Question 1

The nurse is providing discharge teaching to a patient with diarrhea.Which patient statement indicates that teaching has been effective?

Accepted Answer

Weakness and dehydration from fluid loss may occur with diarrhea.B.A ruptured bowel is not an adverse effect of diarrhea.C.Obstipation is a term for chronic constipation.D.The patient's risk for urinary tract infection is not high because of diarrhea.

Question 2

The nurse is teaching a patient with diverticulosis how to avoid complications.Which patient statement indicates that teaching has been effective?

Accepted Answer

Diverticulosis is managed by preventing constipation.Diverticulitis can be prevented by increasing dietary fiber to prevent constipation and onset of diverticulosis.A.B.D.Avoiding milk products,hot and spicy foods,and cooking vegetables will not prevent the development of complications from diverticulosis.

Question 3

The nurse is caring for a patient who is being screened for diverticulosis.Which patient statement indicates understanding of conditions that predispose to diverticulosis?

Accepted Answer

Chronic constipation usually precedes the development of diverticulosis by many years.When the patient is chronically constipated,pressure within the bowel is increased,leading to development of diverticula.A.D.A diet high in red meat is believed to contribute to the development of colon cancer.B.Chronic diarrhea does not cause diverticulosis.

Question 4

The nurse is caring for a patient with an inflamed appendix.Which complication is most likely to occur if the appendix ruptures?

Accepted Answer

Perforation,abscess of the appendix,and peritonitis are major complications of appendicitis.A.B.C.Colitis,enteritis,and hepatitis are not complications of a ruptured appendix.

Question 5

The nurse is monitoring a patient recovering from an emergency appendectomy.Which finding should be reported to the physician immediately?

Accepted Answer

With peritonitis,a life-threatening complication,abdominal rigidity is present.The physician should be notified promptly for treatment orders.A.The patient will be experiencing post-operative pain.B.Absence of bowel sounds is expected after anesthesia.D.Bleeding is expected after surgery.

Question 6

The nurse is caring for a patient who has diarrhea.Which nursing action is the highest priority?

Accepted Answer

Replacing fluids and electrolytes is the first priority which is accomplished by increasing oral fluid intake or using solutions with glucose and electrolytes if ordered by the physician.A.Perineal skin care may or may not need to be done.B.There is no reason to auscultate the abdomen every day.D.There is no indication that the patient is experiencing abdominal pain.

Question 7

The nurse is contributing to the plan of care for a patient with gluten enteropathy (celiac disease).What should the nurse recommend be eliminated from the diet of the patient?

Accepted Answer

Gluten is a protein found in wheat,barley,oats,and rye.In celiac disease,a high-calorie,high-protein,gluten-free diet is ordered to relieve symptoms and improve nutritional status.A.B.C.Gluten is not found in red meat,milk,milk products,or fresh fruits and vegetables.

Question 8

A patient scheduled for an ileostomy for Crohn's disease asks the nurse to explain the procedure.What should the nurse respond?

Accepted Answer

An ileostomy is an end stoma formed by bringing the terminal ileum out to the abdominal wall following a total proctocolectomy.A.B.C.These responses do not appropriately describe an ileostomy.

Question 9

A patient with a colostomy says,"My pouch blows up like a balloon when I pass gas." What is an appropriate response by the nurse?

Accepted Answer

The pouch should be emptied the same as emptying for stool.A.A pinhole will allow odor to escape so that should never be done.D.A new pouch is not necessary and would cost too much.C.Disrupting the skin barrier often could irritate the skin.

Question 10

The nurse is contributing to a patient's plan of care.For which patient would the nursing diagnosis of Risk for Constipation be most appropriate?

Accepted Answer

Medications,such as narcotics,tranquilizers,and antacids with aluminum,decrease motility of the large intestine and may contribute to constipation.A.C.D.NSAIDs,antibiotics,and anticoagulants are not identified as causing constipation.

Question 11

The nurse is reinforcing teaching provided to a patient with acute diarrhea.Which statement indicates the patient understands the most common cause for this health problem?

Accepted Answer

The most common cause of acute diarrhea is a bacterial or viral infection.A.B.Excessive food and fiber are not causes for diarrhea.D.Inflammatory bowel disease can cause chronic diarrhea.

Question 12

The nurse is collecting data from a patient who is reporting abdominal pain.Which symptom suggests that the patient is experiencing appendicitis?

Accepted Answer

Signs and symptoms of appendicitis include fever,increased white blood cells,and generalized pain in the upper abdomen.Within hours of onset,the pain usually becomes localized to the right lower quadrant at McBurney's point.A.B.C.Appendicitis pain is not located in the suprapubic,mid-epigastric,or substernal regions.

Question 13

A patient asks what causes diverticulitis.How should the nurse respond?

Accepted Answer

When food and bacteria are trapped in a diverticulum,inflammation and infection develop.This is called diverticulitis.A.C.D.These responses do not appropriate explain diverticulitis.

Question 14

The nurse is reinforcing patient teaching on the best way to prevent transmission of infectious diarrhea.Which patient statement indicates correct understanding of the teaching?

Accepted Answer

Ensure hand washing by patient,family,and health care staff to prevent the spread of infection.A.A mask and gown do not need to be worn.B.Avoid sharing eating utensils will not prevent the spread of infectious diarrhea.C.Keeping the perineal area clean and dry will promote comfort and prevent skin breakdown.

Question 15

The nurse is collecting data from a newly admitted patient.Which finding should the nurse identify as a risk factor for constipation?

Accepted Answer

Causes for constipation include rectal or anal conditions such as hemorrhoids.A.Absence of milk products in the diet is not a known cause for constipation.C.Stomach surgery is not a cause for constipation.D.History of breast cancer treatment does not cause constipation.

Question 16

The nurse is caring for a patient with an exacerbation of Crohn's disease.Which nursing action is most important to recommend for inclusion in the patient's plan of care?

Accepted Answer

Per Maslow's hierarchy,preventing dehydration from diarrhea is important,so fluids are encouraged.
B.C.D.Ambulation,anti-gas medications,and protective ointment to the perianal skin are not as important as ensuring the patient's fluid and electrolyte status are maintained.

Question 17

The nurse is caring for a patient who reports feeling constipated,yet passes frequent small liquid stools.Which action should the nurse take?

Accepted Answer

Fecal impaction results when the fecal mass is so dry it cannot be passed.Small amounts of liquid stool ooze around the fecal mass and cause incontinence of liquid stools.B.If the incontinence is treated with an antidiarrheal medication,it will worsen the constipation.C.The patient is not experiencing liquid stools.D.Rebound tenderness is not a manifestation of fecal impaction.

Question 18

The nurse suspects appendicitis in a patient complaining of abdominal pain.Which assessment finding should cause the nurse to notify the physician?

Accepted Answer

Local rebound tenderness (intensification of pain when pressure is released after palpation)in the right lower quadrant of the abdomen is a classic sign of appendicitis.A.B.C.Burping,tympanic bowel sounds,and hyperactive bowel sounds are not associated with appendicitis.

Question 19

A patient is to be started on clear liquids after an appendectomy.Which food should the nurse identify as being a clear liquid?

Accepted Answer

A clear liquid is one that can you can see through and has no pulp such as cranberry juice,apple juice,soda,or black coffee.A.Oatmeal would be permitted on a soft diet.B.Ice cream would be permitted on a full liquid diet.D.Graham crackers would be permitted on a regular diet.

Question 20

The nurse notes that a patient with a history of a myocardial infarction is straining during defecation.Which response by the nurse is best?

Accepted Answer

Straining to have a bowel movement (Valsalva's maneuver)can result in cardiac,neurological,and respiratory complications.If the patient has a history of heart failure,hypertension,or recent myocardial infarction,straining can lead to cardiac rupture and death.A.C.D.These responses are not appropriate for the patient with a history of myocardial infarction who is straining with a bowel movement.

Quiz 34: Nursing Care of Patients With Lower Gastrointestinal Disorders