1. A nurse is working with a patient who has chronic 16. The nurse is caring for a patient 27.
nt 27. During a patients scheduled home visit, an older
constipation. What should be included in patient
teaching to promote normal bowel function?
- Consume high-residue, high-fiber foods.
. history and performing the physical
2. A nurse is preparing to provide care for a patient
whose exacerbation of ulcerative colitis has required
hospital admission. During an exacerbation of this
health problem, the nurse would anticipate that the
patients stools will have what characteristics?
- Watery with blood and mucus
3. A patient has had an ileostomy created for the
treatment of irritable bowel disease and the patient is
now preparing for discharge. What should the patient
be taught about changing this device in the home
- Apply a skin barrier to the peristomal skin prior to
applying the pouch.
4. A patient admitted with acute diverticulitis has
experienced a sudden increase in temperature and
complains of a sudden onset of exquisite abdominal
tenderness. The nurses rapid assessment reveals that
the patients abdomen is uncharacteristically rigid on
palpation. What is the nurses best response?
- Contact the primary care provider promptly and
report these signs of perforation.
5. A 35-year-old male patient presents at the
emergency department with symptoms of a small
bowel obstruction. In collaboration with the primary
care provider, what intervention should the nurse
prioritize?
- Insertion of a nasogastric tube
6. A patient admitted with inflammatory bowel disease
asks the nurse for help with menu selections. What
menu selection is most likely the best choice for this
patient?
- Tofu
7. A patient is admitted to the medical unit with a
diagnosis of intestinal obstruction. When planning this
patients care, which of the following nursing diagnoses
should the nurse prioritize?
- Ineffective Tissue Perfusion Related to Bowel
Ischemia
8. A nurse is presenting an educational event to a local
community group. When speaking about colorectal
cancer, what risk factor should the nurse cite?
- High levels of alcohol consumption
9. A patients screening colonoscopy revealed the
presence of numerous polyps in the large bowel. What
principle should guide the subsequent treatment of this
patients health problem?
- The patients polyps constitute a risk factor for
cancer.
10. A nursing instructor is discussing hemorrhoids with
the nursing class. Which patients would the nursing
instructor identify as most likely to develop
hemorrhoids?
- A pregnant woman at 28 weeks gestation
11. A nurse is planning discharge teaching for a 21-
year-old patient with a new diagnosis of ulcerative
colitis. When planning family assessment, the nurse
should recognize that which of the following factors
will likely have the greatest impact on the patients
coping after discharge?
- The familys ability to provide emotional support
12. An older adult who resides in an assisted living
facility has sought care from the nurse because of
recurrent episodes of constipation. Which of the
following actions should the nurse first perform?
- Assess the patients food and fluid intake.
13. A 16-year-old presents at the emergency
department complaining of right lower quadrant pain
and is subsequently diagnosed with appendicitis.
When planning this patients nursing care, the nurse
should
prioritize what nursing diagnosis?
- Risk for Infection Related to Possible Rupture of
Appendix
14. A nurse is talking with a patient who is scheduled
to have a hemicolectomy with the creation of a
colostomy. The patient admits to being anxious, and
has many questions concerning the surgery, the care
of a stoma, and necessary lifestyle changes. Which of
the following nursing actions is most appropriate?
- Maintain an open dialogue with the patient and
facilitate a referral to the wound-ostomy-
continence (WOC) nurse.
15. A nurse is caring for a patient with constipation
whose primary care provider has recommended senna
(Senokot) for the management of this condition. The
nurse should provide which of the following education
points?
- Avoid taking the drug on a long-term basis.
who is undergoing diagnostic testing
for suspected malabsorption.
When taking this patients health
assessment, the nurse should
recognize what finding as most
consistent with this diagnosis?
- Foul-smelling diarrhea that
contains fat
17. A nurse is caring for a patient
admitted with symptoms of an
anorectal infection; cultures indicate
that the patient has a viral infection.
The nurse should anticipate the
administration of what drug?
- Acyclovir (Zovirax)
18. A nurse caring for a patient with
colorectal cancer is preparing the
patient for upcoming surgery. The
nurse administers cephalexin (Keflex)
to the patient and explains what
rationale?
- To reduce intestinal bacteria levels
19. A nurse is teaching a group of
adults about screening and prevention
of colorectal cancer. The nurse should
describe which of the following as the
most common sign of possible colon
cancer?
- Change in bowel habits
20. A nurse caring for a patient with a
newly created ileostomy assesses the
patient and notes that the patient
has had not ostomy output for the past
12 hours. The patient also complains
of worsening nausea. What is the
nurses priority action?
- Report signs and symptoms of
obstruction to the physician.
21. A nurse is working with a patient
who is learning to care for a continent
ileostomy (Kock pouch). Following the
initial period of healing, the nurse is
teaching the patient how to
independently empty the ileostomy.
The nurse should teach the patient to
do which of the following actions?
- Insert the catheter approximately 5
cm into the pouch.
22. A nurse is providing care for a
patient who has a diagnosis of irritable
bowel syndrome (IBS). When planning
this patients care, the nurse should
collaborate with the patient and
prioritize what goal?
- Patient will accurately identify
foods that trigger symptoms.
23. A patient has been experiencing
disconcerting GI symptoms that have
been worsening in severity.
Following medical assessment, the
patient has been diagnosed with
lactose intolerance. The nurse should
recognize an increased need for what
form of health promotion?
- Frequent screening for
osteoporosis
24. An older adult has a diagnosis of
Alzheimers disease and has recently
been experiencing fecal incontinence.
However, the nurse has observed no
recent change in the character of the
patients stools. What is the nurses
most appropriate intervention?
- Toilet the patient on a frequent,
scheduled basis.
25. An adult patient has been
diagnosed with diverticular disease
after ongoing challenges with
constipation. The patient will be
treated on an outpatient basis. What
components of treatment should the
nurse anticipate? Select all that apply.
- Increased fiber intake
- Reduced fat intake
26. A patients health history is
suggestive of inflammatory bowel
disease. Which of the following would
suggest Crohns disease, rather that
ulcerative colitis, as the cause of the
patients signs and symptoms?
- An absence of blood in stool
adult patient has stated to the community health nurse
that she has been experiencing hemorrhoids of
increasing severity in recent months. The nurse should
recommend which of the following?
- Increased fluid and fiber intake
28. A nurse is providing care for a patient whose recent
colostomy has contributed to a nursing diagnosis of
Disturbed Body Image Related to Colostomy. What
intervention best addresses this diagnosis?
- Engage the patient in the care of the ostomy to
the extent that the patient is willing.
29. A nurse is caring for a patient who has been
admitted to the hospital with diverticulitis. Which of the
following would be appropriate nursing diagnoses for
this patient? Select all that apply.
- Acute Pain Related to Increased Peristalsis and
GI Inflammation
- Activity Intolerance Related to Generalized
Weakness
-Deficient Fluid Volume Related to Anorexia,
Nausea, and Diarrhea
30. The nurse is providing care for a patient whose
inflammatory bowel disease has necessitated hospital
treatment. Which of the following would most likely be
included in the patients medication regimen?
- Anticholinergic medications 30 minutes before a
meal
31. A patients colorectal cancer has necessitated a
hemicolectomy with the creation of a colostomy. In the
4 days since the surgery, the patient has been
unwilling to look at the ostomy or participate in any
aspects of ostomy care. What is the nurses most
appropriate response to this observation?
- Acknowledge the patients reluctance and initiate
discussion of the factors underlying it.
32. A nurse is caring for an older adult who has been
experiencing severe Clostridium difficile-related
diarrhea. When reviewing the patients most recent
laboratory tests, the nurse should prioritize which of
the following?
- Potassium level
33. A nurse is assessing a patients stoma on
postoperative day 3. The nurse notes that the stoma
has a shiny appearance and a bright red color. How
should the nurse best respond to this assessment
finding?
- Document that the stoma appears healthy and
well perfused.
34. A patient has been diagnosed with a small bowel
obstruction and has been admitted to the medical unit.
The nurses care should prioritize which of the following
outcomes?
- Maintaining fluid and electrolyte balance
35. A patients large bowel obstruction has failed to
resolve spontaneously and the patients worsening
condition has warranted admission to the medical unit.
Which of the following aspects of nursing care is most
appropriate for this patient?
- Preparing the patient for surgical bowel resection
36. A patient has been experiencing occasional
episodes of constipation and has been unable to
achieve consistent relief by increasing physical activity
and improving his diet. What pharmacologic
intervention should the nurse recommend to the patient
for ongoing use?
- Psyllium hydrophilic mucilloid (Metamucil)
37. A patient with a diagnosis of colon cancer is 2 days
postoperative following bowel resection and
anastomosis. The nurse has planned the patients care
in the knowledge of potential complications. What
assessment should the nurse prioritize?
- Frequent abdominal auscultation
38. A teenage patient with a pilonidal cyst has been
brought for care by her mother. The nurse who is
contributing to the patients care knows that treatment
will be chosen based on what risk?
- Risk for infection
39. A nurse at an outpatient surgery center is caring for
a patient who had a hemorrhoidectomy. What
discharge education topics should the nurse address
with this patient?
- The correct procedure for taking a sitz bath
40. Which of the following is the most plausible nursing
diagnosis for a patient whose treatment for colon
cancer has necessitated a colonostomy?
- Ineffective Sexuality Patterns Related to Changes
in Self-Concept