Deck 29: Care of Patients with Disorders of the Lower Gastrointestinal System

Question 1

The nurse is caring for an older adult patient diagnosed with diverticulitis.Which medication is the best choice to manage the patient's pain?

A) Meperidine (Demerol)
B) Morphine
C) Nalbuphine hydrochloride (Nubain)
D) Naloxone (Narcan)

Answer 1

Morphine

Question 2

The nurse is educating a patient with diverticulitis.Which statement indicates that the nurse's teaching about the importance of seeking treatment has been successful?

A) "If left untreated, the inflamed bowel could spread to the entire bowel."
B) "If left untreated, the inflamed bowel could cause ulcers."
C) "If left untreated, the inflamed bowel can perforate and cause peritonitis."
D) "If left untreated, the inflamed bowel can cause appendicitis."

Answer 2

"If left untreated, the inflamed bowel can perforate and cause peritonitis."

Question 3

The nurse explains which advantage benefits patients with a Kock pouch ileostomy?

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

Answer 3

The patient does not have to wear a collection device.

Question 4

The nurse caring for the patient who is immediately postoperative with a new ileostomy.Which intervention is most important for the nurse to implement at this time?

A) Change the ostomy pouch frequently.
B) Provide emotional support.
C) Administer a stool softener.
D) Offer the patient frequent snacks.

Question 5

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

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."

Question 6

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." Which response is most appropriate for the nurse to make?

A) "The colostomy is part of you now."
B) "Let me change the collection bag so you don't stay 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 7

The nurse explains that a hernioplasty is a surgery that involves which process?

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.

Question 8

The nurse is educating a patient with inflammatory bowel disease (IBD)about recommended nutritional choices.Which statement indicates that the nurse's teaching has been successful?

A) "I should try to eat foods like white rice and lean poultry."
B) "I should avoid red meats and eat large amounts of whole grains."
C) "I should eat food that is mushy in consistency."
D) "I should increase my intake of green leafy vegetables."

Question 9

Which type of hernia can lead to necrosis?

A) Strangulated hernia
B) Indirect hernia
C) Direct hernia
D) Irreducible hernia

Question 10

The nurse is aware that the person with ulcerative colitis is a risk factor for developing which disorder?

A) Colon cancer
B) Chronic urinary infections
C) Intussusception
D) Volvulus

Question 11

The nurse is aware that an unresolved intestinal obstruction can lead to which complications?

A) Systemic infection and fever
B) Intestinal rupture and shock
C) Adhesions and pain
D) Bloating and expelling gas

Question 12

The nurse is caring for patient with a history of a chronic incarcerated hernia.The patient suddenly complains of abdominal pain and vomits dark material with a fecal odor.The nurse recognizes these signs as indications of which complication?

A) Complete intestinal obstruction
B) Rupture
C) Gastroenteritis
D) Duodenal ulcer

Question 13

The nurse caring for a patient admitted with peritonitis who has developed a paralytic ileus.While auscultating bowel sounds,the nurse assesses flatus.What is the significance of this finding?

A) Gas has formed in bowel contents.
B) Flatus results from forceful vomiting.
C) Flatus indicates returning peristalsis.
D) Flatus indicates inadequate decompression.

Question 14

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

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 15

The nurse is teaching a group of patients about the process of a mechanical bowel obstruction.Which example should the nurse include in the teaching?

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 16

The nurse is caring for a patient with a 4-day-old ileostomy.The patient complains of cramping,the nurse notes a drop in the effluent for the ileostomy,and the bowel sounds are rapid with a "tinkling" sound.What action should the nurse take?

A) Ambulate the patient to help expel gas.
B) Irrigate the ileostomy with 500 mL of warm water.
C) Notify the charge nurse immediately.
D) Turn the patient on the left side to help drain the ileostomy.

Question 17

The nurse is caring for a patient whose home medications include bismuth subsalicylate (Pepto Bismol).The nurse should educate the patient about which side effect of this medication?

A) Pink urine
B) Sunburn-like rash
C) Stained teeth
D) Black stools

Question 18

The nurse is caring for a patient 1-day postoperative after a transverse colostomy.When assessing the stoma,which finding requires the nurse's immediate action?

A) A wet, glistening stoma
B) A stoma with scant marginal bleeding
C) An edematous stoma
D) A purplish-red stoma

Question 19

Which age-related change predisposes older adult patients to diverticula?

A) Loss of bowel tone reduces motility.
B) Chronic constipation increases intra-abdominal pressure and allows herniation.
C) The diet may be deficient in bulk.
D) Multipharmacy has altered bowel mucosa.

Question 20

The nurse is educating a group of patients about high-fiber dietary selections.Which patient menu selection indicates that the nurse's teaching has been successful?

A) Turkey sandwich on whole wheat toast, pears, and tea
B) Grilled chicken, corn, and water
C) Cheese pizza, salad, and milk
D) Bacon, lettuce, and tomato sandwich on sourdough, blackberry compote, and orange juice

Question 21

Which contributing factor(s)may lead to hernia development?

A) Heavy lifting
B) Chronic cough
C) Straining with defecation
D) Ascites
E) Strenuous sexual activity

Question 22

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 23

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 24

The nurse is teaching a patient about peristomal skin care.Which information is most important for the nurse to include?

A) Gently remove the faceplate of the appliance to avoid skin irritation.
B) Washing the peristomal area with a scrubbing motion to rid the skin of fecal waste.
C) Thoroughly rinse the skin.
D) Apply a skin barrier to the peristomal area.
E) Cut the faceplate to allow a -inch opening around the stoma.

Question 25

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 26

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

Question 27

The nursing is planning care for a patient with an acute exacerbation of inflammatory bowel disease (IBD).Which action(s)is/are most important for the nurse to include in the care plan?

A) Assess number and character of stools.
B) Auscultate bowel sounds.
C) Obtain weights each shift.
D) Encouraging periods of rest.
E) Assess for internal bleeding.

Question 28

The nurse preparing a teaching plan for a 20-year-old woman who is taking sulfasalazine (Azulfidine)for Crohn disease.Which information should the nurse include in the teaching plan?

A) Avoid tanning beds or going outside during peak hours of sun while taking sulfasalazine (Azulfidine).
B) If taking sulfasalazine (Azulfidine) while on oral contraceptives, use a backup method of birth control.
C) Sulfasalazine (Azulfidine) decreases the effect of hypoglycemic agents.
D) Be aware that sulfasalazine (Azulfidine) may turn the urine orange.
E) Be aware that sulfasalazine (Azulfidine) may cause gastrointestinal (GI) upset.

Question 29

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 30

Which foods or beverages may trigger an attack of irritable bowel syndromes (IBS)?

A) Coffee
B) Yogurt
C) Whole wheat bread
D) White rice
E) Orange juice

Question 31

The presence of which diagnostic criteria are used to confirm the diagnosis of irritable bowel syndrome (IBS)?

A) Abdominal pain that increases with defecation
B) Abdominal pain with a change in stool consistency
C) Mucorrhea
D) Clay colored stools that float
E) Bloating

Question 32

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 33

Conservative treatment of diverticulosis includes which management?

A) Eating a low-fiber diet
B) Increasing fluid intake
C) Taking stool softeners
D) Taking nonsteroidal anti-inflammatory drugs (NSAIDs) for discomfort
E) Taking bulk laxatives