Chapter 29: Care of Patients with Disorders of the Lower Gastrointestinal System

Chapter 29: Care of Patients with Disorders of the Lower Gastrointestinal System

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which type of hernia can lead to necrosis?

a.	Strangulated hernia
b.	Indirect hernia
c.	Direct hernia
d.	Irreducible hernia

 

 

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.

 

PTS:   1                    DIF:    Cognitive Level: Knowledge            REF:   676

OBJ:   1 (theory)       TOP:   Incarcerated Hernia: Complications

KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

2. The nurse is caring for patient with a history of a chronic incarcerated hernia. The patient suddenly complains of abdominal pain and vomits dark material with a fecal odor. The nurse recognizes these signs as indications of which complication?

a.	Complete intestinal obstruction
b.	Rupture
c.	Gastroenteritis
d.	Duodenal ulcer

 

 

ANS:  A

The symptoms of intestinal obstruction vary according to the location of the obstruction. Fecal odor or material in the emesis suggests a complete intestinal obstruction. In this case, the incarcerated hernia has blocked the flow of bowel content. If there is a defect in the muscular wall of the abdomen, the intestine may break through the defect; his protrusion is called a hernia or a rupture. Gastroenteritis is inflammation of the stomach and intestines. A duodenal ulcer occurs in the small intestine (the duodenum).

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   671

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 is a surgery that involves which process?

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.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   676

OBJ:   1 (theory)       TOP:   Hernia Repair: Hernioplasty

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

4. The nurse is caring for a patient whose home medications include bismuth subsalicylate (Pepto Bismol). The nurse should educate the patient about which side effect of this medication?

a.	Pink urine
b.	Sunburn-like rash
c.	Stained teeth
d.	Black stools

 

 

ANS:  D

This medication often turns the stool black. It does not cause a rash, or stain the urine or teeth.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   667, Table 29-1

OBJ:   2 (theory)       TOP:   Bismuth Subsalicylate: Side Effects

KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological Therapies