Unit 2 Chapter 46
A client is being discharged from the outpatient care center after having an inguinal hernia reduced nonsurgically. What can the nurse instruct the client to do to decrease the incidence of recurrence? Select all that apply. A) Avoid heavy lifting and strenuous exercise. B) Avoid constipation. C) How to wear a truss. D) Take analgesics for pain. E) Bend at the waist.
A) Avoid heavy lifting and strenuous exercise. B) Avoid constipation. C) How to wear a truss.
The nurse is preparing a patient for a test that involves inserting a thick barium paste into the rectum with radiographs taken as the client expels the barium. What test will the nurse prepare the patient for? A) Kidneys, ureters, bladder (KUB) B) Colonic transit studies C) Defecography D) Abdominal radiography
C) Defecography
A client with a hernia decides to manage the herniation with a truss. The nurse would emphasize which of the following? A) Using laxatives to ensure regular bowel movement B) Wearing warm, woolen clothes to avoid dryness C) Applying a sunscreen to prevent exposure to direct sunlight D) Using cornstarch to absorb moisture in the area
D) Using cornstarch to absorb moisture in the area
The nurse is caring for four clients with diarrhea. Which client is most likely to be diagnosed with Crohn's disease? A) A 24 year-old Caucasian eastern European Jewish female B) A 46 year-old African American male C) A 32 year-old female from Vietnam D) A 63 year-old Hispanic female with a history of cancer of the vulva
A) A 24 year-old Caucasian eastern European Jewish female
A client has developed an anorectal abscess. Which client is at most risk for the development of this type of abscess? A) A client with Crohn's disease B) A client with hemorrhoids C) A client with colon cancer D) A client with diverticulosis
A) A client with Crohn's disease
The nurse is talking with a group of clients that are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider? A) Change in bowel habits B) Excess gas C) Daily bowel movements D) Abdominal cramping when having a bowel movement
A) Change in bowel habits
The nurse would instruct a client who has an appendectomy to avoid which of the following? A) Heavy lifting B) Harsh sunlight C) Dairy products D) Purine-rich foods
A) Heavy lifting
After teaching a group of students about irritable bowel syndrome and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an opiate-related antidiarrheal agent? A) Loperamide (Imodium) B) Bismuth subsalicylate (Pepto-Bismol) C) Kaolin and pectin (Kaopectate) D) Bisacodyl (Dulcolax)
A) Loperamide (Imodium)
A client comes to the clinic complaining of not having a bowel movement in several days, abdominal cramping, and nausea. When the nurse puts the client on the stretcher, he vomits a large amount of fecal material. What should the first action by the nurse be? A) Notify the physician. B) Start an IV of Ringer's lactate. C) Insert an intestinal tube. D) Insert a nasogastric tube.
A) Notify the physician.
The nurse is obtaining data from an older adult client who is being seen in the clinic for a checkup. The client informs the nurse that he is taking a daily dose of Epsom salts to have a daily bowel movement. What priority intervention should the nurse anticipate doing to detect the changes that can occur from prolonged use? A) Obtaining an ECG B) Obtaining blood for a complete blood count C) Listening to the patient's bowel sounds D) Administering an oil retention enema
A) Obtaining an ECG
When interviewing a client with internal hemorrhoids, which of the following would the nurse expect the client to report? A) Rectal bleeding B) Pain C) Itching D) Soreness
A) Rectal bleeding
The nurse is assessing a client for fecal impaction, and when inserting a lubricated, gloved finger, the stool feels like small rocks. What does the nurse document this finding as? A) Scybala B) Hard stool C) Fecal Impaction D) Obstruction
A) Scybala
A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important? A) The consistency of stool and comfort when passing stool B) That the client has a bowel movement daily C) That the stool is formed and soft D) The client is able to fully evacuate with each bowel movement
A) The consistency of stool and comfort when passing stool
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 the taking a stimulant laxative? A) They can be habit forming and will require increasing doses to be effective. B) As long as the client is drinking 8 glasses of water per day, he can continue to take them. C) The laxative is safe to take with other medication the client is taking. D) The client should take a fiber supplement along with the stimulant laxative.
A) They can be habit forming and will require increasing doses to be effective.
The nurse is preparing discharge instructions for the client with diverticulosis. When instructing the client to increase dietary fiber, what should the nurse inform the patient is the amount that should be taken in daily? A) 10 to 20 g B) 20 to 35 g C) 35 to 45 g D) 45 to 60 g
B) 20 to 35 g
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? A) Avoiding bran cereals and beans in the diet B) Adding fiber-rich foods to the diet gradually C) Limiting fluid intake to 5 to 6 glasses per day D) Minimizing activity levels for at least 2 months
B) Adding fiber-rich foods to the diet gradually
The nurse is caring for a patient who has had diarrhea for 3 days. What major problems associated with severe or prolonged diarrhea should the nurse monitor for when caring for this patient? Select all that apply. A) Oral candidiasis B) Dehydration C) Electrolyte imbalances D) Vitamin deficiencies E) Rectal fissures
B) Dehydration C) Electrolyte imbalances D) Vitamin deficiencies
The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder? A) The bowel twists and turns itself and obstructs the intestinal lumen. B) One part of the intestine telescopes into another portion of the intestine. C) The bowel protrudes through a weakened area in the abdominal wall. D) A loop of intestine adheres to an area that is healing slowly after surgery.
B) One part of the intestine telescopes into another portion of the intestine.
A client with Crohn's disease informs the nurse that he is allergic to aspirin. What medication ordered for the treatment of Crohn's does the nurse know is contraindicated when a client is allergic to aspirin? A) Prednisone B) Sulfasalazine (Pentasa) C) Azathioprine (Imuran) D) Cyclosporine (Sandimmune)
B) Sulfasalazine (Pentasa)
The nurse is following an order to collect a stool specimen from a patient who is having diarrhea for ova and parasites. What does the nurse understand may be required when obtaining this specimen? A) The nurse will be testing for blood in the stool. B) The nurse may have to obtain several samples. C) The test is routine and may be placed in a regular stool specimen cup. D) The stool must be placed on a slide prior to bringing it to the lab.
B) The nurse may have to obtain several samples.
A nurse is preparing a presentation for a local community group of older adults about colon cancer. Which of the following would the nurse include as the primary characteristic associated with this disorder? A) Abdominal distention B) Frank blood in the stool C) A change in bowel habits D) Abdominal pain
C) A change in bowel habits
A client is diagnosed with colon cancer, located in the lower third of the rectum. What does the nurse understand will be the surgical treatment option for this client? A) Colectomy B) Segmental resection C) Abdominoperineal resection D) A low colectomy
C) Abdominoperineal resection
A patient informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The patient states that the physician told him he has irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder? A) Weight loss due to malabsorption B) Blood and mucus in the stool C) Chronic constipation with sporadic bouts of diarrhea D) Client is awakened from sleep due to abdominal pain.
C) Chronic constipation with sporadic bouts of diarrhea
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 boardlike. What complication does the nurse determine may be occurring at this time? A) Constipation B) Paralytic ileus C) Peritonitis D) Accumulation of gas
C) Peritonitis
The nurse observes the physician palpating the abdomen of a client that is suspected of having acute appendicitis. When the abdomen is pressed in the left lower quadrant the client complains of pain on the right side. What does the nurse understand this assessment technique is referred to? A) Referred pain B) Rebound pain C) Rovsing's sign D) Cremasteric reflex
C) Rovsing's sign
The nurse is reviewing the laboratory test results of a client with Crohn's disease. Which of the following would the nurse most likely find? A) Decreased white blood cell count B) Increased albumin levels C) Stool cultures negative for microorganisms or parasite D) Decreased erythrocyte sedimentation rate
C) Stool cultures negative for microorganisms or parasite
A client realizes that regular use of laxatives has greatly improved his bowel pattern. However, the nurse cautions this client against the prolonged use of laxatives for which reason? A) The client may develop inflammatory bowel disease. B) The client may develop arthritis or arthralgia. C) The client's natural bowel function may become sluggish. D) The client may lose his appetite.
C) The client's natural bowel function may become sluggish.
After teaching a group of students about intestinal obstruction, the instructor determines that the teaching was effective when the students identify which of the following as a cause of a functional obstruction? A) Volvulus B) Intussusception C) Tumor D) Abdominal surgery
D) Abdominal surgery
After assessing a client with peritonitis, the nurse likely would document the client's bowel sounds as? A) Mild B) High-pitched C) Hyperactive D) Absent
D) Absent
A client at a long-term care facility informs the nurse that he is having cramping when trying to have a bowel movement, and all that is coming out is liquid. When the nurse reviews the client's last bowel movement history, it is determined that the client has not had a bowel movement in 7 days. What does the nurse understand is most likely occurring with this client? A) Scybala B) The history is incorrect of the last bowel movement. C) Diarrhea D) Encopresis
D) Encopresis
A client is complaining of problems with constipation. What dietary suggestion can the nurse inform the client may help facilitate the passage of stool? A) Increase the carbohydrate content of the diet. B) Increase dietary fat consumption. C) Increase dietary protein such as lean meats. D) Increase dietary fiber.
D) Increase dietary fiber.
The nurse is observing the mucous membranes of a client's mouth and notices that they are darkly discolored. The client has been taking medication for diarrhea. What medication should the nurse ask the client if he has been taking? A) Diphenoxylate with atropine sulfate (Lomotil) B) Loperamide (Imodium) C) Kaopectate D) Pepto-Bismol
D) Pepto-Bismol
The nurse is admitting a client to the acute care facility with abdominal pain related to an umbilical hernia. The nurse is palpating the protrusion, and the client states that it suddenly feels better. What type of hernia does the nurse understand this client has? A) Strangulated B) Incarcerated C) Irreducible D) Reducible
D) Reducible
A client is recently diagnosed with Crohn's disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response? A) Ciprofloxacin (Cipro) B) Methotrexate (MTX) C) Azathioprine (Imuran) D) Sulfasalazine (Azulfidine)
D) Sulfasalazine (Azulfidine)
