Chapter 59: Care of Patients with Noninflammatory Intestinal Disorders

Chapter 59: Care of Patients with Noninflammatory Intestinal Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A client has irritable bowel syndrome. Which menu selections by this client indicate good understanding of dietary teaching?

a.	Tuna salad on white bread, cup of applesauce, glass of diet cola
b.	Broiled chicken with brown rice, steamed green beans, glass of apple juice
c.	Grilled cheese sandwich, small ripe banana, cup of hot tea with lemon
d.	Grilled steak, green beans, dinner roll with butter, cup of coffee with cream

 

 

ANS:  B

Clients with irritable bowel syndrome are advised to eat a high-fiber diet (30 to 40 grams a day), with 8 to 10 cups of liquid daily. This selection has the highest fiber content. They should avoid alcohol, caffeine, and other gastric irritants.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Health Promotion and Maintenance (Self-Care)

MSC:  Integrated Process: Nursing Process (Evaluation)

 

2. The nurse is performing a physical examination on a client. Which assessment finding leads the nurse to check the client’s abdomen for the presence of an acquired umbilical hernia?

a.	Body mass index (BMI) of 41.9
b.	Cholecystectomy last year
c.	History of irritable bowel syndrome
d.	Daily dose of lansoprazole (Prevacid) 30 mg orally

 

 

ANS:  A

This type of hernia is associated with obesity. The other assessment findings do not place the client at increased risk for an acquired umbilical hernia.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Alterations in Body Systems)                   MSC:  Integrated Process: Nursing Process (Assessment)

 

3. The nurse notes a bulge in a client’s groin that is present when the client stands and disappears when the client lies down. Which conclusion does the nurse draw from these assessment findings?

a.	Reducible inguinal hernia
b.	Indirect umbilical hernia
c.	Strangulated ventral hernia
d.	Incarcerated femoral hernia

 

 

ANS:  A

In a reducible hernia, the contents of the hernial sac can be replaced into the abdominal cavity by gentle pressure or by lying flat. The contents of irreducible, strangulated, or incarcerated hernias may not be replaced into the abdomen when the client lies down.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Analysis)

 

4. The nurse is caring for a client with an umbilical hernia who reports increased abdominal pain, nausea, and vomiting. The nurse notes high-pitched bowel sounds. Which conclusion does the nurse draw from these assessment findings?

a.	Bowel obstruction; client should be placed on NPO status.
b.	Perforation of the bowel; client needs emergency surgery.
c.	Adhesions in the hernia; client needs elective surgery.
d.	Hernia is dangerously enlarged; client needs a nasogastric (NG) tube.

 

 

ANS:  A

The client with a hernia presenting with abdominal pain, fever, tachycardia, nausea and vomiting, and hypoactive bowel sounds should be suspected of having developed strangulation. Strangulation poses a risk of intestinal obstruction. The client should be placed on NPO status, and the health care provider should be notified. The symptoms are not suggestive of enlargement of the hernia, adhesion formation, or bowel perforation.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC:  Integrated Process: Nursing Process (Analysis)