Lewis'shMedicalhSurgicalhNursingh11thhEditionhHardinghTesthBank
Chapter 42: Lower Gastrointestinal Problems
h h h h
Harding: Lewis’s Medical-Surgical Nursing, 11th Edition
h h h h h
MULTIPLEhCHOICE
1. Whichhactionhwillhthehnursehincludehinhthehplanhofhcarehforhahpatienthwhohishbeinghadmittedhw
ithhClostridiumhdifficile?
a. Teachhthehpatienthabouthproperhfoodhstorage.
b. Orderhahdiethwithouthdairyhproductshforhthehpatient.
c. Placehthehpatienthinhahprivatehroomhonhcontacthisolation.
d. Teachhthehpatienthabouthwhyhantibioticshwillhnothbehused.
ANS:h C
BecausehC.hdifficilehishhighlyhcontagious,hthehpatienthshouldhbehplacedhinhahprivatehroom,handhco
ntacthprecautionshshouldhbehused.hTherehishnohneedhtohrestricthdairyhproductshforhthishtypehofhdiar
rhea.hMetronidazoleh(Flagyl)hishfrequentlyhusedhtohtreathC.hdifficilehinfections.hImproperhfoodhha
ndlinghandhstoragehdohnothcausehC.hdifficile.
DIF: CognitivehLevel:hApplyh(application) TOP:
NursinghProcess:hPlanninghMSC:h NCLEX:hSafehandhEffectivehCarehEnvironment
2. Ah74-yr-
oldhmalehpatienthtellshthehnursehthathgrowingholdhcauseshconstipation,hsohhehhashbeenhusinghahsu
ppositoryhtohpreventhconstipationheveryhmorning.hWhichhactionhshouldhthehnursehtakehfirst?
a. Encouragehthehpatienthtohincreasehoralhfluidhintake.
b. Questionh theh patienth abou t h ris k h fa cto rs h fo r co nstipation.
N R I G B. C
c. Suggest that the patient incU
h h h h reasSe inN
h takeTof highO-fiber foods.
h h
d. Teachhthehpatienththathahdailyhbowelhmovementhishunnecessary.
ANS:h B
NURSINGTB.COM
, Lewis'shMedicalhSurgicalhNursingh11thhEditionhHardinghTesthBank
Thehnurse’shinitialhactionhshouldhbehfurtherhassessmenthofhthehpatienthforhriskhfactorshforhconstipati
onhandhforhhishusualhbowelhpattern.hThehotherhactionshmayhbehappropriatehbuthwillhbehbasedhonhtheh
assessment.
DIF: CognitivehLevel:hAnalyzeh(analysis)
OBJ:h SpecialhQuestions:hPrioritization
TOP:h NursinghProcess:hImplementationh
MSC:h NCLEX:hPhysiologicalhIntegrity
3. Ahpatienthwhohhashchronichconstipationhaskshthehnursehabouththehusehofhpsylliumh(Metamucil).
Whichhinformationhwillhthehnursehincludehinhthehresponse?
a. Fiber-containinghlaxativeshmayhreducehthehabsorptionhofhfat-solublehvitamins.
b. Dietaryhsourceshofhfiberhshouldhbeheliminatedhtohpreventhexcessivehgashformation.
c. Usehofhthishtypehofhlaxativehtohpreventhconstipationhdoeshnothcausehadverseheffects.
d. Largehamountshofhfluidhshouldhbehtakenhtohpreventhimpactionhorhbowelhobstruction.
ANS:h D
NURSINGTB.COM
, Lewis'shMedicalhSurgicalhNursingh11thhEditionhHardinghTesthBank
Ahhighhfluidhintakehishneededhwhenhpatientsharehusinghbulk-
forminghlaxativeshtohavoidhworseninghconstipation.hAlthoughhbulk-
forminghlaxativesharehgenerallyhsafe,hthehnursehshouldhemphasizehthehpossibilityhofhconstipationh
orhobstipationhifhinadequatehfluidhintakehoccurs.
Althoughhincreasedhgashformationhishlikelyhtohoccurhwithhincreasedhdietaryhfiber,hthehpatienthshoul
dhgraduallyhincreasehdietaryhfiberhandheventuallyhmayhnothneedhthehpsyllium.hFat-
solublehvitaminhabsorptionhishblockedhbyhstoolhsoftenershandhlubricants,hnothbyhbulk-
forminghlaxatives.
DIF: CognitivehLevel:hApplyh(application)
TOP:h NursinghProcess:hImplementation MSC:h NCLEX:hPhysiologicalhIntegrity
4. Ah26-yr-
oldhwomanhishbeinghevaluatedhforhvomitinghandhabdominalhpain.hWhichhquestionhfromhthehnurseh
willhbehmosthusefulhinhdetermininghthehcausehofhthehpatient’shsymptoms?
a. “Whathtypehofhfoodshdohyouheat?”
b. “Ishithpossiblehthathyouharehpregnant?”
c. “Canhyouhtellhmehmorehabouththehpain?”
d. “Whathishyourhusualheliminationhpattern?”
ANS:h C
Ahcompletehdescriptionhofhthehpainhprovideshclueshabouththehcausehofhthehproblem.hAlthoughht
hehnursehshouldhaskhwhetherhthehpatienthishpregnanthtohdeterminehwhetherhthehpatienthmighthha
vehanhectopichpregnancyhandhbeforehanyhradiologyhstudiesharehdone,hthishinformationhishnoththeh
mosthusefulhinhdetermininghthehcausehofhthehpain.hThehusualhdiethandheliminationhpatternsharehl
esshhelpfulhinhdetermininghthehreasonhforhthehpatient’shsymptoms.
ANS:h B
NURSINGTB.COM
, Lewis'shMedicalhSurgicalhNursingh11thhEditionhHardinghTesthBank
DIF: CognitivehLevel:hAnalyzeh(analysis)
TOP:h NursinghProcess:hAssessment MSC:h NCLEX:hPhysiologicalhIntegrity
ANS:h B
NURSINGTB.COM
Chapter 42: Lower Gastrointestinal Problems
h h h h
Harding: Lewis’s Medical-Surgical Nursing, 11th Edition
h h h h h
MULTIPLEhCHOICE
1. Whichhactionhwillhthehnursehincludehinhthehplanhofhcarehforhahpatienthwhohishbeinghadmittedhw
ithhClostridiumhdifficile?
a. Teachhthehpatienthabouthproperhfoodhstorage.
b. Orderhahdiethwithouthdairyhproductshforhthehpatient.
c. Placehthehpatienthinhahprivatehroomhonhcontacthisolation.
d. Teachhthehpatienthabouthwhyhantibioticshwillhnothbehused.
ANS:h C
BecausehC.hdifficilehishhighlyhcontagious,hthehpatienthshouldhbehplacedhinhahprivatehroom,handhco
ntacthprecautionshshouldhbehused.hTherehishnohneedhtohrestricthdairyhproductshforhthishtypehofhdiar
rhea.hMetronidazoleh(Flagyl)hishfrequentlyhusedhtohtreathC.hdifficilehinfections.hImproperhfoodhha
ndlinghandhstoragehdohnothcausehC.hdifficile.
DIF: CognitivehLevel:hApplyh(application) TOP:
NursinghProcess:hPlanninghMSC:h NCLEX:hSafehandhEffectivehCarehEnvironment
2. Ah74-yr-
oldhmalehpatienthtellshthehnursehthathgrowingholdhcauseshconstipation,hsohhehhashbeenhusinghahsu
ppositoryhtohpreventhconstipationheveryhmorning.hWhichhactionhshouldhthehnursehtakehfirst?
a. Encouragehthehpatienthtohincreasehoralhfluidhintake.
b. Questionh theh patienth abou t h ris k h fa cto rs h fo r co nstipation.
N R I G B. C
c. Suggest that the patient incU
h h h h reasSe inN
h takeTof highO-fiber foods.
h h
d. Teachhthehpatienththathahdailyhbowelhmovementhishunnecessary.
ANS:h B
NURSINGTB.COM
, Lewis'shMedicalhSurgicalhNursingh11thhEditionhHardinghTesthBank
Thehnurse’shinitialhactionhshouldhbehfurtherhassessmenthofhthehpatienthforhriskhfactorshforhconstipati
onhandhforhhishusualhbowelhpattern.hThehotherhactionshmayhbehappropriatehbuthwillhbehbasedhonhtheh
assessment.
DIF: CognitivehLevel:hAnalyzeh(analysis)
OBJ:h SpecialhQuestions:hPrioritization
TOP:h NursinghProcess:hImplementationh
MSC:h NCLEX:hPhysiologicalhIntegrity
3. Ahpatienthwhohhashchronichconstipationhaskshthehnursehabouththehusehofhpsylliumh(Metamucil).
Whichhinformationhwillhthehnursehincludehinhthehresponse?
a. Fiber-containinghlaxativeshmayhreducehthehabsorptionhofhfat-solublehvitamins.
b. Dietaryhsourceshofhfiberhshouldhbeheliminatedhtohpreventhexcessivehgashformation.
c. Usehofhthishtypehofhlaxativehtohpreventhconstipationhdoeshnothcausehadverseheffects.
d. Largehamountshofhfluidhshouldhbehtakenhtohpreventhimpactionhorhbowelhobstruction.
ANS:h D
NURSINGTB.COM
, Lewis'shMedicalhSurgicalhNursingh11thhEditionhHardinghTesthBank
Ahhighhfluidhintakehishneededhwhenhpatientsharehusinghbulk-
forminghlaxativeshtohavoidhworseninghconstipation.hAlthoughhbulk-
forminghlaxativesharehgenerallyhsafe,hthehnursehshouldhemphasizehthehpossibilityhofhconstipationh
orhobstipationhifhinadequatehfluidhintakehoccurs.
Althoughhincreasedhgashformationhishlikelyhtohoccurhwithhincreasedhdietaryhfiber,hthehpatienthshoul
dhgraduallyhincreasehdietaryhfiberhandheventuallyhmayhnothneedhthehpsyllium.hFat-
solublehvitaminhabsorptionhishblockedhbyhstoolhsoftenershandhlubricants,hnothbyhbulk-
forminghlaxatives.
DIF: CognitivehLevel:hApplyh(application)
TOP:h NursinghProcess:hImplementation MSC:h NCLEX:hPhysiologicalhIntegrity
4. Ah26-yr-
oldhwomanhishbeinghevaluatedhforhvomitinghandhabdominalhpain.hWhichhquestionhfromhthehnurseh
willhbehmosthusefulhinhdetermininghthehcausehofhthehpatient’shsymptoms?
a. “Whathtypehofhfoodshdohyouheat?”
b. “Ishithpossiblehthathyouharehpregnant?”
c. “Canhyouhtellhmehmorehabouththehpain?”
d. “Whathishyourhusualheliminationhpattern?”
ANS:h C
Ahcompletehdescriptionhofhthehpainhprovideshclueshabouththehcausehofhthehproblem.hAlthoughht
hehnursehshouldhaskhwhetherhthehpatienthishpregnanthtohdeterminehwhetherhthehpatienthmighthha
vehanhectopichpregnancyhandhbeforehanyhradiologyhstudiesharehdone,hthishinformationhishnoththeh
mosthusefulhinhdetermininghthehcausehofhthehpain.hThehusualhdiethandheliminationhpatternsharehl
esshhelpfulhinhdetermininghthehreasonhforhthehpatient’shsymptoms.
ANS:h B
NURSINGTB.COM
, Lewis'shMedicalhSurgicalhNursingh11thhEditionhHardinghTesthBank
DIF: CognitivehLevel:hAnalyzeh(analysis)
TOP:h NursinghProcess:hAssessment MSC:h NCLEX:hPhysiologicalhIntegrity
ANS:h B
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