Question 1

Instruction to a patient who self-medicates with bismuth subsalicylate (Pepto Bismol)tablets should include that the tablets:

Accepted Answer

The drug may cause aspirin toxicity if taken excessively.The patient should not take other medication containing aspirin while taking this drug.The drug should be chewed well.This medication often turns the stool black.It does not affect the teeth.

Question 2

The nurse explains that a hernioplasty involves:

Accepted Answer

Hernioplasty is a surgical intervention in which the hernia is reduced and a synthetic mesh is sewn over the defect in the wall to prevent reoccurrence.

Question 3

The nurse is caring for a patient who has been diagnosed with Crohn's disease.When providing education concerning dietary recommendations,which statement by the patient indicates an understanding of the teaching?

Accepted Answer

A diet of low-fat,low-fiber foods that have a high protein and caloric content is instituted.Small frequent feedings are best.Lactose avoidance helps some patients but is not a global recommendation.

Question 4

The nurse is caring for a patient diagnosed with diverticulitis.In response to the patient's complaints of pain,the most likely medication to be used is:

Accepted Answer

Meperidine (Demerol)is the most likely selection to be prescribed for pain.Morphine increases intraluminal pressure and is likely to be avoided for this patient.Nubain is an analgesic but is not likely to reflect the strength and actions needed for the patient with diverticulitis.Narcan is used as an antagonist for narcotics.

Question 5

The nurse is discussing high-fiber dietary selections with a patient.Later,the patient makes his menu selection.When reviewing the patient's selections,what is most reflective of understanding the teaching provided?

Accepted Answer

A high-fiber diet is encouraged for the patient with diverticular disease.Eating whole-grain cereals and breads,as well as fruits such as apples,seedless berries,peaches,and pears adds fiber.High-fiber vegetables-squash,broccoli,cabbage,and spinach-and legumes,including dried beans,peas,and lentils,provide bulk that decreases constipation and speeds the transit time in the intestine.Drinking plenty of fluids and water helps regularity.

Question 6

The patient who has had an incarcerated hernia for many years begins to experience abdominal pain and vomit dark material with a fecal odor.The nurse recognizes these signs as indications of:

Accepted Answer

Flow of bowel content is blocked by incarceration,causing bowel obstruction with its attendant signs and symptoms of vomiting fecal contents and pain from ischemia and distention of the bowel.

Question 7

The nurse explains to the patient receiving bevacizumab (Avastin)for a tumor in the colon that the drug slows cancer cell growth by the process of:

Accepted Answer

Avastin reduces the blood flow to the tumor cells,depriving them of nutrients.

Question 8

The nurse caring for a patient who has peritonitis and has developed a paralytic ileus assesses that the patient is passing gas.The assessment is an indication of:

Accepted Answer

The passing of gas or stool in the patient who has a paralytic ileus is an indication that peristalsis has returned.

Question 9

The nurse urges the patient with diverticulitis to seek treatment because the inflamed bowel wall may:

Accepted Answer

The term diverticulum refers to a small,blind pouch resulting from a protrusion of the mucous membranes of a hollow organ through weakened areas of the organ's muscular wall.Diverticula occur most often in the intestinal tract,especially in the esophagus and colon.The infected diverticula can perforate through the bowel wall and cause peritonitis.Diverticulitis does not result in ulcerative colitis or appendicitis.

Question 10

The patient with an incarcerated hernia is at risk for the hernia to become:

Accepted Answer

The incarcerated hernia may become strangulated,which cuts off the blood supply and can lead to necrosis of the trapped bowel loop.Hernias are classified as reducible,which means the protruding organ can be returned to its proper place by pressing on the organ,and irreducible,which means that the protruding part of the organ is tightly wedged outside the cavity and cannot be pushed back through the opening.Another name for an irreducible hernia is incarcerated hernia.An indirect hernia protrudes through the inguinal ring.A direct hernia protrudes through the posterior inguinal wall.

Question 11

A 36-year-old woman who had an ascending colostomy angrily declares,"I don't want this hateful thing on my body! This nasty thing is not me." The nurse's most therapeutic response would be:

Accepted Answer

Asking the patient to name the specific concerns helps to conceptualize where the adjustment problem lies.All other options negate the patient's feelings,reinforce the patient's negative feelings,and do not offer any therapeutic response.

Question 12

The nurse explains that diverticula occur in the older adult because:

Accepted Answer

The bowel wall in the older adult becomes thickened and rigid.Intra-abdominal pressure causes herniation of the mucosa through the bowel wall,causing a small pocket in the colon.

Question 13

The nurse explains that the most beneficial diet for a person with inflammatory bowel disease (IBD)is a _____ diet.

Accepted Answer

A low-fat,low-fiber,high-protein,high-calorie diet is recommended for the patient with IBD to make up for the loss of fluid and nutrients in the frequent stools.

Question 14

The nurse explains that the advantage of the Kock pouch ileostomy is that the patient:

Accepted Answer

The major advantage of the Kock pouch is that the patient does not have to wear a collection device.The feces are collected in the pouch and emptied by the patient inserting a catheter into the pouch every 3 or 4 hours.

Question 15

The nurse assessing the stoma of a patient 1 day after a transverse colostomy will immediately report the finding of a(n):

Accepted Answer

The purple hue in the new stoma is an indication of reduced perfusion to the stoma and should be reported immediately.A new stoma should have a pink or beefy red color,be slightly edematous,and have some small bleeding around the stoma.

Question 16

The nurse uses a visual aid to demonstrate the process of a mechanical bowel obstruction that occurs when:

Accepted Answer

Obstruction of the bowel may be mechanical or nonmechanical.Mechanical obstruction results in blockage of the lumen of the bowel.Nonmechanical obstruction results from the absence of peristalsis (movement of contents through the bowel stops).Mechanical obstructions include tumors,adhesions,strangulated hernia,twisting of the bowel (volvulus),telescoping of one part of the bowel into another (intussusception),gallstones,barium impaction,and intestinal parasites.

Question 17

The nurse is aware that the person with ulcerative colitis is at risk for:

Accepted Answer

Ulcerative colitis is an inflammation,with the formation of ulcers,of the mucosa of the colon.It often is a chronic disease,and the patient usually is free from symptoms between acute flare-ups.The person with ulcerative colitis is 10 to 15 times more likely to develop colon cancer than those who do not have the disease.

Question 18

The nurse is aware that an unresolved bowel obstruction can lead to:

Accepted Answer

An unresolved obstruction can cause bowel rupture,peritonitis,shock,and death.

Question 19

The patient with a 4-day-old ileostomy complains of cramping.The nurse notes a drop in the effluent for the ileostomy.The bowel sounds are rapid with a "tinkling" sound.The nurse should:

Accepted Answer

Cramping and reduced effluent from a new ileostomy should be reported immediately as these are signs of obstruction,which could lead to perforation.Ileostomies are not irrigated except by the physician or an enterostomal therapist.

Question 20

The nurse caring for the patient with an ileostomy will include special interventions to prevent skin breakdown and irritation at the stomal site because the:

Accepted Answer

The liquid stool from the ileum has many digestive enzymes,unlike stool that is expelled from the colon.

Quiz 30: Care of Patients With Disorders of the Lower Gastrointestinal System

Instruction to a patient who self-medicates with bismuth subsalicylate (Pepto Bismol) tablets should include that the tablets: