Deck 30: Care of Patients With Disorders of the Lower Gastrointestinal System

Question 1

Instruction to a patient who self-medicates with bismuth subsalicylate (Pepto Bismol)tablets should include that the tablets:

A)may cause aspirin toxicity.
B)should be swallowed whole.
C)may stain teeth.
D)will cause the stool to be black.

Answer 1

may cause aspirin toxicity.

Question 2

The nurse explains that a hernioplasty involves:

A)reducing the hernia by manual pressure.
B)sewing synthetic mesh over the abdominal wall defect to reduce the hernia.
C)applying an individualized truss for the reduction of the hernia.
D)reducing the hernia and suturing the defect in the abdominal wall.

Answer 2

sewing synthetic mesh over the abdominal wall defect to reduce the hernia.

Question 3

The nurse is caring for a patient who has been diagnosed with Crohn's disease.When providing education concerning dietary recommendations,which statement by the patient indicates an understanding of the teaching?

A)"I should try to eat as much fiber daily as I can."
B)"Reducing dietary fat and fiber will be helpful in managing my condition."
C)"I should not have lactose-containing products."
D)"Eating a larger breakfast and smaller lunch and dinner portions is recommended."

Answer 3

"Reducing dietary fat and fiber will be helpful in managing my condition."

Question 4

The nurse is caring for a patient diagnosed with diverticulitis.In response to the patient's complaints of pain,the most likely medication to be used is:

A)meperidine (Demerol).
B)morphine.
C)nalbuphine hydrochloride (Nubain).
D)naloxone (Narcan).

Question 5

The nurse is discussing high-fiber dietary selections with a patient.Later,the patient makes his menu selection.When reviewing the patient's selections,what is most reflective of understanding the teaching provided?

A)Turkey sandwich on whole wheat toast, pears, and water
B)Fried chicken, corn, and diet soda
C)Cheese pizza, salad, and cola
D)Bacon, lettuce, and tomato sandwich, blackberry compote, and orange juice

Question 6

The patient who has had an incarcerated hernia for many years begins to experience abdominal pain and vomit dark material with a fecal odor.The nurse recognizes these signs as indications of:

A)intestinal obstruction.
B)ruptured bowel.
C)gastroenteritis.
D)duodenal ulcer.

Question 7

The nurse explains to the patient receiving bevacizumab (Avastin)for a tumor in the colon that the drug slows cancer cell growth by the process of:

A)changing the pH of the cell environment.
B)reducing blood flow to the tumor.
C)overhydrating cells of the tumor, causing them to burst.
D)interfering with DNA of tumor cells.

Question 8

The nurse caring for a patient who has peritonitis and has developed a paralytic ileus assesses that the patient is passing gas.The assessment is an indication of:

A)gas forming in bowel contents.
B)the result of forceful vomiting.
C)returned peristalsis.
D)inadequate decompression.

Question 9

The nurse urges the patient with diverticulitis to seek treatment because the inflamed bowel wall may:

A)extend the inflammation to the entire bowel.
B)progress into ulcerative colitis.
C)perforate and cause peritonitis.
D)cause appendicitis.

Question 10

The patient with an incarcerated hernia is at risk for the hernia to become:

A)strangulated.
B)indirect.
C)direct.
D)irreducible.

Question 11

A 36-year-old woman who had an ascending colostomy angrily declares,"I don't want this hateful thing on my body! This nasty thing is not me." The nurse's most therapeutic response would be:

A)"The colostomy is part of you now."
B)"Let me change the collection bag so you won't feel so nasty."
C)"All ostomates feel this way at first. I'll go get a list of support groups you may want to join."
D)"What about this colostomy concerns you the most?"

Question 12

The nurse explains that diverticula occur in the older adult because:

A)loss of bowel tone reduces motility.
B)changes in bowel wall allow herniation.
C)the diet may be deficient in bulk.
D)multipharmacy has altered bowel mucosa.

Question 13

The nurse explains that the most beneficial diet for a person with inflammatory bowel disease (IBD)is a _____ diet.

A)low-fat, low-fiber.
B)high-fiber, low-protein.
C)mechanical soft, low-sodium.
D)low-protein, low-calorie.

Question 14

The nurse explains that the advantage of the Kock pouch ileostomy is that the patient:

A)can expel feces from the rectum in the normal fashion.
B)does not have to wear a collection device.
C)only has to evacuate the pouch once a day.
D)can have the pouch reanastomosed to the colon at a later time.

Question 15

The nurse assessing the stoma of a patient 1 day after a transverse colostomy will immediately report the finding of a(n):

A)wet, glistening stoma.
B)stoma with slight bleeding around the margin.
C)edematous stoma.
D)purplish-red stoma.

Question 16

The nurse uses a visual aid to demonstrate the process of a mechanical bowel obstruction that occurs when:

A)a tumor obstructs the lumen of the bowel.
B)a paralytic ileus causes cessation of peristalsis.
C)the bowel is inflamed by diverticulitis.
D)the bowel motility is slowed by antidiarrheal drugs.

Question 17

The nurse is aware that the person with ulcerative colitis is at risk for:

A)cancer of the colon.
B)chronic urinary infections.
C)intussusception.
D)volvulus.

Question 18

The nurse is aware that an unresolved bowel obstruction can lead to:

A)systemic infection and fever.
B)bowel rupture and shock.
C)adhesions and pain.
D)bloating and expelling gas.

Question 19

The patient with a 4-day-old ileostomy complains of cramping.The nurse notes a drop in the effluent for the ileostomy.The bowel sounds are rapid with a "tinkling" sound.The nurse should:

A)ambulate the patient to help expel gas.
B)irrigate the ileostomy with 500 mL of warm water.
C)notify the charge nurse immediately of possible obstruction.
D)turn the patient on the left side to help drain the ileostomy.

Question 20

The nurse caring for the patient with an ileostomy will include special interventions to prevent skin breakdown and irritation at the stomal site because the:

A)large adhesive patch for the collection bag is irritating.
B)ileostomy stoma is very large and difficult to cover completely with the adhesive faceplate.
C)liquid stool from the ileum contains digestive enzymes that are especially harmful to the skin.
D)soft stool is difficult to remove from the skin without abrading the skin.

Question 21

Matching
Match the types of ostomies with the expected type of effluent.

Formed stool on relatively regular basis

A)Ascending colostomy
B)Transverse colostomy
C)Descending colostomy
D)Ileostomy
E)Continent ileostomy

Question 22

Matching
Match the types of ostomies with the expected type of effluent.

Liquid and unformed stool

A)Ascending colostomy
B)Transverse colostomy
C)Descending colostomy
D)Ileostomy
E)Continent ileostomy

Question 23

The mechanical bowel obstruction caused when the bowel twists on itself is _________.

Question 24

Matching
Match the types of ostomies with the expected type of effluent.

Semiliquid stool at unpredictable times

A)Ascending colostomy
B)Transverse colostomy
C)Descending colostomy
D)Ileostomy
E)Continent ileostomy

Question 25

The nursing care of a patient with an acute exacerbation of inflammatory bowel disease (IBS)will include: (Select all that apply.)

A)measuring intake and output.
B)assessing bowel sounds.
C)documenting the patient's weekly weight.
D)encouraging periods of rest.
E)assessing for internal bleeding.
F)None of the above.

Question 26

The nurse is aware that the diagnostic criteria for the confirmation of irritable bowel syndrome include: (Select all that apply.)

A)pain increased by defecation.
B)pain associated with stool frequency.
C)mucorrhea.
D)abdominal tenderness.
E)bloating.

Question 27

The nurse preparing a teaching plan for a 20-year-old woman who is taking sulfasalazine (Azulfidine)for Crohn's disease will include that this drug will: (Select all that apply.)

A)make the patient photosensitive.
B)interfere with effectiveness of oral contraceptives.
C)decrease the effect of hypoglycemic agents.
D)turn the urine orange.
E)cause GI upset.

Question 28

The nurse lists foods and beverages that may trigger an attack of irritable bowel syndromes (IBS),which include: (Select all that apply.)

A)caffeine.
B)dairy products.
C)specific food allergies.
D)wheat products.
E)alcohol.

Question 29

The nurse explains that conservative treatment of diverticulosis includes: (Select all that apply.)

A)low-fiber diet.
B)increased fluids.
C)stool softeners.
D)NSAIDs for discomfort.
E)bulk laxatives.

Question 30

The nurse's instruction to the patient for peristomal skin care should include: (Select all that apply.)

A)gently removing the faceplate of the appliance to avoid skin irritation.
B)washing the peristomal area vigorously to rid the skin of fecal waste.
C)rinsing the area thoroughly.
D)applying a skin barrier to the peristomal area.
E)cutting the faceplate to allow a 1/2-inch opening around the stoma.

Question 31

Matching
Match the types of ostomies with the expected type of effluent.

Extremely watery stool with concentrations of digestive enzymes

A)Ascending colostomy
B)Transverse colostomy
C)Descending colostomy
D)Ileostomy
E)Continent ileostomy

Question 32

Matching
Match the types of ostomies with the expected type of effluent.

No effluent

A)Ascending colostomy
B)Transverse colostomy
C)Descending colostomy
D)Ileostomy
E)Continent ileostomy

Question 33

The nurse lists the contributing factors to developing a hernia,which include: (Select all that apply.)

A)heavy lifting.
B)chronic cough.
C)straining with defecation.
D)ascites.
E)strenuous sexual activity.