Question 1

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.

Accepted Answer

C) Use of a sitz bath can help promote healing and alleviate discomfort.
B) It is important to change the dressing if it becomes soiled with urine or feces to prevent infection. 
A) The patient should be instructed to follow the healthcare provider's specific instructions regarding removal of the dressing.
D) The nurse should provide instructions on completion of the full course of antibiotics prescribed. 
E) Avoiding bowel movements is not a practical or healthy option for this patient. Instead, the patient should be instructed to maintain regular bowel movements and to use stool softeners if necessary to prevent strain on the surgical site.

Question 2

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?

Accepted Answer

This menu choice includes foods that are less likely to cause diarrhea such as chicken and whole wheat crackers. Salad is also a good choice as it is high in fiber which can help regulate bowel movements. The other options such as sweet tea, bacon, mayonnaise, and soft drinks are more likely to worsen diarrhea.

Question 3

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?

Accepted Answer

The patient is showing signs of hypovolemic shock due to the decrease in blood pressure and urinary output, and the high temperature and restlessness indicate an increase in metabolic rate. These are all symptoms of shock, which can be caused by fluid loss, such as in peritonitis. The nurse should address this immediately to prevent a potential life-threatening situation.

Question 4

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

Accepted Answer

Bisacodyl (Dulcolax) is a laxative and can increase colon contractions, which may worsen symptoms of diverticular disease. The other medications listed are commonly used in the treatment of diverticular disease and should not be questioned.

Question 5

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?

Accepted Answer

Antidiarrheals may slow down the elimination of the microorganism causing the diarrhea, allowing it to remain in the body longer and potentially worsen the infection. It is important for the body to eliminate the microorganism causing the diarrhea naturally.

Question 6

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?

Accepted Answer

Adhesions are a common cause of small bowel obstructions and can occur as a result of previous surgeries, such as an appendectomy. Untreated infection of the appendix, a femoral hernia, or an umbilical hernia would not likely lead to the development of adhesions and subsequent bowel obstruction.

Question 7

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?

Accepted Answer

The answer of A patient is being seen for a...

Question 8

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?

Accepted Answer

A prolapsed hemorrhoid occurs when the internal hemorrhoids protrude outside the anus. This could be something the unlicensed assistive staff member observed coming out of the patient's rectum. The other options are less likely to cause something visibly coming out of the rectum.

Quiz 24: Nursing Care of Patients with Bowel Disorders

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.