Chapter 43: Nursing Management: Lower Gastrointestinal Problems

Chapter 43: Nursing Management: Lower Gastrointestinal Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. A patient who is hospitalized with watery, incontinent diarrhea is diagnosed with
Clostridium difficile. Which action will the nurse include in the plan of care?
a. Order a diet with no dairy products for the patient.
b. Place the patient in a private room with contact isolation.
c. Teach the patient about why antibiotics are not being used.
d. Educate the patient about proper food handling and storage.
ANS: B
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. Improper
food handling and storage do not cause C. difficile.
DIF: Cognitive Level: Application REF: 1009-1010 TOP: Nursing Process:
Planning
MSC: NCLEX: Safe and Effective Care Environment
2. A 67-year-old patient tells the nurse, “I have problems with constipation now that I am
older, so I use a suppository every morning.” Which action should the nurse take first?
a. Encourage the patient to increase oral fluid intake.
b. Inform the patient that a daily bowel movement is unnecessary.
c. Assess the patient about individual risk factors for constipation.
d. Suggest that the patient increase dietary intake of high-fiber foods.
ANS: C
The nurse’s initial action should be further assessment of the patient for risk factors for
constipation and for usual bowel pattern. The other actions may be appropriate but will
be based on the assessment.
DIF: Cognitive Level: Application REF: 1012-1013
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. In teaching a patient who has chronic constipation about the use of psyllium (Metamucil),
which information will the nurse include?
a. Absorption of fat-soluble vitamins may be reduced by fiber-containing laxatives.
b. Dietary sources of fiber should be eliminated to prevent excessive gas formation.
c. Use of this type of laxative to prevent constipation does not cause adverse effects.
d. Large amounts of fluid should be taken to prevent impaction or bowel obstruction.
ANS: D
Test Bank 43-2
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: Application REF: 1012-1014
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. The nurse is obtaining a history for a 23-year-old woman who is being evaluated for
acute lower abdominal pain and vomiting. Which question will be most useful in
determining the cause of the patient’s symptoms?
a. “Is it possible that you are pregnant?”
b. “Can you tell me more about the pain?”
c. “What type of foods do you usually eat?”
d. “What is your usual elimination pattern?”
ANS: B
A complete description of the pain provides clues about the cause of the problem. The
usual diet and elimination patterns are less helpful in determining the reason for the
patient’s symptoms. 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.
DIF: Cognitive Level: Application REF: 1015-1016
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity