurse practitioner because he had diarrhea for 2 weeks. He described his stool as large and greasy. The nurse knows that this description is consistent with a diagnosis of: A small bowel disorder. Intestinal malabsorption. Inflammatory colitis. A disorder of the large bowel.
Intestinal malabsorption. Watery stools are characteristic of disorders of the small bowel, whereas loose, semisolid stools are associated more often with disorders of the large bowel. Large, greasy stools suggest intestinal malabsorption, and the presence of mucus and pus in the stools suggests inflammatory enteritis or colitis.
The nurse is conducting a community education program on colorectal cancer. Which statement should the nurse include in the program? It is the third most common cancer in the United States. The lifetime risk of developing colorectal cancer is 1 in 10. The incidence of colorectal cancer decreases with age. Colorectal cancer has no hereditary component.
It is the third most common cancer in the United States.
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
Patients with irritable bowel disease (IBD) are at significantly increased risk for which of the following? Osteoporosis Deep vein thrombosis Hypotension Pneumonia
Osteoporosis
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? Constipation Paralytic ileus Peritonitis Accumulation of gas
Peritonitis Lack of bowel motility typically accompanies peritonitis. The abdomen feels rigid and board-like as it distends with gas and intestinal contents. Bowel sounds typically are absent. The diagnosis of acute appendicitis correlates with the symptoms of rupture of the appendix and peritonitis. A paralytic ileus and gas alone do not produce these symptoms.
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? Right upper quadrant Right lower quadrant Left upper quadrant Left lower quadrant
Right lower quadrant
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? The client may develop inflammatory bowel disease. The client may develop arthritis or arthralgia. The client's natural bowel function may become sluggish. The client may lose his or her appetite.
The client's natural bowel function may become sluggish.
Which is a true statement regarding regional enteritis (Crohn's disease)? It has a progressive disease pattern. It is characterized by pain in the lower left abdominal quadrant. The clusters of ulcers take on a cobblestone appearance. The lesions are in continuous contact with one another.
The clusters of ulcers take on a cobblestone appearance. It is characterized by remissions and exacerbations. The pain is located in the lower right quadrant. The lesions are not in continuous contact with one another and are separated by normal tissue.
The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition? Small-bowel disease Ulcerative colitis Disorders of the colon Intestinal malabsorption
The presence of mucus and pus in the stool suggests ulcerative colitis. Watery stools are characteristic of small-bowel disease. Loose, semisolid stools are associated more often with disorders of the colon. Voluminous, greasy stools suggest intestinal malabsorption.
A client informs the nurse that he is 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? They can be habit forming and will require increasing doses to be effective. As long as the client is drinking 8 glasses of water per day, he can continue to take them. The laxative is safe to take with other medication the client is taking. The client should take a fiber supplement along with the stimulant laxative.
They can be habit forming and will require increasing doses to be effective.
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? Hematocrit 42% White blood cell (WBC) count 22.8/mm3 Serum potassium 4.2 mEq/L Serum sodium 135 mEq/L
White blood cell (WBC) count 22.8/mm3
Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes: caffeinated products. spicy foods. high-fiber diet. fluids with meals.
high-fiber diet.
The nurse caring for an older adult client diagnosed with diarrhea is administering and monitoring the client's medications. Because one of the client's medications is digitalis (digoxin), the nurse monitors the client closely for: hyperkalemia. hypokalemia. hyponatremia. hypernatremia.
hypokalemia.
A client with enteritis reports frequent diarrhea. What assessment should the nurse should anticipate? respiratory acidosis respiratory alkalosis metabolic acidosis metabolic alkalosis
metabolic acidosis
Which client requires immediate nursing intervention? The client who: complains of epigastric pain after eating. complains of anorexia and periumbilical pain. presents with a rigid, board-like abdomen. presents with ribbonlike stools.
presents with a rigid, board-like abdomen.
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? tenderness and pain in the right upper abdominal quadrant jaundice and vomiting severe abdominal pain with direct palpation or rebound tenderness rectal bleeding and a change in bowel habits
severe abdominal pain with direct palpation or rebound tenderness
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"? stool consistency and client comfort one bowel movement daily one bowel movement every other day two bowel movements daily
stool consistency and client comfort
A 75-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. An emergency room nurse is obtaining assessment data from this patient. What assessment finding is characteristic of a small bowel obstruction? Nausea and vomiting Decrease in urine production Mucus in the stool Mucosal edema
Nausea and vomiting
When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. The appendix may develop gangrene and rupture, especially in a middle-aged client. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage.
Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.
The nurse is assessing a client for constipation. To identify the cause of constipation, the nurse should begin by reviewing the client's: usual pattern of elimination. alcohol consumption. activity levels. current medications.
usual pattern of elimination.
A client has been experiencing lower GI difficulties that have increased in severity, and the gastroenterologist is concerned that the client's bowel is not functioning properly. What function of the lower GI tract is most likely to be affected by the client's disorder? water and electrolyte absorption protein digestion fat digestion All options are correct.
water and electrolyte absorption
