Chapter 44 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition


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Chapter 44  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition



Complete Chapter Questions And Answers

Sample Questions


1. A nurse is caring for a patient who is scheduled for a colonoscopy and whose bowel preparation will include polyethylene glycol electrolyte lavage prior to the procedure. The presence of what health problem would contraindicate the use of this form of bowel preparation?

  1. A)  Inflammatory bowel disease
  2. B)  Intestinal polyps
  3. C)  Diverticulitis
  4. D)  Colon cancer

Ans: A


The use of a lavage solution is contraindicated in patients with intestinal obstruction or inflammatory bowel disease. It can safely be used with patients who have polyps, colon cancer, or diverticulitis.

2. A nurse is promoting increased protein intake to enhance a patient’s wound healing. The nurse knows that enzymes are essential in the digestion of nutrients such as protein. What is the enzyme that initiates the digestion of protein?

  1. A)  Pepsin
  2. B)  Intrinsic factor
  3. C)  Lipase
  4. D)  Amylase

Ans: A


The enzyme that initiates the digestion of protein is pepsin. Intrinsic factor combines with vitamin B12 for absorption by the ileum. Lipase aids in the digestion of fats and amylase aids in the digestion of starch.

3. A patient has been brought to the emergency department with abdominal pain and is subsequently diagnosed with appendicitis. The patient is scheduled for an appendectomy but questions the nurse about how his health will be affected by the absence of an appendix. How should the nurse best respond?

  1. A)  “Your appendix doesn’t play a major role, so you won’t notice any difference after you recovery from surgery.”
  2. B)  “The surgeon will encourage you to limit your fat intake for a few weeks after the surgery, but your body will then begin to compensate.”
  3. C)  “Your body will absorb slightly fewer nutrients from the food you eat, but you won’t be aware of this.”
  4. D)  “Your large intestine will adapt over time to the absence of your appendix.”

Ans: A


The appendix is an appendage of the cecum (not the large intestine) that has little or no physiologic function. Its absence does not affect digestion or absorption.

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4. A patient asks the nursing assistant for a bedpan. When the patient is finished, the nursing assistant notifies the nurse that the patient has bright red streaking of blood in the stool. What is this most likely a result of?

  1. A)  Diet high in red meat
  2. B)  Upper GI bleed
  3. C)  Hemorrhoids
  4. D)  Use of iron supplements

Ans: C


Lower rectal or anal bleeding is suspected if there is streaking of blood on the surface of the stool. Hemorrhoids are often a cause of anal bleeding since they occur in the rectum. Blood from an upper GI bleed would be dark rather than frank. Iron supplements make the stool dark, but not bloody and red meat consumption would not cause frank blood.

5. An adult patient is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include when the patient has completed the test?

  1. A)  Stool will be yellow for the first 24 hours postprocedure.
  2. B)  The barium may cause diarrhea for the next 24 hours.
  3. C)  Fluids must be increased to facilitate the evacuation of the stool.
  4. D)  Slight anal bleeding may be noted as the barium is passed.

Ans: C


Postprocedural patient education includes information about increasing fluid intake; evaluating bowel movements for evacuation of barium; and noting increased number of bowel movements, because barium, due to its high osmolarity, may draw fluid into the bowel, thus increasing the intraluminal contents and resulting in greater output. Yellow stool, diarrhea, and anal bleeding are not expected.

6. A patient has come to the outpatient radiology department for diagnostic testing. Which of the following diagnostic procedures will allow the care team to evaluate and remove polyps?

  1. A)  Colonoscopy
  2. B)  Barium enema
  3. C)  ERCP
  4. D)  Upper gastrointestinal fibroscopy

Ans: A


During colonoscopy, tissue biopsies can be obtained as needed, and polyps can be removed and evaluated. This is not possible during a barium enema, ERCP, or gastroscopy.

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