IBD EXAM
A colectomy is scheduled for a 38-year-old woman with ulcerative colitis. The nurse
should plan to include what prescribed measure in the preoperative preparation of this
patient?
Instruction on irrigating a colostomy
Administration of a cleansing enema
A high-fiber diet the day before surgery
Administration of intravenous (IV) antibiotics for bowel preparation - answerB
The nurse has provided teaching to a patient who has diverticular disease but is not
experiencing an acute episode at this time. Which statement by the patient reflects an
adequate understanding of the teaching?
"I will eat a diet that is low in fiber."
"I will avoid eating nuts and seeds."
"I will decrease my intake of fat and red meat."
"I will continue to work out by lifting weights." - answerc
A high-fiber diet, mainly from fruits and vegetables, and decreased intake of fat and red
meat are recommended for preventing diverticular disease. High levels of physical
activity also seem to decrease the risk. A high-fiber diet also is recommended once
diverticular disease is present. Currently there is no evidence to support the theory that
diverticulitis can be prevented by avoiding nuts and seeds. A patient with diverticular
disease should avoid increased intraabdominal pressure because it may precipitate an
attack. Factors that increase intraabdominal pressure are straining at stool, vomiting,
bending, lifting, and wearing tight restrictive clothing.
The nurse is discussing dietary sources of protein for a patient with inflammatory bowel
disease (IBD) who is lactose intolerant. Which instruction is most beneficial to the
patient?
"Include Greek yogurt in your diet."
,"Include cold foods in your diet."
"Include cereals with bran in your diet."
"Include milk and milk products in your diet." - answerA
Patients who are lactose intolerant can include Greek yogurt in their diet as a source of
protein. Greek yogurt contains probiotics, which feed on sugars, thus greatly reducing
the lactose content. Cold foods and high-fiber foods such as cereal with bran may
cause diarrhea. Milk and milk products will promote diarrhea in lactose intolerant
patients and should be avoided.
The nurse is comparing the clinical manifestations of ulcerative colitis and Crohn's
disease. Which clinical manifestations are specific to ulcerative colitis? Select all that
apply.
Diarrhea
Tenesmus
Constipation
Rectal bleeding
Abdominal cramping pain - answera and D
Rectal bleeding and tenesmus (the sensation of incomplete bowel evacuation) are
specific manifestations of ulcerative colitis. Diarrhea and abdominal cramping pain are
common to both ulcerative colitis and Crohn's disease. Constipation is not associated
with either disorder.
When teaching the patient about the diet for diverticular disease, which foods should the
nurse recommend?
White bread, cheese, and green beans
Fresh tomatoes, pears, and corn flakes
Oranges, baked potatoes, and raw carrots
Dried beans, All Bran (100%) cereal, and raspberries - answerD
A high-fiber diet is recommended for diverticular disease. Dried beans, All Bran (100%)
cereal, and raspberries all have higher amounts of fiber than white bread, cheese,
green beans, fresh tomatoes, pears, corn flakes, oranges, baked potatoes, and raw
carrots.
, The nurse is caring for a patient experiencing diarrhea caused by clostridium difficile.
Which nursing diagnosis is the patient at the least risk of experiencing?
Fatigue
Deficient fluid volume
Impaired physical mobility
Intolerance to activity - answerC
Impaired physical mobility would not be a consideration with diarrhea. Patients
experiencing diarrhea may have fatigue due to the loss of fluid volume and acute
infection. Another priority nursing diagnosis for this patient is deficient fluid volume
because in a severe case of diarrhea, this can affect cardiac output, hydration status,
and acid/base balance. Due to fatigue, this patient may experience intolerance to
activity.
A patient reports fever, abdominal pain, nausea, and vomiting. The patient's heart rate
is 150 beats/minute and the respiratory rate is 20 breaths/minute. Which treatment
strategies does the nurse identify will benefit the patient? Select all that apply.
Colectomy
Antibiotic therapy
Nasogastric suction
Antimicrobial therapy
Biologic and targeted therapy - answerB and C
Rationale
A heart rate of 150 beats/minute indicates tachycardia and a respiratory rate of 20
breaths/minute indicates tachypnea. Fever, abdominal pain, nausea, vomiting,
tachypnea, and tachycardia indicate peritonitis, which is localized or generalized
inflammation of the peritoneum. Peritonitis can be managed with the use of antibiotics
and nasogastric suction. Colectomy is used to treat ulcerative colitis. Antimicrobial
therapy, and biologic and targeted therapy are used to treat inflammatory bowel
disease.
The nurse is caring for a patient with inflammatory bowel disease (IBD) and should
monitor the patient for what systemic complication?
Fistulas
Strictures
A colectomy is scheduled for a 38-year-old woman with ulcerative colitis. The nurse
should plan to include what prescribed measure in the preoperative preparation of this
patient?
Instruction on irrigating a colostomy
Administration of a cleansing enema
A high-fiber diet the day before surgery
Administration of intravenous (IV) antibiotics for bowel preparation - answerB
The nurse has provided teaching to a patient who has diverticular disease but is not
experiencing an acute episode at this time. Which statement by the patient reflects an
adequate understanding of the teaching?
"I will eat a diet that is low in fiber."
"I will avoid eating nuts and seeds."
"I will decrease my intake of fat and red meat."
"I will continue to work out by lifting weights." - answerc
A high-fiber diet, mainly from fruits and vegetables, and decreased intake of fat and red
meat are recommended for preventing diverticular disease. High levels of physical
activity also seem to decrease the risk. A high-fiber diet also is recommended once
diverticular disease is present. Currently there is no evidence to support the theory that
diverticulitis can be prevented by avoiding nuts and seeds. A patient with diverticular
disease should avoid increased intraabdominal pressure because it may precipitate an
attack. Factors that increase intraabdominal pressure are straining at stool, vomiting,
bending, lifting, and wearing tight restrictive clothing.
The nurse is discussing dietary sources of protein for a patient with inflammatory bowel
disease (IBD) who is lactose intolerant. Which instruction is most beneficial to the
patient?
"Include Greek yogurt in your diet."
,"Include cold foods in your diet."
"Include cereals with bran in your diet."
"Include milk and milk products in your diet." - answerA
Patients who are lactose intolerant can include Greek yogurt in their diet as a source of
protein. Greek yogurt contains probiotics, which feed on sugars, thus greatly reducing
the lactose content. Cold foods and high-fiber foods such as cereal with bran may
cause diarrhea. Milk and milk products will promote diarrhea in lactose intolerant
patients and should be avoided.
The nurse is comparing the clinical manifestations of ulcerative colitis and Crohn's
disease. Which clinical manifestations are specific to ulcerative colitis? Select all that
apply.
Diarrhea
Tenesmus
Constipation
Rectal bleeding
Abdominal cramping pain - answera and D
Rectal bleeding and tenesmus (the sensation of incomplete bowel evacuation) are
specific manifestations of ulcerative colitis. Diarrhea and abdominal cramping pain are
common to both ulcerative colitis and Crohn's disease. Constipation is not associated
with either disorder.
When teaching the patient about the diet for diverticular disease, which foods should the
nurse recommend?
White bread, cheese, and green beans
Fresh tomatoes, pears, and corn flakes
Oranges, baked potatoes, and raw carrots
Dried beans, All Bran (100%) cereal, and raspberries - answerD
A high-fiber diet is recommended for diverticular disease. Dried beans, All Bran (100%)
cereal, and raspberries all have higher amounts of fiber than white bread, cheese,
green beans, fresh tomatoes, pears, corn flakes, oranges, baked potatoes, and raw
carrots.
, The nurse is caring for a patient experiencing diarrhea caused by clostridium difficile.
Which nursing diagnosis is the patient at the least risk of experiencing?
Fatigue
Deficient fluid volume
Impaired physical mobility
Intolerance to activity - answerC
Impaired physical mobility would not be a consideration with diarrhea. Patients
experiencing diarrhea may have fatigue due to the loss of fluid volume and acute
infection. Another priority nursing diagnosis for this patient is deficient fluid volume
because in a severe case of diarrhea, this can affect cardiac output, hydration status,
and acid/base balance. Due to fatigue, this patient may experience intolerance to
activity.
A patient reports fever, abdominal pain, nausea, and vomiting. The patient's heart rate
is 150 beats/minute and the respiratory rate is 20 breaths/minute. Which treatment
strategies does the nurse identify will benefit the patient? Select all that apply.
Colectomy
Antibiotic therapy
Nasogastric suction
Antimicrobial therapy
Biologic and targeted therapy - answerB and C
Rationale
A heart rate of 150 beats/minute indicates tachycardia and a respiratory rate of 20
breaths/minute indicates tachypnea. Fever, abdominal pain, nausea, vomiting,
tachypnea, and tachycardia indicate peritonitis, which is localized or generalized
inflammation of the peritoneum. Peritonitis can be managed with the use of antibiotics
and nasogastric suction. Colectomy is used to treat ulcerative colitis. Antimicrobial
therapy, and biologic and targeted therapy are used to treat inflammatory bowel
disease.
The nurse is caring for a patient with inflammatory bowel disease (IBD) and should
monitor the patient for what systemic complication?
Fistulas
Strictures
