Question 1

The nursing instructor taught a group of student nurses about the physical examination of clients with appendicitis. In the practical session, the instructor asks one of the student nurses to assess the signs of rebound tenderness in the client. Which assessment by the student nurse indicates effective learning?

Accepted Answer

Rebound tenderness is assessed by deeply palpating the abdomen and then quickly releasing the pressure. This action can cause pain upon release in conditions like appendicitis, indicating effective learning of the technique.

Question 2

What is the significance of propulsive movements in the large intestine?

Accepted Answer

Propulsive movements in the large intestine are important in initiating defecation. These movements help move feces towards the rectum and anus, where elimination can occur. While absorption of water, electrolytes, and bacteria accumulation do occur in the large intestine, these are not directly impacted by propulsive movements.

Question 3

Which is the largest serous membrane in the body?

Accepted Answer

The peritoneum is the largest serous membrane in the body. It lines the abdominal cavity and covers the organs within it. The other options listed are not serous membranes.

Question 4

In a client diagnosed with terminal ileal disease, the nurse administers cholestyramine. Which outcome in the client indicates the effectiveness of the medication?

Accepted Answer

The answer of In a client diagnosed with terminal ileal...

Question 5

In a client diagnosed with terminal ileal disease, the primary health care provider prescribed sulfasalazine. Which outcome in the client indicates the effectiveness of the therapy?

Accepted Answer

Sulfasalazine is an anti-inflammatory drug that is effective in treating inflammatory bowel disease. The terminal ileum is a common site of inflammation in Crohn's disease, and the normalization of the gastrointestinal wall indicates the effectiveness of sulfasalazine therapy. Hematocrit percentage, bile acid absorption, and urinalysis results are not directly related to the effectiveness of sulfasalazine in treating this type of disease.

Question 6

Which diagnostic test should the primary health care provider order to get the most accurate information related to appendicitis?

Accepted Answer

A computerized tomography (CT) scan is the most accurate diagnostic test for appendicitis. It can show the size and inflammation of the appendix and any surrounding inflammation or abscess formation. Urinalysis, abdominal X-rays, and abdominal ultrasound may also be ordered, but they are not as accurate as a CT scan.

Question 7

The nursing students are learning about precautions to be taken while caring for a client with suspected appendicitis. Which statement made by the student nurse indicates effective learning?

Accepted Answer

Clients suspected of having appendicitis should avoid taking pain medications, as these can mask symptoms and make diagnosis more difficult. IV fluids are often given to maintain hydration, antibiotics like ampicillin may be used to treat or prevent infection, and laxatives should be avoided as they can increase the risk of rupturing the appendix.

Question 8

Which side effect will the nurse observe in a client who is on epinephrine therapy?

Accepted Answer

Suppression of the urge to defecate is a side effect of epinephrine therapy.

Question 9

The nursing instructor is teaching a group of student nurses about the importance of inserting a nasogastric tube in clients with large bowel obstruction. Which statement made by the student nurse indicates effective learning?

Accepted Answer

A nasogastric tube helps to relieve pressure caused by bowel obstruction by decompressing the stomach and intestines, which allows for the removal of any gas, fluid or partially digested food that may accumulate in the stomach and intestines. This in turn reduces the pressure and volume of the contents in the bowel, which helps to reduce the risk of complications such as perforation or ruptured bowel. The other options (B, C, D) are incorrect as they do not accurately describe the purpose or function of a nasogastric tube in the context of a large bowel obstruction.

Question 10

Which part of the gastrointestinal (GI) tract is involved in the production of protective mucous?

Accepted Answer

Goblet cells are specialized cells in the GI tract that secrete mucous, which acts as a protective layer for the inner lining of the digestive system.

Question 11

Upon physical examination, the nurse detects abdominal tenderness, increased bowel sounds accompanied by signs of borborygmi, abdominal distension, and tympany on percussion. Which diagnostic test will confirm Crohn's disease in the client?

Accepted Answer

Colonoscopy is the primary diagnostic tool used to confirm Crohn's disease, as it allows for direct visualization of the inflamed intestinal tissue and the extent of the disease. Urinalysis, complete blood count, and chest X-ray may provide additional information about the client's overall health status, but do not specifically confirm the presence of Crohn's disease.

Question 12

What is a characteristic feature of ulcerative colitis?

Accepted Answer

Ulcerative colitis is characterized by both the presence of pseudopolyps and continuous areas of inflammation in the large intestine, leading to symptoms such as diarrhea, abdominal pain, and rectal bleeding.

Question 13

Which diagnostic test will help the nurse to confirm pancreatitis in the client?

Accepted Answer

The serum amylase test is a diagnostic test that measures the levels of amylase, an enzyme produced by the pancreas, in the blood. Elevated levels of amylase are indicative of pancreatitis. The other options may provide additional information but are not specific to pancreatitis diagnosis.

Question 14

The nursing instructor is teaching a group of student nurses about the use of antibiotics in a client diagnosed with appendicitis. Which statement made by the student nurse indicates effective learning?

Accepted Answer

Administering antibiotics before the operation and continuing them until 48 hours after the operation is a common practice in the treatment of appendicitis to prevent infection and promote healing. Option B is incorrect because antibiotics can be administered before the diagnostic signs. Option C is incorrect because antibiotics are not dependent on restoring fluid and electrolyte balance. Option D is incorrect because antibiotics are used in conjunction with surgical removal of the appendix.

Question 15

The nursing instructor is teaching a group of student nurses about the treatment plan for Crohn's disease. Which statement made by the student nurse indicates effective learning?

Accepted Answer

Cholestyramine is a bile acid sequestrate that reduces diarrhea and steatorrhea in clients with ileal disease. It helps to bind bile salts and increase the elimination of bile acids from the body. This is an effective treatment for Crohn's disease.

B is incorrect because loperamide is used to reduce diarrhea but it does not help with abdominal cramps.

C is incorrect because propantheline dicyclomine is an antispasmodic and it can be used for IBS, but not for Crohn's disease.

D is incorrect because clients with Crohn's disease have decreased absorption due to inflammation of the small bowel, and therefore they require multivitamin supplementation to prevent nutritional deficiencies.

Question 16

In a client diagnosed with large bowel obstruction, an abdominal x-ray is performed, which shows the presence of free air under the diaphragm. After the diagnosis, the nurse initiates prophylactic antibiotic therapy and fluid replacement therapy per the directions of the primary healthcare provider. Which outcome in the client indicates the effectiveness of the therapy?

Accepted Answer

The answer of In a client diagnosed with large bowel...

Question 17

A primary healthcare provider suspects diverticular disease in a client. Which diagnostic test would the primary health care provider order to visualize the lower bowel?

Accepted Answer

The answer of A primary healthcare provider suspects diverticular disease...

Question 18

Which disorder is characterized by the presence of cobblestoning upon examining the colon?

Accepted Answer

Cobblestoning refers to the appearance of raised patches or bumps on the inner lining of the colon, which is a classic finding in Crohn's disease. These patches may give the colon a cobblestone-like appearance when viewed through an endoscope or colonoscope. Volvulus is a condition where the bowel twists on itself, resulting in intestinal obstruction. Appendicitis is inflammation of the appendix, typically causing right lower abdominal pain. Ulcerative colitis is a form of inflammatory bowel disease that affects only the colon and rectum, causing inflammation and ulcers.

Question 19

A female client is admitted to the hospital with a complaint of abdominal pain that originates in the umbilical region and radiates to the right lower quadrant. The primary health care provider has ordered a urinalysis. How will this help the primary health care provider in diagnosing the client's condition?

Accepted Answer

A urinalysis can reveal the presence of bacteria, red and white blood cells, and other substances that may indicate an infection or inflammation in the urinary tract. This can help rule out the possibility of a kidney stone or pyelonephritis, both of which can cause abdominal pain that radiates to the right lower quadrant. It does not help in ruling out the other conditions listed.

Question 20

The nursing instructor teaches a group of student nurses about the diagnosis of irritable bowel syndrome. After the teaching session, the nursing instructor asks the student nurse to determine the presence of lactose intolerance in a client with irritable bowel syndrome. Which intervention by the student nurse indicates effective learning?

Accepted Answer

The most appropriate intervention to determine lactose intolerance in a client with irritable bowel syndrome would be a hydrogen breath test. This test measures the amount of hydrogen in a person's breath after consuming a beverage high in lactose. If the client has lactose intolerance, the bacteria in their colon will produce more hydrogen than usual, leading to a positive test result. The other options, such as blood analysis, upper endoscopy or abdominal CT scan, do not specifically measure for lactose intolerance and would not be appropriate for this purpose.

Quiz 30: Common Disorders of the Large Intestine