Lower GI NCLEX Questions

Lower GI NCLEX Questions 4.6 (7 reviews) Students also studied Terms in this set (53) Loyola University Chicago GNUR 294 Save Lower GI NCLEX 27 terms Brittny856Preview Upper GI NCLEX questions 68 terms OxfordllamaPreview Upper GI NCLEX question 32 terms s646680Preview

UNIT 5:

64 terms Hop A 71-year-old male patient tells the nurse that growing old causes constipation so he has been using a suppository for constipation every morning. Which action should the nurse take first?

• Encourage the patient to increase oral fluid intake.
• Assess the patient about risk factors for constipation.
• Suggest that the patient increase intake of high-fiber

foods.

• Teach the patient that a daily bowel movement is

unnecessary.B A 26-year-old woman is being evaluated for vomiting and abdominal pain. Which question from the nurse will be most useful in determining the cause of the patient's symptoms?

• "What type of foods do you eat?"
• "Is it possible that you are pregnant?"
• "Can you tell me more about the pain?"
• "What is your usual elimination pattern?"

C A patient complains of gas pains and abdominal distention two days after a small bowel resection. Which nursing action is best to take?

• Encourage the patient to ambulate.
• Instill a mineral oil retention enema.
• Administer the ordered IV morphine sulfate.
• Offer the ordered promethazine (Phenergan)

suppository.A

A 58-year-old man with blunt abdominal trauma from a motor vehicle crash undergoes peritoneal lavage. If the lavage returns brown fecal drainage, which action will the nurse plan to take next?

• Auscultate the bowel sounds.
• Prepare the patient for surgery.
• Check the patient's oral temperature.
• Obtain information about the accident.

B: Return of brown drainage and fecal material suggests perforation of the bowel and the need for immediate surgery A 27-year-old female patient is admitted to the hospital for evaluation of right lower quadrant abdominal pain with nausea and vomiting. Which action should the nurse take?

• Encourage the patient to sip clear liquids.
• Assess the abdomen for rebound tenderness.
• Assist the patient to cough and deep breathe.
• Apply an ice pack to the right lower quadrant.

D: The patient's clinical manifestations are consistent with appendicitis, and

application of an ice pack will decrease inflammation at the area.Which nursing action will be included in the plan of care for a 27-year-old male patient with bowel irregularity and a new diagnosis of irritable bowel syndrome (IBS)?

• Encourage the patient to express concerns and ask

questions about IBS.

• Suggest that the patient increase the intake of milk and

other dairy products.

• Educate the patient about the use of alosetron

(Lotronex) to reduce symptoms.

• Teach the patient to avoid using nonsteroidal

antiinflammatory drugs (NSAIDs).

A:Because psychologic and emotional factors can affect the symptoms for IBS,

encouraging the patient to discuss emotions and ask questions is an important intervention.A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to

• administer IV metoclopramide (Reglan).
• discontinue the patient's oral food intake.
• administer cobalamin (vitamin B12) injections.
• teach the patient about total colectomy surgery.

B:An initial therapy for an acute exacerbation of inflammatory bowel disease (IBD) is to rest the bowel by making the patient NPO Which nursing action will the nurse include in the plan of care for a 35-year-old male patient admitted with an exacerbation of inflammatory bowel disease (IBD)?

• Restrict oral fluid intake.
• Monitor stools for blood.
• Ambulate four times daily.
• Increase dietary fiber intake.

B: Because anemia or hemorrhage may occur with IBD, stools should be assessed

for the presence of blood

Which patient statement indicates that the nurse's teaching about sulfasalazine (Azulfidine) for ulcerative colitis has been effective?

• "The medication will be tapered if I need surgery."
• "I will need to use a sunscreen when I am outdoors."
• "I will need to avoid contact with people who are sick."
• "The medication will prevent infections that cause the

diarrhea." B A 22-year-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective?

• The patient uses incontinence briefs to contain loose

stools.

• The patient asks for antidiarrheal medication after each

stool.

• The patient uses witch hazel compresses to decrease

irritation.

• The patient cleans the perianal area with soap after

each stool.C: Witch hazel compresses are suggested to reduce anal irritation and discomfort Which diet choice by the patient with an acute exacerbation of inflammatory bowel disease (IBD) indicates a need for more teaching?

• Scrambled eggs
• White toast and jam
• Oatmeal with cream
• Pancakes with syrup

C: During acute exacerbations of IBD, the patient should avoid high-fiber foods

such as whole grains.After a total proctocolectomy and permanent ileostomy, the patient tells the nurse, "I cannot manage all these changes. I don't want to look at the stoma." What is the best action by the nurse?

• Reassure the patient that ileostomy care will become

easier.

• Ask the patient about the concerns with stoma

management.

• Develop a detailed written list of ostomy care tasks for

the patient.

• Postpone any teaching until the patient adjusts to the

ileostomy.B A 51-year-old male patient has a new diagnosis of Crohn's disease after having frequent diarrhea and a weight loss of 10 pounds (4.5 kg) over 2 months. The nurse will plan to teach about

• medication use.
• fluid restriction.
• enteral nutrition.
• activity restrictions.

A: Medications are used to induce and maintain remission in patients with

inflammatory bowel disease (IBD)

A 24-year-old woman with Crohn's disease develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. What information will the nurse add to a general teaching plan about UTIs in order to individualize the teaching for this patient?

• Bacteria in the perianal area can enter the urethra.
• Fistulas can form between the bowel and bladder.
• Drink adequate fluids to maintain normal hydration.
• Empty the bladder before and after sexual intercourse.

B: Fistulas between the bowel and bladder occur in Crohn's disease and can lead

to UTI A 73-year-old patient with diverticulosis has a large bowel obstruction. The nurse will monitor for

• referred back pain.
• metabolic alkalosis.
• projectile vomiting.
• abdominal distention.

D The nurse preparing for the annual physical exam of a 50- year-old man will plan to teach the patient about

• endoscopy.
• colonoscopy.
• computerized tomography screening.
• carcinoembryonic antigen (CEA) testing.

B The nurse is providing preoperative teaching for a 61- year-old man scheduled for an abdominal-perineal resection. Which information will the nurse include?

• Another surgery in 8 to 12 weeks will be used to create

an ileal-anal reservoir.

• The patient will begin sitting in a chair at the bedside

on the first postoperative day.

• The patient will drink polyethylene glycol lavage

solution (GoLYTELY) preoperatively.

• IV antibiotics will be started at least 24 hours before

surgery to reduce the bowel bacteria.C A 74-year-old patient preparing to undergo a colon resection for cancer of the colon asks about the elevated carcinoembryonic antigen (CEA) test result. The nurse explains that the test is used to

• identify any metastasis of the cancer.
• monitor the tumor status after surgery.
• confirm the diagnosis of a specific type of cancer.
• determine the need for postoperative chemotherapy.

B: CEA is used to monitor for cancer recurrence after surgery

A 71-year-old patient had an abdominal-perineal resection for colon cancer. Which nursing action is most important to include in the plan of care for the day after surgery?

• Teach about a low-residue diet.
• Monitor output from the stoma.
• Assess the perineal drainage and incision.
• Encourage acceptance of the colostomy stoma.

C