MEDICAL-SURGICAL NURSING 1

Prepared by: URO RN

COLON CANCER
1. The community health nurse is conducting a health promotion program at a local school and is
discussing the risk factors for colon cancer. Which of the following if identified by the client indicates
further teaching?
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 a. Exposure to radiation c. Low fat, high fiber diet
b. Exposure to chemicals d. Inflammatory bowel disorders
2. A client is admitted with a diagnosis of cancer of the colon. The nurse knows that malignant tumors of
the colon:
a. Are easily detected
b. Are usually localized
c. Occur more frequently in women than in men
d. Account for the majority of intestinal obstructions
3. When teaching a client about the signs of colorectal cancer, the nurse stresses that the most common
complaint of persons with colorectal cancer is:
a. Abdominal pain c. Change in bowel habits
b. Rectal bleeding d. Change in calibre of stools
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4. To establish the diagnosis for Colorectal Cancer, the most significant and determinant test is:
a. Carcinoembryonic antigen c. Digital Rectal Exam
b. Barium Contrast Studies d. Colonoscopy
5. An abdominoperineal resection with a colostomy is scheduled for a client with cancer of the rectum.
The nurse recognizes that the physician will need the client to sign a consent for a:
a. Permanent sigmoid colostomy
b. Permanent ascending colostomy
c. Temporary double-barrel colostomy
d. Temporary transverse loop colostomy
6. To promote perineal wound healing after an abdominoperineal resection for a client with colon cancer,
the nurse should encourage the client to assume the:
a. Knee-chest position b. Sims’ position
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 c. Dorsal recumbent position d. Side lying position
7. Postoperatively, if a client’s colostomy stoma is viable, the nurse would expect the color to be:
a. Pale Pink c. Dark Purple
b. Brick Red d. Jean Gray
8. When teaching a client to care for a new colostomy, the nurse should advise that the irrigations be
done at the same time every day. The time selected should:
a. Be approximately 1 hour before breakfast
b. Provide ample uninterrupted bathroom use at home
c. Approximate the client’s usual daily time for elimination
d. Be about halfway between the two largest meals of the day
9. A client has a permanent sigmoid colostomy because of cancer. The physician orders daily colostomy
irrigations. The nurse should explain to the client that the primary purpose of these irrigations is to:
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 a. Prevent straining at passage of stool
b. Establish a regular elimination schedule
c. Decrease the amount of flatus in the bowel
d. Limit the amount of fluid lost from the intestine
10. A client has a colostomy. When inserting a catheter for irrigation, the nurse should:
a. Use an oil-based lubricant
b. Instruct the client not to breathe
c. Apply gentle but continuous force
d. Insert a length of 3 to 4 inches
11. When teaching colostomy care, it is especially important for Nurse Urocan to teach the client to care for
the skin around the stoma by:
a. Avoiding the use of soaps or irritating agents
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 b. Pouring saline over the stoma and rubbing to removed hardened feces
c. Rinsing the area with hydrogen peroxide and applying fresh gauze bandages
d. Washing the area gently with soap and water and applying a protective ointment
12. Colostomy is a surgically created anus. It can be temporary or permanent, depending on the disease
condition. Skin care around the stoma is critical. Which of the following is not indicated as skin care?
a. Apply liberal amount of mineral oil to the area
b. Use karaya paste and rings around the stoma
c. Clean the area daily with soap and water before applying bag
d. Apply talcum powder twice a day
13. If during a colostomy irrigation, a client complains of abdominal cramps, the nurse should:
a. Discontinue the irrigation
b. Lower the container of fluid
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 c. Clamp the catheter for a few minutes
d. Advance the catheter about an inch
14. When performing a colostomy irrigation, the nurse inserts the catheter into the stoma:

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 a. 5 cm (2 inches) c. 15 cm (6 inches)
b. 10 cm (4 inches) d. 20 cm (8 inches)
15. When teaching a client to irrigate a colostomy for the first time, the nurse indicates that the distance of
the container above the stoma should be no more than:
a. 6 to 8 in. c. 10 to 12 in.
b. 8 to 10 in. d. 12 to 18 in.
16. When teaching a client with a permanent colostomy what might be expected on discharge, the nurse
discuss the:
a. Need for special clothing c. Periodic dilation of the stoma
b. Importance of limiting ADLs d. Bland, low-residue diet regimen
17. A client who has had a colostomy should follow a diet that is:
a. Rich in protein c. High in carbohydrate
b. Low in fiber content d. As close to normal as possible
18. Which of the following food items must not be encouraged for the ostomy client to take?
a. Peanut butter c. Lean meat
b. Rootcrops d. Fresh fruit juices
19. The primary step toward long-term goals in the rehabilitation of a client with a new colostomy involves
the client’s:
a. Mastery of techniques of colostomy care
b. Readiness to accept an altered body function
c. Awareness of available community resources
d. Knowledge of the necessary dietary modifications
20. Which of the following health teachings must be prioritized by the Community Health Nurse in the
advocacy against colorectal cancer?
a. 9 warning signs of cancer
b. Proper nutrition
c. Fecal diversion techniques
d. Immunization