Brunner And Suddarth's Textbook
Of Medical-Surgical Nursing-
Chapter 41 All Questions With
Correct Answers
Multiple Choice
Chapter 41: Management of Patients with Intestinal and Rectal Disorders
1. A nurse is working with a client who has chronic constipation. What should be
included in client teaching to promote normal bowel function?
A. Use glycerin suppositories on a regular basis.
B. Limit physical activity in order to promote bowel peristalsis.
C. Consume high-residue, high-fiber foods.
D. Resist the urge to defecate until the urge becomes intense. - correct answerC
Rationale: Goals for the client include restoring or maintaining a regular pattern
of elimination by responding to the urge to defecate, ensuring adequate intake of
fluids and high-fiber foods, learning about methods to avoid constipation,
relieving anxiety about bowel elimination patterns, and avoiding complications.
Ongoing use of pharmacologic aids should not be promoted, due to the risk of
dependence. Increased mobility helps to maintain a regular pattern of
elimination. The urge to defecate should be heeded.
PTS: 1 REF: p. 1289 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
,Multiple Choice
10. A 16-year-old presents at the emergency department reporting right lower
quadrant pain and is subsequently diagnosed with appendicitis. When planning
this client's nursing care, the nurse should prioritize what nursing diagnosis?
A. Imbalanced nutrition: Less than body requirements related to decreased oral
intake
B. Risk for infection related to possible rupture of appendix
C. Constipation related to decreased bowel motility and decreased fluid intake
D. Chronic pain related to appendicitis - correct answerB
Rationale: The client with a diagnosis of appendicitis has an acute risk of infection
related to the possibility of rupture. This immediate physiologic risk is a priority
over nutrition and constipation, though each of these concerns should be
addressed by the nurse. The pain associated with appendicitis is acute, not
chronic.
PTS: 1 REF: p. 1299
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
11. A nurse is talking with a client who is scheduled to have a hemicolectomy with
the creation of a colostomy. The client admits to being anxious, and has many
questions concerning the surgery, the care of a stoma, and necessary lifestyle
changes. What nursing action is most appropriate?
A. Reassure the client that the procedure is relatively low risk and that clients are
usually successful in adjusting to an ostomy.
B. Provide the client with educational materials that match the client's learning
style.
C. Encourage the client to write down these concerns and questions to bring
forward to the surgeon.
D. Maintain an open dialogue with the client and facilitate a referral to the
wound-ostomy-continence (WOC) nurse. - correct answerD
, Rationale: A wound-ostomy-continence (WOC) nurse is a registered nurse who
has received advanced education in an accredited program to care for clients with
stomas. The enterostomal nurse therapist can assist with the selection of an
appropriate stoma site, teach about stoma care, and provide emotional support.
The surgeon is less likely to address the client's psychosocial and learning needs.
Reassurance does not address the client's questions, and education may or may
not alleviate anxiety.
PTS: 1 REF: p. 1321
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
12. The nurse is caring for a client who is undergoing diagnostic testing for
suspected malabsorption. When taking this client's health history and performing
the physical assessment, the nurse should recognize what finding as most
consistent with this diagnosis?
A. Recurrent constipation coupled with weight loss
B. Foul-smelling diarrhea that contains fat
C. Fever accompanied by a rigid, tender abdomen
D. Bloody bowel movements accompanied by fecal incontinence - correct
answerB
Rationale: The hallmarks of malabsorption syndrome from any cause are diarrhea
or frequent, loose, bulky, foul-smelling stools that have increased fat content and
are often grayish (steatorrhea). Constipation and bloody bowel movements are
not suggestive of malabsorption syndromes. Fever and a tender, rigid abdomen
are associated with peritonitis.
PTS: 1 REF: p. 1291
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Of Medical-Surgical Nursing-
Chapter 41 All Questions With
Correct Answers
Multiple Choice
Chapter 41: Management of Patients with Intestinal and Rectal Disorders
1. A nurse is working with a client who has chronic constipation. What should be
included in client teaching to promote normal bowel function?
A. Use glycerin suppositories on a regular basis.
B. Limit physical activity in order to promote bowel peristalsis.
C. Consume high-residue, high-fiber foods.
D. Resist the urge to defecate until the urge becomes intense. - correct answerC
Rationale: Goals for the client include restoring or maintaining a regular pattern
of elimination by responding to the urge to defecate, ensuring adequate intake of
fluids and high-fiber foods, learning about methods to avoid constipation,
relieving anxiety about bowel elimination patterns, and avoiding complications.
Ongoing use of pharmacologic aids should not be promoted, due to the risk of
dependence. Increased mobility helps to maintain a regular pattern of
elimination. The urge to defecate should be heeded.
PTS: 1 REF: p. 1289 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
,Multiple Choice
10. A 16-year-old presents at the emergency department reporting right lower
quadrant pain and is subsequently diagnosed with appendicitis. When planning
this client's nursing care, the nurse should prioritize what nursing diagnosis?
A. Imbalanced nutrition: Less than body requirements related to decreased oral
intake
B. Risk for infection related to possible rupture of appendix
C. Constipation related to decreased bowel motility and decreased fluid intake
D. Chronic pain related to appendicitis - correct answerB
Rationale: The client with a diagnosis of appendicitis has an acute risk of infection
related to the possibility of rupture. This immediate physiologic risk is a priority
over nutrition and constipation, though each of these concerns should be
addressed by the nurse. The pain associated with appendicitis is acute, not
chronic.
PTS: 1 REF: p. 1299
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
11. A nurse is talking with a client who is scheduled to have a hemicolectomy with
the creation of a colostomy. The client admits to being anxious, and has many
questions concerning the surgery, the care of a stoma, and necessary lifestyle
changes. What nursing action is most appropriate?
A. Reassure the client that the procedure is relatively low risk and that clients are
usually successful in adjusting to an ostomy.
B. Provide the client with educational materials that match the client's learning
style.
C. Encourage the client to write down these concerns and questions to bring
forward to the surgeon.
D. Maintain an open dialogue with the client and facilitate a referral to the
wound-ostomy-continence (WOC) nurse. - correct answerD
, Rationale: A wound-ostomy-continence (WOC) nurse is a registered nurse who
has received advanced education in an accredited program to care for clients with
stomas. The enterostomal nurse therapist can assist with the selection of an
appropriate stoma site, teach about stoma care, and provide emotional support.
The surgeon is less likely to address the client's psychosocial and learning needs.
Reassurance does not address the client's questions, and education may or may
not alleviate anxiety.
PTS: 1 REF: p. 1321
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
12. The nurse is caring for a client who is undergoing diagnostic testing for
suspected malabsorption. When taking this client's health history and performing
the physical assessment, the nurse should recognize what finding as most
consistent with this diagnosis?
A. Recurrent constipation coupled with weight loss
B. Foul-smelling diarrhea that contains fat
C. Fever accompanied by a rigid, tender abdomen
D. Bloody bowel movements accompanied by fecal incontinence - correct
answerB
Rationale: The hallmarks of malabsorption syndrome from any cause are diarrhea
or frequent, loose, bulky, foul-smelling stools that have increased fat content and
are often grayish (steatorrhea). Constipation and bloody bowel movements are
not suggestive of malabsorption syndromes. Fever and a tender, rigid abdomen
are associated with peritonitis.
PTS: 1 REF: p. 1291
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
