Deck 24: Nursing Care of Patients with Bowel Disorders

Question 1

A patient with cancer of the rectum is scheduled for surgery and the placement of a permanent ostomy. Which of the following types of ostomies will this patient most likely have performed during the surgery?

A)ileostomy
B)double-barrel
C)sigmoid
D)transverse loop

Answer 1

sigmoid

Question 2

A patient is diagnosed with gastroenteritis. The nurse should assess which of the following serum laboratory values first?

A)sodium
B)bicarbonate
C)calcium
D)potassium

Answer 2

potassium

Question 3

A patient with irritable bowel syndrome asks the nurse, "Why did the doctor order something for depression?" How should the nurse respond?

A)"Didn't the doctor tell you that you are depressed?"
B)"Depression can be caused by irritable bowel syndrome.
C)"Did the doctor not give you an opportunity to ask questions?"
D)"These medications help with the symptoms associated with your bowel problem."

Answer 3

"These medications help with the symptoms associated with your bowel problem."

Question 4

A patient with Crohn's disease is recovering from a bowel resection. The nurse realizes that this patient will do which of the following?

A)never have another recurrence of the disease
B)possibly have a recurrence in another portion of the bowel
C)develop ulcerative colitis
D)experience intestinal strictures

Question 5

Place an "X" over the location on the diagram where a nurse would typically palpate for the most common type of hernia.

Question 6

A 28-year-old female patient is diagnosed with inflammatory disease of the small bowel. The nurse realizes that this patient most likely is experiencing which of the following?

A)ulcerative colitis
B)chronic diarrhea
C)gastroenteritis
D)Crohn's disease

Question 7

A patient tells the nurse about diarrhea after eating ice cream. The nurse realizes that this patient might be experiencing which of the following?

A)disease of the colon
B)inflammation of the small intestines
C)cholera
D)lactose intolerance

Question 8

The nurse is caring for a patient with a fecal impaction. Which of the following types of enemas will best assist in relieving the fecal impaction?

A)normal saline
B)oil retention
C)tap water
D)soap suds

Question 9

Place the following steps of the procedure for ileostomy lavage in the correct order. Click and drag the options below to move them up or down.

A)Lubricate the catheter and insert into the stoma.
B)Gently examine stoma digitally.
C)Don gloves, then remove pouch and apply irrigation sleeve.
D)Clamp bottom of sleeve or place in bedpan.
E)Instill 30 to 50 mL of normal saline.
F)Clean peristomal skin and apply pouch.

Question 10

A patient comes into the emergency department with suspected appendicitis. Which of the following should the nurse do for this patient?

A)Provide a hot water bottle to place over the abdomen.
B)Provide with clear water to drink.
C)Inspect the abdomen and assess bowel sounds.
D)Prepare to administer a Biscodyl (Dulcolax) suppository.

Question 11

After a company barbecue three people out of a group of 12 developed signs of enteritis. Which of the following could be an indication of the source of the health problem?

A)The three patients ate hamburgers.
B)Nine people ate hotdogs.
C)Most of the people drank canned soda.
D)All of the people ate ice cream.

Question 12

The nurse is providing care to a patient admitted with acute diarrhea. Which of the following interventions would assist in this patient's care?

A)Provide a normal diet as tolerated.
B)Hold all medications until the diarrhea stops.
C)Provide clear liquids in small amounts.
D)Encourage normal activities of daily living in the hospital room.

Question 13

Diverticulitis is commonly manifested by a palpable mass in the __________ .

A)upper-right quadrant
B)lower-left quadrant
C)area of McBurney's point.
D)epigastric region

Question 14

A patient who is newly diagnosed with short bowel syndrome asks, "Now what do I need to do? I'm so tired of being sick." The nurse should respond with which of the following?

A)"Dealing with this problem will be difficult in the beginning."
B)"Sometimes minor diet changes will alleviate the problem."
C)"I think more surgery is in your future."
D)"Short bowel syndrome is a long term challenge."

Question 15

A patient is suspected as having sprue. Which of the following should the nurse instruct this patient about his diet?

A)Avoid all milk products.
B)A vegetarian diet is the best treatment for this condition.
C)Gluten products must be eliminated from the diet.
D)All whey products must be eliminated from the diet.

Question 16

A patient with Crohn's disease is demonstrating Imbalanced Nutrition: Less than Body Requirements. Which of the following should be included in this patient's plan of care?

A)a low-calorie, high-milk diet
B)a low-calorie, low-residue diet.
C)a high-calorie, low-protein diet
D)a high-calorie, low-fat diet

Question 17

The nurse can detect no bowel sounds on a patient recovering from bowel surgery. This finding should be noted as which of the following?

A)borborygmi
B)paralytic ileus
C)hypoactive bowel sounds
D)atonic bowel

Question 18

Place an "X" on the diagram below which indicates the most common site of ulcerative colitis.

Question 19

The nurse is implementing a bowel retraining program for a patient. Which of the following should be included in this patient's plan of care?

A)Assess the patient to determine the best time of day to use the commode for defecation.
B)Keep the bedpan near the patient at all times.
C)Instruct the patient to not attempt to use the bathroom unattended.
D)Stay with the patient while defecating.

Question 20

Which of the following food choices should be avoided by the patient on a low-residue diet?

A)wine, vinegar, beer, liquor
B)rice, grains, pasta
C)canned vegetables
D)chilled fruit gelatin desserts

Question 21

The nurse is providing discharge instructions to a patient who is recovering from anal-rectal surgery for repair of an anal fissure. Which of the following should be included in these instructions? Select all that apply.

A)Do not remove the dressing.
B)Change the dressing if it becomes soiled with urine or feces.
C)Use the sitz bath.
D)Use the antibiotic until all drainage stops.
E)Avoid bowel movements.

Question 22

The nurse has instructed the patient who is experiencing diarrhea associated with irritable bowel syndrome on dietary changes to prevent diarrhea. The nurse knows the patient understands the dietary changes if the patient selects which of the following menu choices?

A)yogurt, crackers, and sweet tea
B)salad with chicken, whole wheat crackers
C)bacon, tomato, lettuce with mayonnaise, and a soft drink
D)tuna on white bread and green grapes

Question 23

The nurse is caring for a patient experiencing peritonitis. The patient develops a temperature of 103° F (39.4° C), is restless, has blood pressure of 85/45 and has a urinary output of 76 mL in eight hours. The nurse should develop a plan of care related to which of the following?

A)hypovolemic shock
B)inflammation
C)third spacing
D)bowel dysfunction

Question 24

The nurse is providing medications to a patient with diverticular disease. Which of the following medications should the nurse question for this patient?

A)docusate (Colace)
B)metronidazole (Flagyl)
C)trimethoprim-sulfamethoxazole (Bactrim)
D)bisacodyl (Dulcolax) suppository

Question 25

The nurse is instructing a patient who is experiencing diarrhea associated with a microorganism not to use antidiarrheals. The patient asks, "Why can't I take something to stop the diarrhea?" The nurse's best response is which of the following?

A)"Antidiarrheals slow down the elimination of the microorganism causing the diarrhea."
B)"Antibiotics are always used to treat the microorganisms but antibiotics may worsen diarrhea."
C)"The potassium you are taking will help to slow down the diarrhea."
D)"Your physician does not like to use antidiarrheal medications."

Question 26

A patient learns that a small bowel obstruction was caused by an appendectomy five years ago. The nurse realizes that this obstruction was most likely caused by which of the following?

A)an untreated infection of the appendix
B)adhesions
C)undiagnosed femoral hernia
D)umbilical hernia

Question 27

A patient is being seen for a "sudden lump" in the groin after lifting a heavy box to a shelf. The nurse realizes that this patient might be experiencing which of the following?

A)an umbilical inguinal hernia
B)a direct inguinal hernia
C)a femoral hernia
D)an incisional hernia

Question 28

An unlicensed assistive staff member says to the nurse, "I need for you to assess a patient. Something is coming out of his rectum." The nurse realizes that the assistant most likely observed which of the following?

A)internal hemorrhoids
B)colostomy
C)prolapsed hemorrhoids
D)femoral hernia