Brunner and Suddarth's Textbook
of Medical-surgical Nursing-
Chapter 38, 39, 40, 41, 43,44 All
questions with answers // verified
100%
Chapter 38: Assessment of Digestive and Gastrointestinal Function
1. A nurse is caring for a client who is scheduled for a colonoscopy and whose
preparation will include polyethylene glycol electrolyte lavage prior to the
procedure. The presence of what health problem would contraindicate the use of
this form of bowel preparation?
A. Inflammatory bowel disease
B. Intestinal polyps
C. Diverticulitis
D. Colon cancer - correct answerA
Rationale: The use of a lavage solution is contraindicated in clients with intestinal
obstruction or inflammatory bowel disease. It can safely be used with clients who
have polyps, colon cancer, or diverticulitis.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
,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
10. A client has undergone a laparoscopic cholecystectomy and is being prepared
for discharge home. When providing health education, the nurse should prioritize
what topic?
A. Management of fluid balance in the home setting
B. The need for blood glucose monitoring for the next week
C. Signs and symptoms of intra-abdominal complications
D. Appropriate use of prescribed pancreatic enzymes - correct answerC
Rationale: Because of the early discharge following laparoscopic cholecystectomy,
the client needs thorough education in the signs and symptoms of complications.
Fluid balance is not typically a problem in the recovery period after laparoscopic
cholecystectomy. There is no need for blood glucose monitoring or pancreatic
enzymes.
PTS: 1 REF: p. 1425
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 44: Assessment and Management of Clients With Biliary Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
10. A client was treated in the emergency department and critical care unit after
ingesting bleach. What possible complication of the resulting gastritis should the
nurse recognize?
A. Esophageal or pyloric obstruction related to scarring
B. Uncontrolled proliferation of H. pylori
C. Gastric hyperacidity related to excessive gastrin secretion
, D. Chronic referred pain in the lower abdomen - correct answerA
Rationale: A severe form of acute gastritis is caused by the ingestion of strong
acid or alkali, which may cause the mucosa to become gangrenous or to
perforate. Scarring can occur, resulting in pyloric stenosis (narrowing or
tightening) or obstruction. Chronic referred pain to the lower abdomen is a
symptom of peptic ulcer disease, but would not be an expected finding for a client
who has ingested a corrosive substance. Bacterial proliferation and hyperacidity
would not occur.
PTS: 1 REF: p. 1272
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
Multiple Choice
10. A nurse is addressing the prevention of esophageal cancer in response to a
question posed by a participant in a health promotion workshop. What action
should the nurse recommend as having the greatest potential to prevent
esophageal cancer?
A. Promotion of a nutrient-dense, low-fat diet
B. Annual screening endoscopy for clients over 50 with a family history of
esophageal cancer
C. Early diagnosis and treatment of gastroesophageal reflux disease
D. Adequate fluid intake and avoidance of spicy foods - correct answerC
Rationale: There are numerous risk factors for esophageal cancer but chronic
esophageal irritation or GERD is among the most significant. This is a more
significant risk factor than dietary habits. Screening endoscopies are not
recommended solely on the basis of family history.
PTS: 1 REF: p. 1257
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 39: Management of Clients with Oral and Esophageal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
of Medical-surgical Nursing-
Chapter 38, 39, 40, 41, 43,44 All
questions with answers // verified
100%
Chapter 38: Assessment of Digestive and Gastrointestinal Function
1. A nurse is caring for a client who is scheduled for a colonoscopy and whose
preparation will include polyethylene glycol electrolyte lavage prior to the
procedure. The presence of what health problem would contraindicate the use of
this form of bowel preparation?
A. Inflammatory bowel disease
B. Intestinal polyps
C. Diverticulitis
D. Colon cancer - correct answerA
Rationale: The use of a lavage solution is contraindicated in clients with intestinal
obstruction or inflammatory bowel disease. It can safely be used with clients who
have polyps, colon cancer, or diverticulitis.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
,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
10. A client has undergone a laparoscopic cholecystectomy and is being prepared
for discharge home. When providing health education, the nurse should prioritize
what topic?
A. Management of fluid balance in the home setting
B. The need for blood glucose monitoring for the next week
C. Signs and symptoms of intra-abdominal complications
D. Appropriate use of prescribed pancreatic enzymes - correct answerC
Rationale: Because of the early discharge following laparoscopic cholecystectomy,
the client needs thorough education in the signs and symptoms of complications.
Fluid balance is not typically a problem in the recovery period after laparoscopic
cholecystectomy. There is no need for blood glucose monitoring or pancreatic
enzymes.
PTS: 1 REF: p. 1425
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 44: Assessment and Management of Clients With Biliary Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
10. A client was treated in the emergency department and critical care unit after
ingesting bleach. What possible complication of the resulting gastritis should the
nurse recognize?
A. Esophageal or pyloric obstruction related to scarring
B. Uncontrolled proliferation of H. pylori
C. Gastric hyperacidity related to excessive gastrin secretion
, D. Chronic referred pain in the lower abdomen - correct answerA
Rationale: A severe form of acute gastritis is caused by the ingestion of strong
acid or alkali, which may cause the mucosa to become gangrenous or to
perforate. Scarring can occur, resulting in pyloric stenosis (narrowing or
tightening) or obstruction. Chronic referred pain to the lower abdomen is a
symptom of peptic ulcer disease, but would not be an expected finding for a client
who has ingested a corrosive substance. Bacterial proliferation and hyperacidity
would not occur.
PTS: 1 REF: p. 1272
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
Multiple Choice
10. A nurse is addressing the prevention of esophageal cancer in response to a
question posed by a participant in a health promotion workshop. What action
should the nurse recommend as having the greatest potential to prevent
esophageal cancer?
A. Promotion of a nutrient-dense, low-fat diet
B. Annual screening endoscopy for clients over 50 with a family history of
esophageal cancer
C. Early diagnosis and treatment of gastroesophageal reflux disease
D. Adequate fluid intake and avoidance of spicy foods - correct answerC
Rationale: There are numerous risk factors for esophageal cancer but chronic
esophageal irritation or GERD is among the most significant. This is a more
significant risk factor than dietary habits. Screening endoscopies are not
recommended solely on the basis of family history.
PTS: 1 REF: p. 1257
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 39: Management of Clients with Oral and Esophageal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
