Chapter 56: Care of Patients with Noninflammatory Intestinal Disorders

Chapter 56: Care of Patients with Noninflammatory Intestinal Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client’s understanding. Which menu selection indicates that the client correctly understands the dietary teaching?
   1. Ham sandwich on white bread, cup of applesauce, glass of diet cola
   2. Broiled chicken with brown rice, steamed broccoli, glass of apple juice
   3. Grilled cheese sandwich, small banana, cup of hot tea with lemon
   4. Baked tilapia, fresh green beans, cup of coffee with low-fat milk

ANS:   B

Clients with IBS are advised to eat a high-fiber diet (30 to 40 g/day), with 8 to 10 cups of liquid daily. Chicken with brown rice, broccoli, and apple juice has the highest fiber content. They should avoid alcohol, caffeine, and other gastric irritants.

DIF:     Applying/Application                         REF: 1145                   KEY: Irritable bowel| nutritional requirements                                                   MSC: Integrated Process: Teaching/Learning                       NOT:                                                 Client Needs Category: Physiological Integrity: Basic Care and Comfort

2. A nurse assesses a client who is prescribed alosetron (Lotronex). Which assessment question should the nurse ask this client?
   1. “Have you been experiencing any constipation?”
   2. “Are you eating a diet high in fiber and fluids?”
   3. “Do you have a history of high blood pressure?”
   4. “What vitamins and supplements are you taking?”

ANS:   A

Ischemic colitis is a life-threatening complication of alosetron. The nurse should assess the client for constipation. The other questions do not identify complications related to alosetron.

DIF:     Applying/Application                         REF: 1146

KEY:   Medications| adverse effects

MSC:   Integrated Process: Nursing Process: Assessment                 NOT: Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

3. After teaching a client who has a femoral hernia, the nurse assesses the client’s understanding. Which statement indicates the client needs additional teaching related to the proper use of a truss?
   1. “I will put on the truss before I go to bed each night.”
   2. “I’ll put some powder under the truss to avoid skin irritation.”
   3. “The truss will help my hernia because I can’t have surgery.”
   4. “If I have abdominal pain, I’ll let my health care provider know right away.”

ANS:           A

The client should be instructed to apply the truss before arising, not before going to bed at night. The other statements show an accurate understanding of using a truss.

DIF:            Applying/Application                         REF:    1147                KEY: Herniation MSC: Integrated Process: Teaching/Learning                                               NOT:              Client Needs Category: Health Promotion and Maintenance

4. A nurse assesses a client who is recovering from a hemorrhoidectomy that was done the day before. The nurse notes that the client has lower abdominal distention accompanied by dullness to percussion over the distended area. Which action should the nurse take?
   1. Assess the client’s heart rate and blood pressure.
   2. Determine when the client last voided.
   3. Ask if the client is experiencing flatus.
   4. Auscultate all quadrants of the client’s abdomen.

ANS:           B

Assessment findings indicate that the client may have an over-full bladder. In the immediate postoperative period, the client may experience difficulty voiding due to urinary retention. The nurse should assess when the client last voided. The client’s vital signs may be checked after the nurse determines the client’s last void. Asking about flatus and auscultating bowel sounds are not related to a hemorrhoidectomy.

DIF:            Applying/Application                         REF:    1165                 KEY: Postoperative nursing| urinary retention                                                                 MSC:             Integrated Process: Nursing Process: Implementation                                        NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential