PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
MULTIPLE CHOICE
1. Whichaction will the nurse include in the plan of care for a 42-year-old patient who is
being admitted with Clostridium difficile?
a. Educate the patient about proper food storage.
b. Order a diet with no dairy products for the patient.
c. Place the patient in a private room on contact isolation.
d. Teach the patient about why antibiotics will not be used.
ANS: C
Because C. difficile is highly contagious, the patient should be placed in a private room and
contact precautions should be used. There is no need to restrict dairy products for this type of
diarrhea. Metronidazole (Flagyl) is frequently used to treat C. difficile. Improper food handling
and storage do not cause C. difficile.
DIF: Cognitive Level: Apply (application) REF: 964
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
2. A 71-year-oldmale 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?
a. Encourage the patient to increase oral fluid intake.
b. Assess the patient about risk factors for constipation.
PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
, PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
c. Suggest that the patient increase intake of high-fiber foods.
d. Teach the patient that a daily bowel movement is unnecessary.
ANS: B
The nurse’s initial action should be further assessment of the patient for risk factors for
constipation and for his usual bowel pattern. The other actions may be appropriate but will be
based on the assessment.
DIF: Cognitive Level: Apply (application) REF: 968-969
OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
3. 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?
a. Absorption of fat-soluble vitamins may be reduced by fiber-containing laxatives.
b. Dietary sources of fiber should be eliminated to prevent excessive gas formation.
c. Use of this type of laxative to prevent constipation does not cause adverse effects.
d. Large amounts of fluid should be taken to prevent impaction or bowel obstruction.
ANS: D
PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
, PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
A high fluid intake is needed when patients are using bulk-forming laxatives to avoid worsening
constipation. Although bulk-forming laxatives are generally safe, the nurse should emphasize the
possibility of constipation or obstipation if inadequate fluid intake occurs. Although increased
gas formation is likely to occur with increased dietary fiber, the patient should gradually increase
dietary fiber and eventually may not need the psyllium. Fat-soluble vitamin absorption is blocked
by stool softeners and lubricants, not by bulk-forming laxatives.
DIF: Cognitive Level: Apply (application) REF: 967
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. A 26-year-oldwoman is being evaluated for vomiting and abdominal pain. Which question
from the nurse will be most useful in determining the cause of the patient’s symptoms?
a. “What type of foods do you eat?”
b. “Is it possible that you are pregnant?”
c. “Can you tell me more about the pain?”
d. “What is your usual elimination pattern?”
ANS: C
A complete description of the pain provides clues about the cause of the problem. Although the
nurse should ask whether the patient is pregnant to determine whether the patient might have an
ectopic pregnancy and before any radiology studies are done, this information is not the most
useful in determining the cause of the pain. The usual diet and elimination patterns are less
helpful in determining the reason for the patient’s symptoms.
DIF: Cognitive Level: Apply (application) REF: 971
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. A patient complains of gas pains and abdominal distention two days after a small bowel
PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
, PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
resection. Which nursing action is best to take?
a. Encourage the patient to ambulate.
b. Instill a mineral oil retention enema.
c. Administer the ordered IV morphine sulfate.
d. Offer the ordered promethazine (Phenergan) suppository.
ANS: A
Ambulation will improve peristalsis and help the patient eliminate flatus and reduce gas pain. A
mineral oil retention enema is helpful for constipation with hard stool. A return-flow enema
might be used to relieve persistent gas pains. Morphine will further reduce peristalsis.
Promethazine (Phenergan) is used as an antiemetic rather than to decrease gas pains or
distention.
DIF: Cognitive Level: Apply (application) REF: 971
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
6. 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?
a. Auscultate the bowel sounds.
b. Prepare the patient for surgery.
PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
Gastrointestinal Problems Test Bank Questions with answers
100% correct
MULTIPLE CHOICE
1. Whichaction will the nurse include in the plan of care for a 42-year-old patient who is
being admitted with Clostridium difficile?
a. Educate the patient about proper food storage.
b. Order a diet with no dairy products for the patient.
c. Place the patient in a private room on contact isolation.
d. Teach the patient about why antibiotics will not be used.
ANS: C
Because C. difficile is highly contagious, the patient should be placed in a private room and
contact precautions should be used. There is no need to restrict dairy products for this type of
diarrhea. Metronidazole (Flagyl) is frequently used to treat C. difficile. Improper food handling
and storage do not cause C. difficile.
DIF: Cognitive Level: Apply (application) REF: 964
TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment
2. A 71-year-oldmale 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?
a. Encourage the patient to increase oral fluid intake.
b. Assess the patient about risk factors for constipation.
PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
, PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
c. Suggest that the patient increase intake of high-fiber foods.
d. Teach the patient that a daily bowel movement is unnecessary.
ANS: B
The nurse’s initial action should be further assessment of the patient for risk factors for
constipation and for his usual bowel pattern. The other actions may be appropriate but will be
based on the assessment.
DIF: Cognitive Level: Apply (application) REF: 968-969
OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
3. 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?
a. Absorption of fat-soluble vitamins may be reduced by fiber-containing laxatives.
b. Dietary sources of fiber should be eliminated to prevent excessive gas formation.
c. Use of this type of laxative to prevent constipation does not cause adverse effects.
d. Large amounts of fluid should be taken to prevent impaction or bowel obstruction.
ANS: D
PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
, PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
A high fluid intake is needed when patients are using bulk-forming laxatives to avoid worsening
constipation. Although bulk-forming laxatives are generally safe, the nurse should emphasize the
possibility of constipation or obstipation if inadequate fluid intake occurs. Although increased
gas formation is likely to occur with increased dietary fiber, the patient should gradually increase
dietary fiber and eventually may not need the psyllium. Fat-soluble vitamin absorption is blocked
by stool softeners and lubricants, not by bulk-forming laxatives.
DIF: Cognitive Level: Apply (application) REF: 967
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. A 26-year-oldwoman is being evaluated for vomiting and abdominal pain. Which question
from the nurse will be most useful in determining the cause of the patient’s symptoms?
a. “What type of foods do you eat?”
b. “Is it possible that you are pregnant?”
c. “Can you tell me more about the pain?”
d. “What is your usual elimination pattern?”
ANS: C
A complete description of the pain provides clues about the cause of the problem. Although the
nurse should ask whether the patient is pregnant to determine whether the patient might have an
ectopic pregnancy and before any radiology studies are done, this information is not the most
useful in determining the cause of the pain. The usual diet and elimination patterns are less
helpful in determining the reason for the patient’s symptoms.
DIF: Cognitive Level: Apply (application) REF: 971
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. A patient complains of gas pains and abdominal distention two days after a small bowel
PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
, PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
resection. Which nursing action is best to take?
a. Encourage the patient to ambulate.
b. Instill a mineral oil retention enema.
c. Administer the ordered IV morphine sulfate.
d. Offer the ordered promethazine (Phenergan) suppository.
ANS: A
Ambulation will improve peristalsis and help the patient eliminate flatus and reduce gas pain. A
mineral oil retention enema is helpful for constipation with hard stool. A return-flow enema
might be used to relieve persistent gas pains. Morphine will further reduce peristalsis.
Promethazine (Phenergan) is used as an antiemetic rather than to decrease gas pains or
distention.
DIF: Cognitive Level: Apply (application) REF: 971
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
6. 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?
a. Auscultate the bowel sounds.
b. Prepare the patient for surgery.
PSYCH 320 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions with answers
100% correct
