Chapter 30: Care of Patients with Disorders of the Lower Gastrointestinal System

Chapter 30: Care of Patients with Disorders of the Lower Gastrointestinal System

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The patient with an incarcerated hernia is at risk for the hernia to become:

a.	strangulated.
b.	indirect.
c.	direct.
d.	irreducible.

 

 

ANS:  A

The incarcerated hernia may become strangulated, which cuts off the blood supply and can lead to necrosis of the trapped bowel loop. Hernias are classified as reducible, which means the protruding organ can be returned to its proper place by pressing on the organ, and irreducible, which means that the protruding part of the organ is tightly wedged outside the cavity and cannot be pushed back through the opening. Another name for an irreducible hernia is incarcerated hernia. An indirect hernia protrudes through the inguinal ring. A direct hernia protrudes through the posterior inguinal wall.

 

DIF:    Cognitive Level: Comprehension     REF:   663                OBJ:   1 (theory)

TOP:   Incarcerated Hernia: Complications

KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

2. The patient who has had an incarcerated hernia for many years begins to experience abdominal pain and vomit dark material with a fecal odor. The nurse recognizes these signs as indications of:

a.	intestinal obstruction.
b.	ruptured bowel.
c.	gastroenteritis.
d.	duodenal ulcer.

 

 

ANS:  A

Flow of bowel content is blocked by incarceration, causing bowel obstruction with its attendant signs and symptoms of vomiting fecal contents and pain from ischemia and distention of the bowel.

 

DIF:    Cognitive Level: Comprehension     REF:   663-664         OBJ:   1 (theory)

TOP:   Incarcerated Hernia: Obstructions    KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Health Promotion and Maintenance

 

3. The nurse explains that a hernioplasty involves:

a.	reducing the hernia by manual pressure.
b.	sewing synthetic mesh over the abdominal wall defect to reduce the hernia.
c.	applying an individualized truss for the reduction of the hernia.
d.	reducing the hernia and suturing the defect in the abdominal wall.

 

 

ANS:  B

Hernioplasty is a surgical intervention in which the hernia is reduced and a synthetic mesh is sewn over the defect in the wall to prevent reoccurrence.

 

DIF:    Cognitive Level: Application           REF:   664                OBJ:   1 (theory)

TOP:   Hernia Repair: Hernioplasty             KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

4. Instruction to a patient who self-medicates with bismuth subsalicylate (Pepto Bismol) tablets should include that the tablets:

a.	may cause aspirin toxicity.
b.	should be swallowed whole.
c.	may stain teeth.
d.	will cause the stool to be black.

 

 

ANS:  A

The drug may cause aspirin toxicity if taken excessively. The patient should not take other medication containing aspirin while taking this drug. The drug should be chewed well. This medication often turns the stool black. It does not affect the teeth.

 

DIF:    Cognitive Level: Application           REF:   666                OBJ:   2 (theory)

TOP:   Bismuth Subsalicylate: Side Effects

KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological Therapies