Chapter 34. Nursing Care of Patients With Lower Gastrointestinal Disorders

Chapter 34. Nursing Care of Patients With Lower Gastrointestinal Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   The nurse is collecting data from a newly admitted patient. Which finding should the nurse identify as a risk factor for constipation?

a.	The patient does not like milk or milk products.
b.	The patient has had hemorrhoids for the past 5 years.
c.	The patient had part of the stomach removed 10 years ago because of ulcers.
d.	The patient has a history of breast cancer treated with chemotherapy 3 years ago.

 

 

____     2.   The nurse is contributing to a patient’s plan of care. For which patient would the nursing diagnosis of Risk for Constipation be most appropriate?

a.	A 37-year-old taking NSAIDs for bursitis
b.	A 59-year-old taking narcotics for chronic pain control
c.	A 74-year-old taking antibiotics for a urinary tract infection
d.	A 67-year-old taking anticoagulant therapy for a history of deep vein thrombosis

 

 

____     3.   The nurse is caring for a patient who reports feeling constipated, yet passes frequent small liquid stools. Which action should the nurse take?

a.	Check the patient for a fecal impaction.
b.	Administer an antidiarrheal medication.
c.	Explain that liquid stools indicate diarrhea.
d.	Check the abdomen for rebound tenderness.

 

 

____     4.   The nurse notes that a patient with a history of a myocardial infarction is straining during defecation. Which response by the nurse is best?

a.	“Be careful, you might get a headache when you push so hard.”
b.	“It is important that you not strain because it could cause damage to your heart.”
c.	“Your blood pressure gets very low when you strain like that and you could faint.”
d.	“Chronic constipation often causes a dilated colon, so it is good that you are staying empty.”

 

 

____     5.   A patient with a colostomy says, “My pouch blows up like a balloon when I pass gas.” What is an appropriate response by the nurse?

a.	“Make a tiny pinhole in the top of the pouch to let air out.”
b.	“Empty the gas like you would if the pouch was full of stool.”
c.	“Peel back a tiny corner of the skin barrier to allow gas to escape.”
d.	“Remove the pouch and put on a new one when it gets too full of gas.”

 

MULTIPLE CHOICE

 

1. ANS:  B

Causes for constipation include rectal or anal conditions such as hemorrhoids. A. Absence of milk products in the diet is not a known cause for constipation. C. Stomach surgery is not a cause for constipation. D. History of breast cancer treatment does not cause constipation.

 

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Analysis

 

2. ANS:  B

Medications, such as narcotics, tranquilizers, and antacids with aluminum, decrease motility of the large intestine and may contribute to constipation. A. C. D. NSAIDs, antibiotics, and anticoagulants are not identified as causing constipation.

 

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Analysis

 

3. ANS:  A

Fecal impaction results when the fecal mass is so dry it cannot be passed. Small amounts of liquid stool ooze around the fecal mass and cause incontinence of liquid stools. B. If the incontinence is treated with an antidiarrheal medication, it will worsen the constipation. C. The patient is not experiencing liquid stools. D. Rebound tenderness is not a manifestation of fecal impaction.

 

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Application

 

4. ANS:  B

Straining to have a bowel movement (Valsalva’s maneuver) can result in cardiac, neurological, and respiratory complications. If the patient has a history of heart failure, hypertension, or recent myocardial infarction, straining can lead to cardiac rupture and death. A. C. D. These responses are not appropriate for the patient with a history of myocardial infarction who is straining with a bowel movement.

 

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application

 

5. ANS:  B

The pouch should be emptied the same as emptying for stool. A. A pinhole will allow odor to escape so that should never be done. D. A new pouch is not necessary and would cost too much. C. Disrupting the skin barrier often could irritate the skin.

 

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Application