Deck 30: Common Disorders of the Large Intestine

Question 1

The nurse is providing care for a client with a recent spinal cord injury resulting in paralysis from the midthoracic region downward. The client is unable to initiate or control bowel function, but states to the nurse, "I am going to get bowel training later." Which factor does the nurse consider in response to the client?
1)Ability to control the sphincter muscles may return
2)Strong abdominal muscles can replace peristalsis
3)Bowel stimulants will aid in self-management
4)Neural control of the large intestine is likely lost

Answer 1

4

Question 2

The nurse is providing care for an older adult client who presents with abdominal cramping, abdominal distention, and the inability to have a bowel movement. An abdominal x-ray reveals a distended colon, with loops of dilated bowel superior to an obstruction. Which treatment does the nurse expect to be prescribed?
1)Placement of a nasogastric tube
2)Laxatives to stimulate peristalsis
3)Pureed, bland diet as tolerated
4)Enemas until return is clear

Answer 2

1

Question 3

The nurse is reviewing with a group of staff nurses the use of antibiotics in a client diagnosed with appendicitis. Which statement made by a nurse indicates understanding?
1)"Antibiotics are administered before an operation and continued until 48 hours after the operation."
2)"Antibiotics are not administered before diagnosis, as they interfere with the diagnostic signs."
3)"Antibiotics are to be administered after restoring the fluid and electrolyte balance."
4)"Antibiotics are used when there is no need for surgical removal of the appendix."

Answer 3

1

Question 4

For a client diagnosed with terminal ileal disease, the health-care provider prescribes sulfasalazine. Which outcome in the client indicates the effectiveness of the therapy?
1)The client's gastrointestinal wall is normalized.
2)The client's hematocrit percentage is normal.
3)The client is able to absorb bile acids.
4)The client's urinalysis results show normal values.

Question 5

The nurse reviews the colonoscopy report on a client. The nurse concludes that which disorder is diagnosed by the presence of a "cobblestoning" appearance?
1)Volvulus
2)Appendicitis
3)Crohn's disease
4)Ulcerative colitis

Question 6

Upon physical examination, the nurse detects abdominal tenderness, increased bowel sounds accompanied by signs of borborygmi, abdominal distension, and tympany on percussion. Which diagnostic test distinguishes Crohn's disease from ulcerative colitis in the client?
1)Colonoscopy
2)Urinalysis
3)Complete blood count
4)Chest x-ray

Question 7

The nurse is preparing information for a client newly diagnosed with ulcerative colitis. Which information is more likely associated with Crohn's disease than with ulcerative colitis?
1)Only the large intestine is affected.
2)The patient is prone to anal fistula and fissure formation.
3)It predisposes the client to colon cancer.
4)The disease affects only the mucosa and submucosa layers.

Question 8

The nurse is reviewing the treatment plan for Crohn's disease with staff nurses. Which statement made by a nurse indicates understanding?
1)"Cholestyramine is prescribed to clients with ileal disease."
2)"Loperamide is administered in clients to reduce abdominal cramps."
3)"Propantheline dicyclomine is administered to relieve chronic diarrhea."
4)"Multivitamin supplements are contraindicated in clients with decreased absorption."

Question 9

Which part of the gastrointestinal (GI) tract is involved in the production of protective mucus?
1)Goblet cells
2)Submucosal layer
3)Circular muscle layer
4)Columnar epithelial cells

Question 10

The staff nurses are reviewing precautions to be taken while caring for a client with suspected need of surgery for appendicitis. Which statement made by a nurse indicates understanding?
1)"The client will not require IV fluids."
2)"The client will not be prescribed ampicillin."
3)"The client is given a laxative before surgery."
4)"The client is not given prediagnosis pain medications."

Question 11

A health-care provider suspects the presence of hemorrhoids in a client. Which diagnostic test does the health-care provider prescribe to support the suspected diagnosis?
1)Biopsy
2)Chest x-ray
3)Colonoscopy
4)Sigmoidoscopy

Question 12

Which diagnostic test does the health-care provider order to get the most accurate information related to appendicitis?
1)Urinalysis
2)Abdominal x-ray
3)Abdominal ultrasound
4)Computerized tomography scan

Question 13

Which is a characteristic feature of ulcerative colitis?
1)Presence of cobblestone appearance
2)Continuous areas of inflammation in the large intestine
3)Healthy tissues interrupted by areas of diseased tissue
4)Presence of anal fissure and anal fistula formations

Question 14

The nurse is providing care for a client in the emergency room with an initial presence of pain in the abdomen. Assessment elicits the presence of rebound pain at McBurney's point, an ultrasound is positive for an inflamed appendix, and white blood cells (WBCs) are moderately elevated. Which prescription does the nurse anticipate from the health-care provider?
1)Initiate nothing by mouth (NPO) status and start an IV infusion
2)Medicate the client with opioids for pain above a level 5
3)Administer oral antibiotics and explain continued use at home
4)Present information regarding the risk for developing peritonitis

Question 15

The nurse teaches a group of staff nurses about the diagnosis of irritable bowel syndrome. After the teaching session, an attending nurse is asked to determine the presence of lactose intolerance in a client with irritable bowel syndrome. Which intervention by the nurse indicates effective learning?
1)The nurse performs a complete blood analysis of the client.
2)The nurse performs a hydrogen breath test on the client.
3)The nurse performs a blood draw for culture and sensitivity.
4)The nurse performs testing on a stool sample for occult blood.

Question 16

Which is the largest serous membrane in the body?
1)Peritoneal serosa
2)Submucosal layer
3)Columnar epithelium
4)Circular muscle layer

Question 17

Which side effect does the nurse expect to observe in a client who is on epinephrine therapy?
1)Gastrocolic reflex
2)Injuries to the gastric epithelium
3)Suppression of the urge to defecate
4)Decreased gastrointestinal secretions

Question 18

A female client is admitted to the hospital with abdominal pain that originates in the umbilical region and radiates to the right lower quadrant. The health-care provider prescribes a urinalysis. In which manner does this help the health-care provider diagnose the client's condition?
1)Rules out the possibility of calcium stones within the appendix
2)Rules out the possibility of a kidney stone or pyelonephritis
3)Rules out the possibility of ectopic pregnancy
4)Rules out the possibility of a gynecological disorder

Question 19

In a client diagnosed with large bowel obstruction, an abdominal x-ray is performed, which shows the presence of free air under the diaphragm. After the diagnosis, the nurse initiates prophylactic antibiotic therapy and fluid replacement therapy per the prescriptions of the health-care provider. Which outcome in the client indicates the effectiveness of the therapy?
1)The client has normal levels of serum amylase.
2)The client has a normal count of red blood cells.
3)The client no longer experiences abdominal cramps.
4)The client no longer experiences chronic diarrhea.

Question 20

The nurse educator is teaching a group of staff nurses about the importance of inserting a nasogastric tube in clients with large bowel obstruction. Which statement made by an attending nurse indicates effective learning?
1)"A nasogastric tube relieves pressure caused by bowel obstruction."
2)"A nasogastric tube is primarily used to deliver medications directly to the client's stomach."
3)"A nasogastric tube removes free air present under the client's diaphragm."
4)"A nasogastric tube removes the mechanical obstruction in the large intestine."

Question 21

Which disorder of the large intestine may require laparoscopic surgery to unwind the intestine?
1)Volvulus
2)Appendicitis
3)Hemorrhoids
4)Diverticular disease

Question 22

Prioritize the order of performing the physical examination of the abdomen in a client with bowel disorder. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) Inspection
2) Palpation
3) Percussion
4) Auscultation

Question 23

Which conditions show an elevated level of white blood cells? Select all that apply.
1)Appendicitis
2)Constipation
3)Diverticular disease
4)Large bowel obstruction
5)Irritable bowel syndrome

Question 24

The nursing instructor is discussing the physical assessment findings for hemorrhoids. Which statement made by the student nurse indicates effective learning?
1)"Presence of anal fistulas is observed."
2)"Presence of blood in stools may be observed."
3)"McBurney's point indicates tenderness."
4)"Auscultation indicates high-pitched bowel sounds."

Question 25

The health-care provider asks a client to lie down facing upwards and flex the right thigh at the hip. The client says, "I cannot do this. This position is hurting my abdomen." Which sign of appendicitis does the nurse recognize in this client?
1)Psoas sign
2)Rovsing sign
3)Obturator sign
4)Rebound tenderness