Deck 58: Coordinating Care for Patients With Intestinal Disorders

Question 1

Which statement by the patient scheduled for a lower gastrointestinal series as diagnostic evaluation for colorectal diagnosis indicates understanding of the teaching about this procedure?
1)"A stool sample is collected by my doctor by digital rectal examination."
2)"After I have expelled most of the contrast, my intestine is filled with air and x-ray images are taken."
3)"Constipation may occur as a result of this procedure, so I will increase my water and fiber intake."
4)"A flexible tube with a light and camera is inserted into my rectum so that tissue can be biopsied."

Answer 1

3

Question 2

The diagnosis of celiac disease may be complicated in the patient with which disorder because the clinical manifestations are similar?
1)Appendicitis
2)Diverticulitis
3)Hernia
4)Lactose intolerance

Answer 2

4

Question 3

Which statement by the patient scheduled for an ileal pouch-anal anastomosis (IPAA) procedure for treatment of ulcerative colitis indicates the teaching was effective?
1)"My colon and rectum will be removed, and my anus will be closed."
2)"My colon will be removed, and my ileum is sutured to the anal canal."
3)"My colon will be removed while the distal portion of my ileum is used to create a pouch."
4)"My colon and rectal mucosa will be removed and a reservoir created using a portion of my ileum."

Answer 3

4

Question 4

The nurse is providing care to a patient who is diagnosed with irritable bowel syndrome (IBS). Which medication prescription should the nurse anticipate to provide pain relief?
1)Tegaserod
2)Loperamide
3)Linaclotide
4)Amitriptyline

Question 5

In reviewing the emergency records of a patient admitted to the unit for appendicitis, the nurse notes that there is documentation the patient complained of pain in the right lower quadrant when the left lower quadrant was palpated. The nurse correlates this finding to which diagnostic sign?
1)Cullen's
2)McBurney's
3)Rovsing's
4)Turner's

Question 6

Which statement by the patient scheduled for proctocolectomy with permanent ileostomy for treatment of ulcerative colitis indicates the teaching was effective?
1)"My colon and rectum will be removed, and my anus will be closed."
2)"My colon will be removed, and my ileum is sutured to the anal canal."
3)"My colon will be removed while the distal portion of my ileum is used to create a pouch."
4)"My colon and rectal mucosa will be removed and a reservoir created using a portion of my ileum."

Question 7

Which action by the patient care technician who is providing care to the patient diagnosed with appendicitis indicates the need for an intervention by the nurse?
1)Elevating the head of the patient's bed 30 to 45 degrees
2)Placing a heating pad on the patient's abdomen
3)Measuring all urine output and emesis
4)Positioning the patient with knees flexed

Question 8

The nurse administers which prescribed medication to treat diarrhea in the patient diagnosed with irritable bowel syndrome (IBS)?
1)Tegaserod
2)Loperamide
3)Dicyclomine
4)Amitriptyline

Question 9

The nurse is speaking with a patient who wants information regarding colorectal cancer. Which statement by the patient indicates that the teaching was effective?
1)"The risk of colorectal cancer is greatest in people ages 35 to 50."
2)"Colorectal cancer can be detected in early stages by measuring the level of the carcinogenic embryonic antigen (CEA)."
3)"Colorectal cancer occurs more often in patients who have a history of ulcerative colitis."
4)"Colorectal cancer has no symptoms in the early stage, and there are no definitive diagnostic tests."

Question 10

Which statement by the patient scheduled for abdominal colectomy with ileoanal anastomosis for treatment of ulcerative colitis indicates the teaching was effective?
1)"My colon and rectum will be removed, and my anus will be closed."
2)"My colon will be removed, and my ileum is sutured to the anal canal."
3)"My colon will be removed while the distal portion of my ileum is used to create a pouch."
4)"My colon and rectal mucosa will be removed and a reservoir created using a portion of my ileum."

Question 11

Which medication prescription should the nurse anticipate for a patient, diagnosed with hemorrhoids, to form a physical barrier on the skin to prevent irritation?
1)Zinc oxide
2)Benzocaine
3)Witch hazel
4)Hydrocortisone

Question 12

Which medication prescribed to the patient diagnosed with hemorrhoids does the nurse correlate to the treatment of pain?
1)Zinc oxide
2)Benzocaine
3)Witch hazel
4)Hydrocortisone

Question 13

Which finding in the patient diagnosed with a hernia indicates the need for an intervention?
1)Abdominal distension
2)Radiating pain
3)Pain in the inguinal area
4)Visible bulging in the inguinal area

Question 14

In providing care to a patient receiving chemotherapy for the treatment of colorectal cancer, the nurse correlates which mechanism of action to the prescribed 5-fluorouracil (5-FU)?
1)This medication is cell-cycle specific and interferes with the synthesis of DNA and RNA, causing its death.
2)This medication is converted in the tissue to 5-FU, which inhibits DNA and RNA synthesis by preventing thymidine production, causing death of rapidly replicating cells.
3)This medication is a platinum-based antineoplastic agent that binds to DNA and RNA, miscoding information and/or inhibiting DNA replication, causing cell death.
4)This medication is an antiangiogenesis agent that reduces blood flow to the tumor cells, depriving them of nutrients needed for replication.

Question 15

Which statement by the patient scheduled for proctocolectomy with continent ileostomy for treatment of ulcerative colitis indicates the teaching was effective?
1)"My colon and rectum will be removed, and my anus will be closed."
2)"My colon will be removed, and my ileum is sutured to the anal canal."
3)"My colon will be removed while the distal portion of my ileum is used to create a pouch."
4)"My colon and rectal mucosa will be removed and a reservoir created using a portion of my ileum."

Question 16

The nurse provides an educational session for community members about the risk factors for colorectal cancer. Which participant statement indicates the need for further teaching?
1)"There is a genetic link in the development of colorectal cancer."
2)"People with other bowel disease are at increased risk for developing this cancer."
3)"Eating a diet high in red meat reduces the risk for developing this type of cancer."
4)"Taking aspirin and a multivitamin each day reduces the risk of colorectal cancer."

Question 17

The nurse provides discharge instructions to a patient who is postoperative for an appendectomy. Which patient statement indicates a need for additional teaching?
1)"I can go home as soon as I am able to urinate."
2)"I will get up and walk around as much as I can."
3)"I will take the antibiotics until I no longer have a fever."
4)"I will use the incentive spirometer 10 times an hour while awake."

Question 18

Which statement by the patient using complementary and alternative therapy for the management of irritable bowel syndrome (IBS) requires follow-up by the nurse?
1)"I use different types of herbal teas and elixirs to manage my IBS."
2)"I use hypnosis to help manage my IBS."
3)"I use relaxation exercises to manage my IBS."
4)"I use acupuncture to manage my IBS."

Question 19

Which statement by the patient scheduled for a double-contrast barium enema as diagnostic evaluation for colorectal diagnosis indicates understanding of the teaching about this procedure?
1)"A stool sample is collected by my doctor by digital rectal examination."
2)"After I have expelled most of the contrast, my intestine is filled with air and x-rays images are taken."
3)"Constipation may occur as a result of this procedure, so I will increase my water and fiber intake."
4)"A flexible tube with a light and camera is inserted into my rectum so that tissue can be biopsied."

Question 20

Which statement by the patient recently diagnosed with irritable bowel syndrome indicates the need for further teaching?
1)"I need to drink more water every day."
2)"I need to avoid trigger foods, such as beans."
3)"I can use nicotine gum to help my stop smoking."
4)"I can use ginger to help control the nausea that I am experiencing."

Question 21

The nurse is evaluating care provided to a patient recovering from surgery for colorectal cancer. Which assessment data indicates the need for further intervention by the nurse?
1)Patient has an hourly urine output of 45 mL.
2)Patient performs morning care with assistance.
3)Patient states family members will care for the ostomy at home.
4)Patient tolerates full liquid diet and is requesting solid food.

Question 22

A patient recovering from surgery to place a permanent colostomy as treatment for colon cancer is concerned that her spouse will no longer find her sexually attractive. Which response by the nurse is the most appropriate?
1)"Tell me more about the concerns you are having."
2)"Would you like me to speak with your husband for you?"
3)"I am sure that he will get used to the change in your body."
4)"I will refer you to a counselor to talk about your concerns."

Question 23

In providing care to a patient who underwent a colostomy 2 days ago for the treatment of colon cancer, which finding requires an immediate intervention?
1)Serosanguineous drainage from the stoma
2)Dark red, purplish color of the stoma
3)Slight edema of the stoma
4)Reddish-pink, moist stoma

Question 24

The nurse monitors for which clinical manifestations of hypovolemic shock in the patient diagnosed with blunt abdominal trauma? Select all that apply.
1)Elevated temperature
2)Tachycardia
3)Hot, dry skin
4)Restlessness
5)Hypotension

Question 25

Which statement by the patient scheduled for an abdominoperineal resection indicates the need for further teaching?
1)"I should not have much pain in the perianal area because of severed nerves."
2)"I will have a permanent colostomy."
3)"The pain in the perianal area may be greater that the surgical incision."
4)"I will need to have a tube in my nose for a few days after the surgery."

Question 26

The nurse is preparing care for a patient recovering from surgery for colorectal cancer. Which interventions should the nurse use when creating a pain management plan for this patient? Select all that apply.
1)Provide pain medication on request
2)Assess surgical site for inflammation
3)Assess bowel sounds
4)Administer pain medication after painful procedures
5)Instruct to use a pillow to splint when deep breathing and coughing

Question 27

Which statements by the patient diagnosed with celiac disease indicate the need for further teaching? Select all that apply.
1)"I am glad this can be cured with surgery."
2)"I cannot have any gluten in my diet."
3)"I wash all my dishes with only water."
4)"I may become anemic because of this disease."
5)"I am at risk of for osteoporosis."

Question 28

The nurse is developing an educational session regarding hernias for a staff development program, and includes which data about this health problem? Select all that apply.
1)Abdominal distention is a common clinical manifestation.
2)Femoral hernias are more common in males than females.
3)Inguinal hernias occur only in males
4)Previous abdominal surgery increases the risk of ventral hernias.
5)Umbilical hernias occur more often in females than males.

Question 29

The nurse monitors for which clinical manifestations of ulcerative colitis in the patient admitted for the treatment of irritable bowel disease (IBD)? Select all that apply.
1)Fistulas
2)Weight loss
3)Hemorrhage
4)Intermittent fever
5)Frequent, liquid stools

Question 30

The nurse monitors for which clinical manifestations in the patient diagnosed with ulcerative colitis? Select all that apply.
1)Frequent, watery stools with mucus
2)Fistulas commonly develop
3)Nutritional deficiencies
4)Five to six loose stools per day
5)Hemorrhage