Chapter 38 Management of Patients With Intestinal and Rectal Disorders

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Chapter 38  Management of Patients With Intestinal and Rectal Disorders

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. You are caring for an elderly patient diagnosed with a broken hip. When assessing the patient you find that they also have chronic constipation. What should be included in patient teaching to prevent constipation?
A) Establish a bowel routine based upon the fact that the best time for defecation is after dinner. B) Exercise may prolong a bowel movement.

C) Consume high-residue, high-fiber foods.
D) Resist the urge to defecate until the scheduled time.

Ans: C
Chapter: 38
Client Needs: D-4
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Teaching/Learning Objective: 1
Page and Header: 1070, Constipation

Feedback: Goals for the patient include restoring or maintaining a regular pattern of elimination by responding to the urge to defecate, ensuring adequate intake of fluids and high-fiber foods, learning about methods to avoid constipation, relieving anxiety about bowel elimination patterns,

and avoiding complications. Identifying a regular time, such as after stimulation of the gastrointestinal (GI) tract by breakfast intake, may aid in initiating the reflex. The urge to defecate should be heeded. Increased mobility helps to maintain a regular pattern of elimination.

2. The nursing instructor is discussing ulcerative colitis with her clinical group. What would she tell her students about the characteristics of the stools of these patients?
A) Watery with blood and mucus
B) Hard and black

C) Long and cylinder shaped D) Loose and fatty

Ans: A
Chapter: 38
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 4
Page and Header: 1083, Types of Inflammatory Bowel Disease

Feedback: The predominant symptoms of ulcerative colitis are diarrhea and abdominal pain. Stools may be bloody and contain mucus. Therefore options B, C, and D are incorrect.

3. A patient with a new ileostomy is preparing to go home. What should the patient be taught about changing their ileostomy?
A) Apply moisturizing lotion after cleaning the stoma.
B) Apply a skin barrier to the peristomal skin prior to applying the pouch.

C) Dispose of the clamp with each bag change.
D) Cleanse the area surrounding the stoma with alcohol.

Ans: B
Chapter: 38
Client Needs: D-3
Cognitive Level: Application
Difficulty: Easy
Integrated Process: Teaching/Learning
Objective: 6
Page and Header: 1093, Management of Chronic Inflammatory Bowel Disease

Feedback: Guidelines for changing an ileostomy appliance are as follows. Skin should be

washed with soap and water and dried. A skin barrier should be applied to the peristomal skin prior to applying the pouch. Clamps are supplied one per box and should be reused with each bag change.

4. A patient admitted with acute diverticulitis is being cared for by a staff nurse and a student nurse. The student asks the staff nurse what the signs of bowel perforation are. What should the staff nurse answer the student?
A) A decreased sedimentation rate

B) An elevated white cell count C) Bradycardia
D) Hypertension

Ans: B
Chapter: 38
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 3
Page and Header: 1080, Diverticular Disease

Feedback: Signs of diverticular perforation include elevated white blood cell count, elevated sedimentation rate, increased temperature, tachycardia, and hypotension.

5. A 35-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. An emergency room nurse is obtaining assessment data from this patient. What assessment finding is characteristic of a small bowel obstruction?
A) Nausea and vomiting

B) Decrease in urine production C) Mucus in the stool
D) Mucosal edema

Ans: A
Chapter: 38
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 7
Page and Header: 1097, Small Bowel Obstruction

Feedback: Nausea and vomiting are symptoms of a small bowel obstruction. Decrease in urine production, mucus in the stool, and mucosal edema are not symptoms of a bowel obstruction.

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