Chapter 57: Care of Patients with Inflammatory Intestinal Disorders

Chapter 57: Care of Patients with Inflammatory Intestinal Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse assesses a client who has appendicitis. Which clinical manifestation should the nurse expect to find?
   1. Severe, steady right lower quadrant pain
   2. Abdominal pain associated with nausea and vomiting
   3. Marked peristalsis and hyperactive bowel sounds
   4. Abdominal pain that increases with knee flexion

ANS:   A

Right lower quadrant pain, specifically at McBurney’s point, is characteristic of appendicitis. Usually if nausea and vomiting begin first, the client has gastroenteritis. Marked peristalsis and hyperactive bowel sounds are not indicative of appendicitis. Abdominal pain due to appendicitis decreases with knee flexion.

DIF:     Remembering/Knowledge                 REF: 1169                   KEY: Inflammatory bowel disorder| assessment/diagnostic examination  MSC:                        Integrated Process: Nursing Process: Assessment                                       NOT:                          Client Needs Category: Physiological Integrity: Physiological Adaptation

2. A nurse cares for an older adult client who has Salmonella food poisoning. The client’s vital signs are heart rate: 102 beats/min, blood pressure: 98/55 mm Hg, respiratory rate: 22 breaths/min, and oxygen saturation: 92%. Which action should the nurse complete first?
   1. Apply oxygen via nasal cannula.
   2. Administer intravenous fluids.
   3. Provide perineal care with a premedicated wipe.
   4. Teach proper food preparation to prevent contamination.

ANS:   B

Dehydration caused by diarrhea can occur quickly in older clients with Salmonella food poisoning, so maintenance of fluid balance is a high priority. Monitoring vital signs and providing perineal care are important nursing actions but are of lower priority than fluid replacement. The nurse should teach the client about proper hand hygiene to prevent the spread of infection, and preparation of food and beverages to prevent contamination.

DIF:     Applying/Application                         REF: 1173                   KEY: Inflammatory bowel disorder| hydration                                          MSC:                         Integrated Process: Nursing Process: Implementation                                 NOT:                          Client Needs Category: Safe and Effective Care Environment: Management of Care

3. A nurse teaches a client who has viral gastroenteritis. Which dietary instruction should the nurse include in this client’s teaching?
   1. “Drink plenty of fluids to prevent dehydration.”
   2. “You should only drink 1 liter of fluids daily.”
   3. “Increase your protein intake by drinking more milk.”
   4. “Sips of cola or tea may help to relieve your nausea.”

ANS:           A

The client should drink plenty of fluids to prevent dehydration. Milk products may not be tolerated. Caffeinated beverages increase intestinal motility and should be avoided.

DIF:            Applying/Application                         REF:    1173                 KEY: Inflammatory bowel disorder| nutritional requirements                          MSC: Integrated Process: Teaching/Learning                               NOT:                                                 Client Needs Category: Physiological Integrity: Basic Care and Comfort

4. After teaching a client who was hospitalized for Salmonella food poisoning, a nurse assesses the client’s understanding. Which statement made by the client indicates a need for additional teaching?
   1. “I will let my husband do all of the cooking for my family.”
   2. “I’ll take the ciprofloxacin until the diarrhea has resolved.”
   3. “I should wash my hands with antibacterial soap before each meal.”
   4. “I must place my dishes into the dishwasher after each meal.”

ANS:           B

Ciprofloxacin should be taken for 10 to 14 days to treat Salmonella infection, and should not be stopped once the diarrhea has cleared. Clients should be advised to take the entire course of medication. People with Salmonella should not prepare foods for others because the infection may be spread in this way. Hands should be washed with antibacterial soap before and after eating to prevent spread of the bacteria. Dishes and eating utensils should not be shared and should be cleaned thoroughly. Clients can be carriers for up to 1 year.

DIF:     Applying/Application             REF:    1173     KEY: Inflammatory bowel disorder| medications| antibiotics| medication safety MSC:   Integrated Process: Teaching/Learning                       NOT: Client Needs Category: Health Promotion and Maintenance