Nursing Management Lower Gastro-intestinal Problems

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Question 1
Free
Multiple Choice

The nurse is caring for a client who has watery, incontinent diarrhea and has diagnosed with Clostridium difficile. Which of the following actions should the nurse include in the plan of care?

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A

Order a diet with no dairy products for the client.

B

Place the client in a private room with contact isolation.

C

Teach the client about why antibiotics are not being used.

D

Educate the client about proper food handling and storage.

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Question 2
Free
Multiple Choice

Aclient tells the nurse, "I have problems with constipation now that I am older, so I use a suppository every morning." Which of the following actions should the nurse take first?

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A

Encourage the client to increase oral fluid intake.

B

Inform the client that a daily bowel movement is unnecessary.

C

Assess the client about individual risk factors for constipation.

D

Suggest that the client increase dietary intake of high-fibre foods.

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Question 3
Free
Multiple Choice

The nurse is teaching a client who has chronic constipation about the use of psyllium. Which of the following information should the nurse include?

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A

Absorption of fat-soluble vitamins may be reduced by fibre-containing laxatives.

B

Dietary sources of fibre 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.

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Question 4
Free
Multiple Choice

The nurse is obtaining a history for a female client who is being evaluated for acute lower abdominal pain and vomiting. Which of the following questions is most useful in determining the cause of the client's symptoms?

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A

"Is it possible that you are pregnant?"

B

"Can you tell me more about the pain?"

C

"What type of foods do you usually eat?"

D

"What is your usual elimination pattern?"

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Question 5
Free
Multiple Choice

The nurse is caring for a client who had an exploratory laparotomy with a resection of a short segment of small bowel two days previously. The client has gas pains and abdominal distension. Which of the following nursing actions is best to take at this time?

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A

Give a return-flow enema.

B

Assist the client to ambulate.

C

Administer the ordered IV morphine sulphate.

D

Insert the ordered promethazine suppository.

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Question 6
Multiple Choice

The nurse is caring for a client who has blunt abdominal trauma after an automobile accident and severe pain. A peritoneal lavage returns brown drainage with fecal material. Which of the following actions should the nurse plan to take next?

Choose correct answer/s
A
Auscultate the bowel sounds.
B
Prepare the client for surgery.
C
Check the client's oral temperature.
D
Obtain information about the accident.
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Question 7
Multiple Choice

The nurse is admitting a client for evaluation of right lower quadrant abdominal pain with nausea and vomiting and an O2 saturation of 90%. Which of the following actions should the nurse take?

Choose correct answer/s
A
Check for rebound tenderness.
B
Assist the client to cough and deep breathe.
C
Administer oxygen via nasal cannula.
D
Encourage the client to take sips of clear liquids.
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Question 8
Multiple Choice

Which of the following nursing actions should be included in the plan of care for a male client with bowel irregularity and a new diagnosis of irritable bowel syndrome (IBS)?

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A
Encourage the client to express feelings and ask questions about IBS.
B
Suggest that the client increase the intake of milk and other dairy products.
C
Educate the client about the use of Tegaserod to reduce symptoms.
D
Teach the client to avoid using nonsteroidal anti-inflammatory drugs (NSAIDs).
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Question 9
Multiple Choice

The nurse is caring for a client with an acute exacerbation of ulcerative colitis having 14-16 bloody stools a day and crampy abdominal pain associated with the diarrhea. Which of the following actions should the nurse take?

Choose correct answer/s
A
Place the client on NPO status.
B
Administer IV metoclopramide.
C
Teach the client about total colectomy surgery.
D
Administer cobalamin injections.
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Question 10
Multiple Choice

The nurse is admitting a client with an exacerbation of inflammatory bowel disease (IBD). Which of the following nursing actions should the nurse include in the plan of care?

Choose correct answer/s
A
Restrict oral fluid intake.
B
Monitor stools for blood.
C
Increase dietary fibre intake.
D
Ambulate four times daily.
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Question 11
Multiple Choice

The nurse is teaching a client with ulcerative colitis about sulphasalazine. Which of the following client statements indicates that the teaching has been effective?

Choose correct answer/s
A
"I will need to take this medication for at least one year."
B
"I will need to avoid contact with people who are sick."
C
"The medication will need to be tapered if I need surgery."
D
"The medication will prevent infections that cause the diarrhea."
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Question 12
Multiple Choice

The nurse is caring for a client with an exacerbation of ulcerative colitis who is having 15-20 stools daily and has external hemorrhoids. Which of the following client behaviours indicate that teaching regarding maintenance of skin integrity has been effective?

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A
The client uses incontinence briefs to contain loose stools.
B
The client asks for antidiarrheal medication after each stool.
C
The client uses witch hazel compresses to decrease anal discomfort.
D
The client cleans the perianal area with soap and water after each stool.
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Question 13
Multiple Choice

The nurse is providing client teaching about recommended dietary choices for a client with an acute exacerbation of inflammatory bowel disease (IBD). Which of the following diet choices by the client indicates a need for more teaching?

Choose correct answer/s
A
Scrambled eggs
B
White toast and jam
C
Oatmeal with cream
D
Pancakes with syrup
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Question 14
Multiple Choice

The nurse is caring for a client who has had a total proctocolectomy and permanent ileostomy who tells the nurse, "I cannot bear to even look at the stoma. I do not think I can manage all these changes." Which of the following actions is best?

Choose correct answer/s
A
Develop a detailed written plan for ostomy care for the client.
B
Ask the client more about the concerns with stoma management.
C
Reassure the client that care for the ileostomy will become easier.
D
Postpone any client teaching until the client adjusts to the ileostomy.
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Question 15
Multiple Choice

The nurse is caring for a client who has a new diagnosis of Crohn's disease after having frequent diarrhea and a weight loss of 4.5 kg over 2 months. Which of the following topics should the nurse plan to include in the teaching plan?

Choose correct answer/s
A
Medication use
B
Fluid restriction
C
Enteral nutrition
D
Activity restrictions
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Question 16
Multiple Choice

The nurse is caring for a client with Crohn's disease who develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. Which of the following information should the nurse teach the client?

Choose correct answer/s
A
To clean the perianal area carefully after any stools
B
About fistula formation between the bowel and bladder
C
To empty the bladder before and after sexual intercourse
D
About the effects of corticosteroid use on immune function
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Question 17
Multiple Choice

The nurse is caring for a client who has a large bowel obstruction that occurred as a result of diverticulosis. Which of the following symptoms should the nurse monitor for when assessing the client?

Choose correct answer/s
A
Referred back pain
B
Metabolic alkalosis
C
Projectile vomiting
D
Abdominal distension
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Question 18
Multiple Choice

The nurse is preparing a 50-year-old client for an annual physical examination. Which of the following diagnostic tests should the nurse teach to the client?

Choose correct answer/s
A
Endoscopy
B
Fecal occult blood test
C
Computerized tomography screening
D
Carcinoembryonic antigen (CEA) testing
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Question 19
Multiple Choice

The nurse is conducting preoperative preparation for a client scheduled for an abdominal-perineal resection. Which of the following actions should the nurse implement?

Choose correct answer/s
A
Give IV antibiotics starting 24 hours before surgery to reduce the number of bowel bacteria.
B
Teach the client that activities such as sitting at the bedside will be started the first postoperative day.
C
Instruct the client that another surgery in 8-12 weeks will be used to create an ileal-anal reservoir.
D
Administer polyethylene glycol lavage solution (GoLYTELY) to ensure that the bowel is empty before the surgery.
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Question 20
Multiple Choice

Before undergoing a colon resection for cancer of the colon, a client has an elevated carcinoembryonic antigen (CEA) test. Which of the following explanations should the nurse provide to the client about this test?

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A
It confirms the diagnosis of colon cancer.
B
It monitors the tumour status after surgery.
C
It identifies the extent of cancer spread or metastasis.
D
It determines the need for postoperative chemotherapy.
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