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Test Bank for Chapter 48: Intestinal Problems -
Medical-Surgical Nursing, 10th Edition by
Ignatavicius, Workman, Rebar & Heimgartner
A nurse is caring for a patient who has been admitted to the hospital
with diverticulitis. Which of the following would be appropriate nursing
diagnoses for this patient? Select all that apply.
a) Activity Intolerance Related to Generalized Weakness
b) Impaired Urinary Elimination Related to GI Pressure on the Bladder
c) Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea
d) Acute Pain Related to Increased Peristalsis and GI Inflammation
e) Bowel Incontinence Related to Increased Intestinal Peristalsis -
ANSWER-A, C, D
Explanation:
Patients with diverticulitis are likely to experience pain and decreased
activity levels, and are at risk of fluid volume deficit. The patient is
unlikely to experience fecal incontinence and urinary function is not
directly influenced. (less)
Mrs. Henry has been diagnosed with cancer in the descending colon.
Which of the following symptoms would you expect her to report when
obtaining a history? Select all that apply.
a) Constipation
b) Black, tarry stools
c) Tenesmus
d) Narrowing of stools - ANSWER-• Narrowing of stools
• Constipation
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Correct
Explanation:
Abdominal pain and cramping, narrowing of stools, constipation,
abdominal distension, and bright red blood in stools are symptoms
associated with a left-sided lesion. Black, tarry stools and tenesmus are
symptoms associated with a right-sided lesion. (less)
The nurse caring for a patient with diverticulitis is preparing to
administer the patient's medications. The nurse anticipates
administration of which category of medications due to the patient's
diverticulitis?
a) Antispasmodic
b) Antianxiety
c) Anti-inflammatory
d) Antiemetic - ANSWER-Antispasmodic
Explanation:
The nurse anticipates administration of antispasmodic medication to
decrease intestinal spasm associated with diverticulitis. The patient may
also be ordered an opioid analgesic to relieve the associated pain. There
is no indication that the patient needs antianxiety, antiemetic, or anti-
inflammatory medications at this time. (less)
A client has a 10-year history of Crohn's disease and is seeing the
physician in the GI group where you practice nursing due to increased
diarrhea and fatigue. What is the recommended dietary approach to treat
Crohn's disease?
a) Dietary approach varies.
b) Lactose-rich foods
c) Low-fiber diet
d) High-fiber diet - ANSWER-A
Explanation:
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The dietary approach varies. A high-fiber diet may be indicated when it
is desirable to add bulk to loose stools. A low-fiber diet may be
indicated in cases of severe inflammation or stricture. A high-calorie and
high-protein diet helps replace nutritional losses from chronic diarrhea.
The client may need nutritional supplements, depending on the area of
the bowel affected. When the small intestine is inflamed, some clients
experience lactose intolerance, requiring avoidance of lactose-rich foods.
When the small intestine is inflamed, some clients experience lactose
intolerance, requiring avoidance of lactose-rich foods. (less)
What is the primary nursing diagnosis for a client with a bowel
obstruction?
a) Deficient fluid volume
b) Deficient knowledge
c) Acute pain
d) Ineffective tissue perfusion - ANSWER-Deficient fluid volume
Explanation:
Feces, fluid, and gas accumulate above a bowel obstruction. Then the
absorption of fluids decreases and gastric secretions increase. This
process leads to a loss of fluids and electrolytes in circulation. Therefore,
Deficient fluid volume is the primary diagnosis. Deficient knowledge,
Acute pain, and Ineffective tissue perfusion are applicable but not the
primary nursing diagnosis. (less)
Barbara Allen, a 69-year-old retired cab driver, is undergoing diagnostic
testing in the hospital where you practice nursing. She has been
experiencing lower GI difficulties that have increased in severity, and
her gastroenterologist is concerned that her bowel is not functioning
properly. What function of the lower GI tract is most likely to be
affected by her disorder?
a) Fat digestion
b) Protein digestion
c) Water and electrolyte absorption
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d) All options are correct. - ANSWER-Water and electrolyte absorption
Correct
Explanation:
Disorders of the lower GI tract usually affect movement of feces toward
the anus, absorption of water and electrolytes, and elimination of dietary
wastes. Water and electrolyte absorption would most likely be affected.
(less)
A nurse caring for a client with small-bowel obstruction should plan to
implement which nursing intervention first?
a) Preparing to insert a nasogastric (NG) tube
b) Obtaining a blood sample for laboratory studies
c) Administering I.V. fluids
d) Administering pain medication - ANSWER-Administering I.V.
fluids
Explanation:
The nurse should first administer I.V. infusions containing normal saline
solution and potassium to maintain fluid and electrolyte balance. For the
client's comfort and to assist in bowel decompression, the nurse should
prepare to insert an NG tube next. A blood sample is then obtained for
laboratory studies to help diagnose bowel obstruction and guide
treatment. Blood studies usually include a complete blood count, serum
electrolyte levels, and blood urea nitrogen level. Pain medication
commonly is withheld until obstruction is diagnosed because analgesics
can decrease intestinal motility. (less)
After teaching a group of students about intestinal obstruction, the
instructor determines that the teaching was effective when the students
identify which of the following as a cause of a functional obstruction?
a) Tumor
b) Abdominal surgery
c) Volvulus
d) Intussusception - ANSWER-Abdominal surgery
Test Bank for Chapter 48: Intestinal Problems -
Medical-Surgical Nursing, 10th Edition by
Ignatavicius, Workman, Rebar & Heimgartner
A nurse is caring for a patient who has been admitted to the hospital
with diverticulitis. Which of the following would be appropriate nursing
diagnoses for this patient? Select all that apply.
a) Activity Intolerance Related to Generalized Weakness
b) Impaired Urinary Elimination Related to GI Pressure on the Bladder
c) Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea
d) Acute Pain Related to Increased Peristalsis and GI Inflammation
e) Bowel Incontinence Related to Increased Intestinal Peristalsis -
ANSWER-A, C, D
Explanation:
Patients with diverticulitis are likely to experience pain and decreased
activity levels, and are at risk of fluid volume deficit. The patient is
unlikely to experience fecal incontinence and urinary function is not
directly influenced. (less)
Mrs. Henry has been diagnosed with cancer in the descending colon.
Which of the following symptoms would you expect her to report when
obtaining a history? Select all that apply.
a) Constipation
b) Black, tarry stools
c) Tenesmus
d) Narrowing of stools - ANSWER-• Narrowing of stools
• Constipation
,2|Page
Correct
Explanation:
Abdominal pain and cramping, narrowing of stools, constipation,
abdominal distension, and bright red blood in stools are symptoms
associated with a left-sided lesion. Black, tarry stools and tenesmus are
symptoms associated with a right-sided lesion. (less)
The nurse caring for a patient with diverticulitis is preparing to
administer the patient's medications. The nurse anticipates
administration of which category of medications due to the patient's
diverticulitis?
a) Antispasmodic
b) Antianxiety
c) Anti-inflammatory
d) Antiemetic - ANSWER-Antispasmodic
Explanation:
The nurse anticipates administration of antispasmodic medication to
decrease intestinal spasm associated with diverticulitis. The patient may
also be ordered an opioid analgesic to relieve the associated pain. There
is no indication that the patient needs antianxiety, antiemetic, or anti-
inflammatory medications at this time. (less)
A client has a 10-year history of Crohn's disease and is seeing the
physician in the GI group where you practice nursing due to increased
diarrhea and fatigue. What is the recommended dietary approach to treat
Crohn's disease?
a) Dietary approach varies.
b) Lactose-rich foods
c) Low-fiber diet
d) High-fiber diet - ANSWER-A
Explanation:
,3|Page
The dietary approach varies. A high-fiber diet may be indicated when it
is desirable to add bulk to loose stools. A low-fiber diet may be
indicated in cases of severe inflammation or stricture. A high-calorie and
high-protein diet helps replace nutritional losses from chronic diarrhea.
The client may need nutritional supplements, depending on the area of
the bowel affected. When the small intestine is inflamed, some clients
experience lactose intolerance, requiring avoidance of lactose-rich foods.
When the small intestine is inflamed, some clients experience lactose
intolerance, requiring avoidance of lactose-rich foods. (less)
What is the primary nursing diagnosis for a client with a bowel
obstruction?
a) Deficient fluid volume
b) Deficient knowledge
c) Acute pain
d) Ineffective tissue perfusion - ANSWER-Deficient fluid volume
Explanation:
Feces, fluid, and gas accumulate above a bowel obstruction. Then the
absorption of fluids decreases and gastric secretions increase. This
process leads to a loss of fluids and electrolytes in circulation. Therefore,
Deficient fluid volume is the primary diagnosis. Deficient knowledge,
Acute pain, and Ineffective tissue perfusion are applicable but not the
primary nursing diagnosis. (less)
Barbara Allen, a 69-year-old retired cab driver, is undergoing diagnostic
testing in the hospital where you practice nursing. She has been
experiencing lower GI difficulties that have increased in severity, and
her gastroenterologist is concerned that her bowel is not functioning
properly. What function of the lower GI tract is most likely to be
affected by her disorder?
a) Fat digestion
b) Protein digestion
c) Water and electrolyte absorption
, 4|Page
d) All options are correct. - ANSWER-Water and electrolyte absorption
Correct
Explanation:
Disorders of the lower GI tract usually affect movement of feces toward
the anus, absorption of water and electrolytes, and elimination of dietary
wastes. Water and electrolyte absorption would most likely be affected.
(less)
A nurse caring for a client with small-bowel obstruction should plan to
implement which nursing intervention first?
a) Preparing to insert a nasogastric (NG) tube
b) Obtaining a blood sample for laboratory studies
c) Administering I.V. fluids
d) Administering pain medication - ANSWER-Administering I.V.
fluids
Explanation:
The nurse should first administer I.V. infusions containing normal saline
solution and potassium to maintain fluid and electrolyte balance. For the
client's comfort and to assist in bowel decompression, the nurse should
prepare to insert an NG tube next. A blood sample is then obtained for
laboratory studies to help diagnose bowel obstruction and guide
treatment. Blood studies usually include a complete blood count, serum
electrolyte levels, and blood urea nitrogen level. Pain medication
commonly is withheld until obstruction is diagnosed because analgesics
can decrease intestinal motility. (less)
After teaching a group of students about intestinal obstruction, the
instructor determines that the teaching was effective when the students
identify which of the following as a cause of a functional obstruction?
a) Tumor
b) Abdominal surgery
c) Volvulus
d) Intussusception - ANSWER-Abdominal surgery
