Chapter 42: Lower Gastrointestinal Problems

Chapter 42: Lower Gastrointestinal Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which action will the nurse include in the plan of care for a patient who is being admitted with Clostridium difficile?

ANS:  C

Because C. difficile is highly contagious, the patient should be placed in a private room, and contact precautions should be used. There is no need to restrict dairy products for this type of diarrhea. Metronidazole (Flagyl) is frequently used to treat C. difficile infections. Improper food handling and storage do not cause C. difficile.

DIF:    Cognitive Level: Apply (application)           REF:               932

TOP:   Nursing Process: Planning               MSC:  NCLEX: Safe and Effective Care Environment

2. A 74-yr-old male patient tells the nurse that growing old causes constipation so he has been using a suppository for constipation every morning. Which action should the nurse take first?

ANS:  B

The nurse’s initial action should be further assessment of the patient for risk factors for constipation and for his usual bowel pattern. The other actions may be appropriate but will be based on the assessment.

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   933

OBJ:   Special Questions: Prioritization      TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity

3. A patient who has chronic constipation asks the nurse about the use of psyllium (Metamucil). Which information will the nurse include in the response?

ANS:  D

A high fluid intake is needed when patients are using bulk-forming laxatives to avoid worsening constipation. Although bulk-forming laxatives are generally safe, the nurse should emphasize the possibility of constipation or obstipation if inadequate fluid intake occurs. Although increased gas formation is likely to occur with increased dietary fiber, the patient should gradually increase dietary fiber and eventually may not need the psyllium. Fat-soluble vitamin absorption is blocked by stool softeners and lubricants, not by bulk-forming laxatives.

DIF:    Cognitive Level: Apply (application)           REF:               935

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

4. A 26-yr-old woman is being evaluated for vomiting and abdominal pain. Which question from the nurse will be most useful in determining the cause of the patient’s symptoms?

ANS:  C

A complete description of the pain provides clues about the cause of the problem. Although the nurse should ask whether the patient is pregnant to determine whether the patient might have an ectopic pregnancy and before any radiology studies are done, this information is not the most useful in determining the cause of the pain. The usual diet and elimination patterns are less helpful in determining the reason for the patient’s symptoms.

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   939

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity