Chapter 42: Lower Gastrointestinal Problems

MULTIPLE CHOICE

1. Question: Which action will the nurse include in the plan of care for a 42-year-old patient who is being admitted with Clostridium difficile?
2. Question: A 71-year-old male patient tells the nurse that growing old causes constipation so he has been using a suppository for constipation every morning. Which action should the nurse take first?
3. Question: A 64-year-old woman who has chronic constipation asks the nurse about the use of psyllium (Metamucil). Which information will the nurse include in the response?
4. Question: A 26-year-old woman is being evaluated for vomiting and abdominal pain. Which question from the nurse will be most useful in determining the cause of the patients symptoms?
5. Question: A patient complains of gas pains and abdominal distention two days after a small bowel resection. Which nursing action is best to take?
6. Question: A 58-year-old man with blunt abdominal trauma from a motor vehicle crash undergoes peritoneal lavage. If the lavage returns brown fecal drainage, which action will the nurse plan to take next?
7. Question: A 27-year-old female patient is admitted to the hospital for evaluation of right lower quadrant abdominal pain with nausea and vomiting. Which action should the nurse take?
8. Question: Which nursing action will be included in the plan of care for a 27-year-old male patient with bowel irregularity and a new diagnosis of irritable bowel syndrome (IBS)?
9. Question: A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to
10. Question: Which nursing action will the nurse include in the plan of care for a 35-year-old male patient admitted with an exacerbation of inflammatory bowel disease (IBD)?
11. Question: Which patient statement indicates that the nurses teaching about sulfasalazine (Azulfidine) for ulcerative colitis has been effective?
12. Question: A 22-year-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective?
13. Question: Which diet choice by the patient with an acute exacerbation of inflammatory bowel disease (IBD) indicates a need for more teaching?
14. Question: After a total proctocolectomy and permanent ileostomy, the patient tells the nurse, I cannot manage all these changes. I dont want to look at the stoma. What is the best action by the nurse?
15. Question: A 51-year-old male patient has a new diagnosis of Crohns disease after having frequent diarrhea and a weight loss of 10 pounds (4.5 kg) over 2 months. The nurse will plan to teach about
16. Question: A 24-year-old woman with Crohns disease develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. What information will the nurse add to a general teaching plan about UTIs in order to individualize the teaching for this patient?
17. Question: A 73-year-old patient with diverticulosis has a large bowel obstruction. The nurse will monitor for
18. Question: The nurse preparing for the annual physical exam of a 50-year-old man will plan to teach the patient about
19. Question: The nurse is providing preoperative teaching for a 61-year-old man scheduled for an abdominal-perineal resection. Which information will the nurse include?
20. Question: A 74-year-old patient preparing to undergo a colon resection for cancer of the colon asks about the elevated carcinoembryonic antigen (CEA) test result. The nurse explains that the test is used to
21. Question: A 71-year-old patient had an abdominal-perineal resection for colon cancer. Which nursing action is most important to include in the plan of care for the day after surgery?
22. Question: A 47-year-old female patient is transferred from the recovery room to a surgical unit after a transverse colostomy. The nurse observes the stoma to be deep pink with edema and a small amount of sanguineous drainage. The nurse should
23. Question: Which information will the nurse include in teaching a patient who had a proctocolectomy and ileostomy for ulcerative colitis?
24. Question: The nurse will determine that teaching a 67-year-old man to irrigate his new colostomy has been effective if the patient
25. Question: A 34-year-old female patient with a new ileostomy asks how much drainage to expect. The nurse explains that after the bowel adjusts to the ileostomy, the usual drainage will be about cups.
26. Question: The nurse admitting a patient with acute diverticulitis explains that the initial plan of care is to
27. Question: A 42-year-old male patient has had a herniorrhaphy to repair an incarcerated inguinal hernia. Which patient teaching will the nurse provide before discharge?
28. Question: Which breakfast choice indicates a patients good understanding of information about a diet for celiac disease?
29. Question: A 62-year-old patient has had a hemorrhoidectomy at an outpatient surgical center. Which instructions will the nurse include in discharge teaching?
30. Question: A 50-year-old female patient calls the clinic to report a new onset of severe diarrhea. The nurse anticipates that the patient will need to
31. Question: The nurse will plan to teach a patient with Crohns disease who has megaloblastic anemia about the need for
32. Question: The nurse is assessing a 31-year-old female patient with abdominal pain. Th nurse,who notes that there is ecchymosis around the area of umbilicus, will document this finding as
33. Question: A 54-year-old critically ill patient with sepsis is frequently incontinent of watery stools. What action by the nurse will prevent complications associated with ongoing incontinence?
34. Question: Which question from the nurse would help determine if a patients abdominal pain might indicate irritable bowel syndrome?
35. Question: A patient in the emergency department has just been diagnosed with peritonitis caused by a ruptured diverticulum. Which prescribed intervention will the nurse implement first?
36. Question: A 25-year-old male patient calls the clinic complaining of diarrhea for 24 hours. Which action should the nurse take first?
37. Question: A 45-year-old patient is admitted to the emergency department with severe abdominal pain and rebound tenderness. Vital signs include temperature 102 F (38.3 C), pulse 120, respirations 32, and blood pressure (BP) 82/54. Which prescribed intervention should the nurse implement first?
38. Question: Four hours after a bowel resection, a 74-year-old male patient with a nasogastric tube to suction complains of nausea and abdominal distention. The first action by the nurse should be to
39. Question: A 19-year-old female is brought to the emergency department with a knife handle protruding from the abdomen. During the initial assessment of the patient, the nurse should
40. Question: Which activity in the care of a 48-year-old female patient with a new colostomy could the nurse delegate to unlicensed assistive personnel (UAP)?
41. Question: Which information obtained by the nurse interviewing a 30-year-old male patient is most important to communicate to the health care provider?
42. Question: Which care activity for a patient with a paralytic ileus is appropriate for the registered nurse (RN) to delegate to unlicensed assistive personnel (UAP)?
43. Question: After several days of antibiotic therapy, an older hospitalized patient develops watery diarrhea. Which action should the nurse take first?
44. Question: Which patient should the nurse assess first after receiving change-of-shift report?
45. Question: A 51-year-old woman with Crohns disease who is taking infliximab (Remicade) calls the nurse in the outpatient clinic about new symptoms. Which symptom is most important to communicate to the health care provider?
46. Question: A 33-year-old male patient with a gunshot wound to the abdomen undergoes surgery, and a colostomy is formed as shown in the accompanying figure. Which information will be included in patient teaching?
47. Question: A 76-year-old patient with obstipation has a fecal impaction and is incontinent of liquid stool. Which action should the nurse take first?
48. Question: A female patient is awaiting surgery for acute peritonitis. Which action will the nurse include in the plan of care?
49. Question: A 72-year-old male patient with dehydration caused by an exacerbation of ulcerative colitis is receiving 5% dextrose in normal saline at 125 mL/hour. Which assessment finding by the nurse is most important to report to the health care provider?
50. Question: A new 19-year-old male patient has familial adenomatous polyposis (FAP). Which action will the nurse in the gastrointestinal clinic include in the plan of care?
51. Question: Which menu choice by the patient with diverticulosis is best for preventing diverticulitis?
52. Question: After change-of-shift report, which patient should the nurse assess first?
53. Question: The nurse is admitting a 67-year-old patient with new-onset steatorrhea. Which question is most important for the nurse to ask?
54. Question: Which information will the nurse teach a 23-year-old patient with lactose intolerance?
55. Question: Which prescribed intervention for a 61-year-old female patient with chronic short bowel syndrome will the nurse question?