Lewis Med-Surg Test-Bank! Chapter 45 Exam Practice Questions and Answers

Lewis Med-Surg Test-Bank! Chapter 45 Exam Practice Questions and Answers A patient with acute diarrhea of 24 hours' duration calls the clinic to ask for directions for care. In talking with the patient, what should the nurse do? a. Ask the patient to describe the character of the stools and any associated symptoms. b. Advise the patient to use over-the-counter loperamide (Imodium) to slow gastrointestinal motility. c. Inform the patient that laboratory testing of blood and stool specimens will be necessary. d. Advise the patient to drink clear liquid fluids with electrolytes, such as Gatorade or Pedialyte. - Ans:-*ANS: A* The nurse's initial response should be further assessment of the patient. The other responses may be appropriate, depending on what is learned in the assessment. A 78-year-old patient is transferred to the hospital from a nursing home on developing abdominal pain and watery, incontinent diarrhea following a course of antibiotic therapy for pneumonia. Stool cultures ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/15 reveal the presence of Clostridium difficile. In planning care for the patient, the nurse will do which of the following? a. Order a diet with no dairy products for the patient. b. Place the patient in a private room with contact isolation. c. Explain to the patient why antibiotics are not being used. d. Teach the patient about proper food handling and storage. - Ans:-*ANS: B* Because C. difficile is highly contagious, the patient should be placed in a private room and contact precautions should be used. Psyllium (Metamucil) is prescribed for a patient with chronic constipation. In teaching the patient about chronic constipation, what should the nurse stress? a.The use of bulk-forming laxatives is safe, and they do not cause any adverse effects. b.At least 3000 mL of fluid daily must be taken to prevent impaction or bowel obstruction. c.Dietary sources of fibre should be eliminated from the diet to prevent excessive gas formation. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/15 d.Supplemental fat-soluble vitamins must be taken because the medication blocks absorption of these vitamins. - Ans:-*ANS: B* A high fluid intake is needed to prevent hardened stools leading to impaction or bowel obstruction. Although bulk-forming laxatives are generally safe, the nurse should emphasize the possibility of constipation or obstipation if inadequate fluid intake occurs. A patient is admitted to the emergency department with severe abdominal pain, anorexia, and chills. His vital signs include temperature 38.3°C, pulse 130 beats/min, respiration 34 breaths/min, and blood pressure (BP) 82/50 mm Hg. His pain is more intense in the left lower quadrant but radiates throughout the entire abdomen, with rebound tenderness and abdominal rigidity. The nurse plans care for the patient based on the knowledge that management of his condition initially involves which of the following actions? a.Intravenous (IV) fluid resuscitation b.Exploratory laparotomy c.Administration of IV antibiotics d.Diagnostic testing with barium studies and endoscopy - Ans:-*ANS: A