Deck 24: Nursing Care of Patients With Bowel Disorders

Question 1

The nurse is providing care to a patient admitted with acute diarrhea. What intervention 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.

Answer 1

Provide clear liquids in small amounts.

Question 2

A patient with Crohn disease is recovering from a bowel resection. What does the nurse realize will most likely occur in this patient?

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

Answer 2

The patient will possibly have a recurrence in another portion of the bowel.

Question 3

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 health problem?

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

Answer 3

an indirect inguinal hernia

Question 4

The nurse is planning to review the pathophysiology of ulcerative colitis with a patient who is newly diagnosed with the disorder. Place an "X" on the diagram below which indicates the most common site of ulcerative colitis.

Question 5

A patient is prescribed a low-residue diet. What foods should the nurse instruct the patient to avoid while on this diet?

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

Question 6

The nurse is conducting a physical assessment and wants to palpate for hernias. Place an "X" over the location on the diagram where the nurse should palpate for the most common type of hernia.

Question 7

A patient comes into the emergency department with suspected appendicitis. What 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 8

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 what health problem?

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

Question 9

The nurse can detect no bowel sounds on a patient recovering from bowel surgery. What should the nurse suspect is occurring in this patient?

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

Question 10

After a company barbecue three people out of a group of 12 developed signs of enteritis. Which assessment finding should the nurse use as 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 11

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

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

Question 12

A patient is suspected as having sprue. What diet teaching does this patient need?

A) Avoid high-protein foods.
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 13

A patient with Crohn disease is experiencing weight loss. What 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 14

A patient is diagnosed with gastroenteritis. The nurse should assess which serum laboratory value first?

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

Question 15

The nurse is implementing a bowel training program for a patient. What 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 not to attempt to use the bathroom unattended.
D) Stay with the patient while defecating.

Question 16

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

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

Question 17

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."

Question 18

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." How should the nurse respond to this patient?

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 19

The nurse is preparing to assess a patient with diverticulitis. Which area of the patient's abdomen should the nurse expect to palpate a mass?

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

Question 20

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

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

Question 21

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 what health problem?

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

Question 22

The nurse suspects that a patient with ulcerative colitis has taken a dose of diphenoxylate (Lomotil) to help with diarrhea. What did the nurse assess to make this clinical decision?

A) fever
B) tachycardia
C) hypotension
D) low urine output
E) abdominal cramps

Question 23

The nurse instructs a patient with irritable bowel syndrome about the newly prescribed medication sulfasalazine (Azulfidine). Which patient statements indicate that no additional teaching about this medication is required?

A) "I should take this medication before meals."
B) "I should use sunscreen while taking this medication."
C) "I should not take any aspirin while taking this medication."
D) "I should restrict my fluid intake while taking this medication."
E) "I should not take any vitamin C while taking this medication."

Question 24

A patient has been experiencing diarrhea for several days. What should the nurse assess to determine if adverse effects are occurring within this patient?

A) skin turgor
B) muscle tone
C) serum potassium level
D) serum magnesium level
E) orthostatic blood pressure

Question 25

The nurse is providing discharge instructions to a patient who is recovering from anal-rectal surgery for repair of an anal fissure. What should be included in these instructions?

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 26

A patient recovering from surgery for a small bowel obstruction is prescribed enteral feedings. Which actions should the nurse take to ensure the feedings are provided safely to the patient?

A) Keep the head of the bed elevated 30 to 45 degrees.
B) Check for tube placement by flushing with normal saline.
C) Flush the tube with club soda after administering medications.
D) Measure external tube length after verifying placement with an x-ray.
E) Stop the tube feeding 10 minutes before changing the position to supine.

Question 27

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 health problem?

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

Question 28

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

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

Question 29

An older patient is diagnosed with severe acute diverticulitis. What treatment should the nurse expect to be prescribed for this patient?

A) complete bed rest
B) intravenous fluids
C) nothing by mouth
D) aspirin or NSAIDs for pain
E) intravenous cefoxitin (Mefoxin)

Question 30

The nurse determines that a patient taking metronidazole (Flagyl) for a protozoan infection has been drinking alcohol while taking the medication. What assessment findings did the nurse use to make this clinical decision?

A) Bruising
B) Flushing
C) Vomiting
D) Sore throat
E) Severe headache

Question 31

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 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 32

The nurse is caring for an older patient recovering from a bleeding ulcer. Which manifestations should the nurse use to determine whether the patient is experiencing peritonitis?

A) confusion
B) bradycardia
C) restlessness
D) abdominal discomfort
E) decreased urinary output

Question 33

A patient with chronic diarrhea has been advised by the healthcare provider to avoid foods containing sorbitol and mannitol. What should the nurse instruct the patient to avoid consuming for this health problem?

A) mints
B) honey
C) pear juice
D) apple juice
E) orange juice

Question 34

The nurse teaches a patient with Crohn disease about surgery to create a continent ileostomy. Which patient statements indicate that teaching has been effective?

A) "I will need to change my diet."
B) "Stool will collect in an internal pouch."
C) "Stool will not leak through the stoma."
D) "I will use a catheter to drain the stool."
E) "I will need to change the bag every day."

Question 35

Type: MCMA A patient with malabsorption syndrome is prescribed vitamin B₁₂ injections. Which manifestations of this health problem should the nurse expect to improve with this vitamin supplement?

A) anemia
B) cheilosis
C) bone pain
D) paresthesias
E) muscle cramps

Question 36

A patient with Crohn disease is instructed to ingest a low-residue diet. Which dietary choices indicate that the patient needs additional information about this eating plan?

A) corn flakes
B) poppy seed roll
C) tapioca pudding
D) steamed broccoli
E) whole grain bread

Question 37

A patient with peritonitis 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 8 hours. The nurse should develop a plan of care related to which health problem?

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

Question 38

After learning that a patient has abdominal pain that occurs at least 3 days per month over the last 3 months, the nurse suspects that a patient is experiencing irritable bowel syndrome. What findings did the nurse use to make this clinical decision?

A) abdominal pain that is relieved by eating
B) abdominal pain that improves with defecation
C) abdominal pain that is associated with a change in stool form
D) abdominal pain that is associated with a change in bowel frequency
E) abdominal pain that improves with physical activity and limiting food intake

Question 39

A patient receiving long-term antibiotic therapy for an infected joint replacement begins to experience diarrhea, abdominal cramps, malaise, fever, and anorexia. What interventions should the nurse prepare to administer to this patient?

A) Maintain nothing by mouth status.
B) Prepare to administer metronidazole.
C) Insert a nasogastric tube for feedings.
D) Collect all urine for a 24-hour specimen.
E) Discontinue the currently prescribed antibiotic.

Question 40

The nurse is instructing a patient who is experiencing diarrhea associated with a microorganism not to use an antidiarrheal medication. The patient asks, "Why can't I take something to stop the diarrhea?" How should the nurse respond to this patient?

A) "Antidiarrheal medication slows 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."