Chapter 47: Management of Patients With Intestinal and Rectal Disorders

Chapter 47: Management of Patients With Intestinal and Rectal Disorders Question A nurse is teaching an older adult client about good bowel habits. Which statement by the client indicates to the nurse that additional teaching is required? • "I need to use laxatives regularly to prevent constipation." Question A client is being treated for diverticulosis. Which information should the nurse include in this client's teaching plan? • Drink at least 8 to 10 large glasses of fluid every day Question A client who has undergone colostomy surgery is experiencing constipation. Which intervention should a nurse consider for such a client? • Suggest fluid intake of at least 2 L/day Question A client realizes that regular use of laxatives has greatly improved his bowel pattern. However, the nurse cautions this client against the prolonged use of laxatives for which reason? • he client's natural bowel function may become sluggish. Question A client is being treated for prolonged diarrhea. Which of the following foods should the nurse encourage the client to consume? • Potassium-rich foods Question When interviewing a client with internal hemorrhoids, which of the following would the nurse expect the client to report? • Rectal bleeding Question In women, which of the following types of cancer exceeds colorectal cancer? • Breast Question A client reports severe pain and bleeding while having a bowel movement. Upon inspection, the health care provider notes a linear tear in the anal canal tissue. The client is diagnosed with a: • fissure. Question The nurse is performing a community screening for colorectal cancer. Which characteristic should the nurse include in the screening? • Familial polyposis Question The nurse caring for an older adult client diagnosed with diarrhea is administering and monitoring the client’s medications. Because one of the client’s medications is digitalis (digoxin), the nurse monitors the client closely for: • hypokalemia. Question Nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. The nurse also expects to find: • severe abdominal pain with direct palpation or rebound tenderness. Question What is the most common cause of small-bowel obstruction? • Adhesions Question Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes: • high-fiber diet. Question The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation? • Usual pattern of elimination Question A patient arrives in the emergency department with complaints of right lower abdominal pain that began 4 hours ago and is getting worse. The nurse assesses rebound tenderness at McBurney’s point. What does this assessment data indicate to the nurse? • Appendicitis Question Nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. The nurse also expects to find: • severe abdominal pain with direct palpation or rebound tenderness. Question What is the most common cause of small-bowel obstruction? • Adhesions Question Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes: • high-fiber diet. Question The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation? • Usual pattern of elimination Question A patient arrives in the emergency department with complaints of right lower abdominal pain that began 4 hours ago and is getting worse. The nurse assesses rebound tenderness at McBurney’s point. What does this assessment data indicate to the nurse? • Appendicitis Question A surgeon is discussing surgery with a client diagnosed with colon cancer. The client is visibly shaken over the possibility of a colostomy. Based on the client's response, the surgeon should collaborate with which health team member? • Enterostomal nurse Question A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult? • "I didn't eat anything I shouldn't have; I just ate roast beef on rye bread." Question The nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching? • Drink 8 to 10 glasses of fluid daily. Question A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of: • increasing fluid intake to prevent dehydration. Question A client is being treated for diverticulosis. Which information should the nurse include in this client's teaching plan? • Drink at least 8 to 10 large glasses of fluid every day Question A client who has undergone colostomy surgery is experiencing constipation. Which intervention should a nurse consider for such a client? • Suggest fluid intake of at least 2 L/day Question Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes: • high-fiber diet. Question Which term refers to a protrusion of the intestine through a weakened area in the abdominal wall? • Hernia Question A nurse is preparing a presentation for a local community group of older adults about colon cancer. Which of the following would the nurse include as the primary characteristic associated with this disorder? • A change in bowel habits Question Which of the following would a nurse expect to assess in a client with peritonitis? • Board-like abdomen Question A client reports severe pain and bleeding while having a bowel movement. Upon inspection, the health care provider notes a linear tear in the anal canal tissue. The client is diagnosed with a: • fissure. Question The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation? • Usual pattern of elimination Question What is the most common cause of small-bowel obstruction? • Adhesions Question Nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. The nurse also expects to find: • severe abdominal pain with direct palpation or rebound tenderness. Question A client has a newly created colostomy. After participating in counseling with the nurse and receiving support from the spouse, the client decides to change the colostomy pouch unaided. Which behavior suggests that the client is beginning to accept the change in body image? • The client touches the altered body part. Question A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult? • "I didn't eat anything I shouldn't have; I just ate roast beef on rye bread." Question A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location? • Right lower quadrant Question Which of the following will the nurse observe as symptoms of perforation in a patient with intestinal obstruction? • Sudden, sustained abdominal pain Question The nurse is caring for a patient diagnosed with abdominal perforation. Which of the following is a clinical manifestation of this disease process? You Selected: • Hypotension Question The nurse is performing and documenting the findings of an abdominal assessment. When the nurse hears intestinal rumbling and the client then experiences diarrhea, the nurse documents the presence of which condition? • Borborygmus Question The nurse is teaching a client with an ostomy how to change the pouching system. Which information should the nurse include when teaching a client with no peristomal skin irritation? • Dry skin thoroughly after washing Question The nurse is performing an abdominal assessment for a patient with diarrhea and auscultates a loud rumbling sound in the left lower quadrant. What will the nurse document this sound as on the nurse’s notes? • Borborygmus Question Vomiting results in which of the following acid–base imbalances? • Metabolic alkalosis Question An older adult client in a long term care facility is concerned about bowel regularity. During a client education session, the nurse reinforces the medically acceptable definition of “regularity.” What is the actual measurement of “regular”? • stool consistency and client comfort Question The nurse is monitoring a client’s postoperative course after an appendectomy. The nurse’s assessment reveals that the client has vomited, has abdominal tenderness and rigidity, and has tachycardia. The nurse reports to the physician that the client has signs/symptoms of which complication? • Peritonitis Question The nurse is irrigating a colostomy when the patient says, “You will have to stop, I am cramping so badly.” What is the priority action by the nurse? • Clamp the tubing and give the patient a rest period. Question A patient diagnosed with IBS is advised to eat a diet that is: • High in fiber. Question When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? • Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. Question As part of the management of constipation, the client is instructed to take 30 mL of mineral oil orally. Mineral oil facilitates bowel evacuation by: • Lubricating and softening fecal matter Question Which of the following is the most common symptom of a polyp? • Rectal bleeding Question Which of the following is considered a bulk-forming laxative? • Metamucil Question A resident at a long-term care facility lost the ability to swallow following a stroke 4 years ago. The client receives nutrition via a PEG tube, has adapted well to the tube feedings, and remains physically and socially active. Occasionally, the client develops constipation that requires administration of a laxative to restore regular bowel function. What is the most likely cause of this client’s constipation? • lack of free water intake Question A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of: • increasing fluid intake to prevent dehydration. Question The presence of mucus and pus in the stools suggests which condition? • Ulcerative colitis Question Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes: • high-fiber diet. Question A nurse is preparing a presentation for a local community group of older adults about colon cancer. Which of the following would the nurse include as the primary characteristic associated with this disorder? • A change in bowel habits Question A client tells the nurse, “I am not having normal bowel movements.” When differentiating between what are normal and abnormal bowel habits, what indicators are the most important? • The consistency of stool and comfort when passing stool Question Nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. The nurse also expects to find: • severe abdominal pain with direct palpation or rebound tenderness. Question Celiac sprue is an example of which category of malabsorption? • Mucosal disorders causing generalized malabsorption Question When interviewing a client with internal hemorrhoids, which of the following would the nurse expect the client to report? • Rectal bleeding Question Which of the following is the diagnostic of choice if the suspected diagnosis is diverticulitis? • Computed tomography scan Question The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation? • Usual pattern of elimination