Chapter 40: Lower Digestive Tract Disorders
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. What is the most current endoscopic procedure for examining the small intestine?
a.
Capsule camera
b.
Fiberoptic light probe
c.
Rigid lighted tubes
d.
Flat plate
2. Which instruction given to a patient with irritable bowel syndrome (IBS) should lessen
discomfort?
a.
Eat only whole grains.
b.
Take small bites and chew well.
c.
Include dietary fiber in at least two meals per day.
d.
Drink herbal teas and low-calorie cola drinks.
3. A nurse has collected several stool specimens for ova and parasites that are to be sent to the
laboratory. What action is most appropriate for the nurse to implement?
a.
Immediately take the specimens to the laboratory to be tested for parasites and ova.
b.
Take the specimens to the laboratory to be tested for culture and sensitivity and
leave them for later pickup.
c.
Take the specimens to the refrigerator to be tested later for parasites and ova.
d.
Leave the specimens in a warm place until convenient time to deliver to the
laboratory.
4. A nurse is caring for a 34-year-old patient admitted with severe diarrhea that has been going
on for 2 weeks. What assessment should the nurse anticipate?
a.
Edema of lower legs and feet
b.
Hypotension and fatigue
c.
Hypertension and hunger
d.
Metabolic alkalosis
5. Stool softeners are prescribed to promote normal elimination of feces. What is the most
appropriate way to ensure effectiveness of this type of drug?
a.
Mouth care
b.
Ambulation
c.
Adequate fluid intake
d.
High-fiber diet
6. Which set of findings best indicates that a patient with intestinal obstruction has achieved
normal hydration?
a.
Pulse and blood pressure are within the patient’s norms, mucous membranes are
moist, and fluid intake and output are equal.
b.
Pulse rate is strong (at least 60 beats/min), bowel sounds are normal, and a
respiratory rate of 22 breaths/min is recorded.
c.
Blood pressure is within the patient’s norm, the temperature is below normal, and
adequate tissue turgor is observed.
d.
Mucous membranes are moist, the 24-hour fluid intake is higher than the 24-hour
output, and the pulse rate is elevated.
7. After abdominal surgery, a patient must cough and take deep breaths. How can the nurse best
achieve this with this patient?
a.
Withhold analgesics until the patient performs this task.
b.
Help the patient splint the incision with a pillow.
c.
Explain that pneumonia occurs if deep breathing is not carried out every 4 hours.
d.
Ambulate the patient 40 feet to increase his need for oxygen.
8. A nurse describes a patient as morbidly obese because the patient has a weight of 387 lb and a
height of 2 meters. What is the patient’s body mass index (BMI)?
a.
58.4
b.
52.8
c.
43.9
d.
31.6
9. Which statement by a patient with an ileostomy as a remedy for ulcerative colitis indicates the
need for further teaching?
a.
“I will avoid milk products.”
b.
“I should select food with less dietary fiber.”
c.
“I’ll miss my martini before dinner.”
d.
“I will be glad when the surgeon closes this ileostomy.”
10. A nurse identifies a risk factor in an older man that places him at risk for developing
diverticulosis. What patient information indicates such a risk factor?
a.
Eats a low-fiber diet
b.
Chronic diarrhea
c.
History of using nonsteroidal antiinflammatory drugs (NSAIDs)
d.
Family history of colon cancer
11. Which foods should an individual with diverticulosis avoid?
a.
Peanuts and raspberries
b.
Apples and pears
c.
Red meat and dairy products
d.
Bran and whole grains
12. Colonoscopy results indicate the diagnosis of irritable bowel disease (IBD) in a patient
admitted to the hospital with diarrhea. What information should the nurse include when
preparing patient education regarding diet?
a.
Dairy products are encouraged.
b.
No added salt is required.
c.
Low roughage should be followed.
d.
Protein foods are restricted.
13. A nurse is caring for a patient diagnosed with diverticulosis and assesses a temperature of
102.4° F and abdominal rigidity. What should the nurse be aware is the most likely cause of
these signs and symptoms?
a.
Infection
b.
Constipation
c.
Perforation
d.
Obstruction
14. A patient is diagnosed with cancer of the large intestine. What is the most likely initial
recommended medical intervention?
a.
Repeat colonoscopy
b.
Surgery
c.
Radiation therapy
d.
Chemotherapy
15. A nurse is performing an assessment of a patient after an abdominoperineal resection. How
many incision sites will be present?
a.
Two
b.
Three
c.
Four
d.
Five
16. A patient reports severe pain after an abdominoperineal resection. What position should the
nurse assist this patient into in order to promote comfort?
a.
Side-lying
b.
Supine
c.
Prone
d.
Semi-Fowler
17. A nurse provides education to a patient after a hemorrhoidectomy. Which statement by the
patient demonstrates the need for further instruction?
a.
“Sitz baths are ordered to soothe the area.”
b.
“Imagery may help control pain.”
c.
“Bleeding should be reported.”
d.
“Fluids are restricted.”
18. A nurse notes a diagnosis of pilonidal cyst on a patient’s admission assessment. What
anatomical location should the nurse expect to assess this cyst?
a.
Rectum
b.
Sacrococcygeal area
c.
Abdomen
d.
Anus
19. A patient is being seen for the first time at a physician’s office. When assisting with the
assessment, a nurse notices abdominal striae. What alternative term should the nurse use when
the patient asks what it is all over her abdomen?
a.
Scarring
b.
Lesions
c.
Rashes
d.
Stretch marks
MULTIPLE RESPONSE
20. A home health nurse is instructing an older adult patient regarding dietary changes to help
prevent constipation. What changes should the nurse indicate when providing this education?
(Select all that apply.)
a.
Addition of whole-grain cereal
b.
Cessation of laxative use
c.
Increase in liquid intake
d.
Increase in sugar intake
e.
Eating fresh vegetables