Ch24 Test Bank Nursing Care Of Patients With Bowel Disorders - Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff by LeMone, Burke, Gerene Bauldoff. DOCX document preview.
LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 24 Nursing Care of Patients with Bowel Disorders
1) The nurse is preparing to assess a patient with diverticulitis. Which area of the patient's abdomen should the nurse expect to palpate a mass?
1. Upper-right quadrant
2. Lower-left quadrant
3. Area of McBurney point
4. Epigastric region
Page Ref: 778
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with bowel disorders.
2) A patient is prescribed a low-residue diet. What foods should the nurse instruct the patient to avoid while on this diet?
1. Wine, vinegar, beer, liquor
2. Rice, grains, pasta
3. Canned vegetables
4. Chilled fruit gelatin desserts
Page Ref: 774
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
3) A patient tells the nurse about diarrhea after eating ice cream. Which health problem should the nurse suspect this patient is experiencing?
1. Disease of the colon
2. Inflammation of the small intestines
3. Cholera
4. Lactose intolerance
Page Ref: 783
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.4 Describe the pathophysiology and manifestations of malabsorption disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with bowel disorders.
4) The nurse is providing care to a patient admitted with acute diarrhea. What intervention would assist in this patient's care?
1. Provide a normal diet as tolerated.
2. Hold all medications until the diarrhea stops.
3. Provide clear liquids in small amounts.
4. Encourage normal activities of daily living in the hospital room.
Page Ref: 738
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 24.1 Describe the pathophysiology and manifestations of disorders of motility, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
5) The nurse is caring for a patient with a fecal impaction. Which type of enema will best assist in relieving the fecal impaction?
1. Normal saline
2. Oil retention
3. Tap water
4. Soap suds
Page Ref: 743
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 24.1 Describe the pathophysiology and manifestations of disorders of motility, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
6) A patient with irritable bowel syndrome (IBS) asks why medication was prescribed to treat depression. Which response should the nurse make?
1. "Didn't the doctor tell you that you are depressed?"
2. "Depression can be caused by irritable bowel syndrome."
3. "Did the doctor not give you an opportunity to ask questions?"
4. "These medications help with the symptoms associated with your bowel problem."
Page Ref: 745
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 24.1 Describe the pathophysiology and manifestations of disorders of motility, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with bowel disorders.
7) The nurse is implementing a bowel training program for a patient. What should be included in this patient's plan of care?
1. Assess the patient to determine the best time of day to use the commode for defecation.
2. Keep the bedpan near the patient at all times.
3. Instruct the patient not to attempt to use the bathroom unattended.
4. Stay with the patient while defecating.
Page Ref: 748
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 24.1 Describe the pathophysiology and manifestations of disorders of motility, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
8) A patient comes into the emergency department with suspected appendicitis. What should the nurse do for this patient?
1. Provide a hot water bottle to place over the abdomen.
2. Provide with clear water to drink.
3. Inspect the abdomen and assess bowel sounds.
4. Prepare to administer a biscodyl (Dulcolax) suppository.
Page Ref: 752
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 24.2 Describe the pathophysiology and manifestations of acute inflammatory and infectious bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
9) The nurse can detect no bowel sounds on a patient recovering from bowel surgery. What should the nurse suspect is occurring in this patient?
1. Borborygmi
2. Paralytic ileus
3. Hyperactive bowel sounds
4. Atonic bowel
Page Ref: 754
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.2 Describe the pathophysiology and manifestations of acute inflammatory and infectious bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with bowel disorders.
10) A patient is diagnosed with gastroenteritis. The nurse should assess which serum laboratory value first?
1. Sodium
2. Bicarbonate
3. Calcium
4. Potassium
Page Ref: 758
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.2 Describe the pathophysiology and manifestations of acute inflammatory and infectious bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with bowel disorders.
11) After a company barbecue three people out of a group of 12 developed signs of enteritis. Which assessment finding should the nurse use as an indication of the source of the health problem?
1. The three patients ate hamburgers.
2. Nine people ate hotdogs.
3. Most of the people drank canned soda.
4. All of the people ate ice cream.
Page Ref: 761
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.2 Describe the pathophysiology and manifestations of acute inflammatory and infectious bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with bowel disorders.
12) A young adult female patient is diagnosed with inflammatory disease of the small bowel. Which health problem is this patient most likely experiencing?
1. Ulcerative colitis
2. Chronic diarrhea
3. Gastroenteritis
4. Crohn disease
Page Ref: 764
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with bowel disorders.
13) A patient with Crohn disease is recovering from a bowel resection. What does the nurse realize will most likely occur in this patient?
1. The patient will never have another recurrence of the disease.
2. The patient will possibly have a recurrence in another portion of the bowel.
3. The patient will develop ulcerative colitis.
4. The patient will experience intestinal strictures.
Page Ref: 771
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with bowel disorders.
14) A patient with Crohn disease is experiencing weight loss. What should be included in this patient's plan of care?
1. A low-calorie, high-milk diet
2. A low-calorie, low-residue diet
3. A high-calorie, low-protein diet
4. A high-calorie, low-fat diet
Page Ref: 775
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
15) A patient is suspected as having sprue. What diet teaching does this patient need?
1. Avoid high-protein foods.
2. A vegetarian diet is the best treatment for this condition.
3. Gluten products must be eliminated from the diet.
4. All whey products must be eliminated from the diet.
Page Ref: 782
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 24.4 Describe the pathophysiology and manifestations of malabsorption disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
16) A patient who is newly diagnosed with short bowel syndrome asks what can be done to help the problem. How should the nurse respond to this patient?
1. "Dealing with this problem will be difficult in the beginning."
2. "Sometimes minor diet changes will alleviate the problem."
3. "I think more surgery is in your future."
4. "Short bowel syndrome is a long-term challenge."
Page Ref: 784
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 24.4 Describe the pathophysiology and manifestations of malabsorption disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with bowel disorders.
17) A patient with cancer of the rectum is scheduled for surgery and the placement of a permanent ostomy. Which type of ostomy will this patient most likely have performed during the surgery?
1. Ileostomy
2. Double-barrel
3. Sigmoid
4. Transverse loop
Page Ref: 788
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.6. Implement patient and family care around resolution of end-of-life and palliative care issues, such as symptom management, support of rituals, and respect for patient and family preferences | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 24.5 Describe the pathophysiology and manifestations of neoplastic disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with bowel disorders.
18) A patient is being seen for a "sudden lump" in the groin after lifting a heavy box to a shelf. Which health problem should the nurse suspect is occurring with this patient?
1. Indirect inguinal hernia
2. Direct inguinal hernia
3. Femoral hernia
4. Incisional hernia
Page Ref: 795
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.6 Describe the pathophysiology and manifestations of structural and obstructive bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with bowel disorders.
19) A patient learns that a small bowel obstruction was caused by an appendectomy five years ago. Which health problem most likely is causing the obstruction?
1. An untreated infection of the appendix
2. Adhesions
3. Undiagnosed femoral hernia
4. Umbilical hernia
Page Ref: 797
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.6 Describe the pathophysiology and manifestations of structural and obstructive bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with bowel disorders.
20) The nurse is providing medications to a patient with diverticular disease. Which medication should the nurse question for this patient?
1. Docusate (Colace)
2. Metronidazole (Flagyl)
3. Trimethoprim-sulfamethoxazole (Bactrim)
4. Bisacodyl (Dulcolax) suppository
Page Ref: 778
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with bowel disorders.
21) The nurse is asked to "look at" a patient because "something is coming out" of the rectum. Which health problem is the patient most likely experiencing?
1. Internal hemorrhoids
2. Colostomy
3. Prolapsed hemorrhoids
4. Femoral hernia
Page Ref: 801
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.7 Describe the pathophysiology and manifestations of anorectal disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with bowel disorders.
22) The nurse is providing discharge instructions to a patient who is recovering from anal-rectal surgery for repair of an anal fissure. What should be included in these instructions? Select all that apply.
1. Do not remove the dressing.
2. Change the dressing if it becomes soiled with urine or feces.
3. Use the sitz bath.
4. Use the antibiotic until all drainage stops.
5. Avoid bowel movements.
Page Ref: 804
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 24.7 Describe the pathophysiology and manifestations of anorectal disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
23) A patient who is experiencing diarrhea associated with a microorganism asks why antidiarrheal medication is not to be used. What should the nurse respond to this patient?
1. "Antidiarrheal medication slows down the elimination of the microorganism causing the diarrhea."
2. "Antibiotics are always used to treat the microorganisms but antibiotics may worsen diarrhea."
3. "The potassium you are taking will help to slow down the diarrhea."
4. "Your physician does not like to use antidiarrheal medications."
Page Ref: 737
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 24.1 Describe the pathophysiology and manifestations of disorders of motility, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
24) The nurse has instructed the patient who is experiencing diarrhea associated with irritable bowel syndrome on dietary changes to prevent diarrhea. Which menu selection indicates that patient teaching was effective?
1. Yogurt, crackers, and sweet tea
2. Salad with chicken, whole wheat crackers
3. Bacon, tomato, lettuce with mayonnaise, and a soft drink
4. Tuna on white bread and green grapes
Page Ref: 738
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 24.1 Describe the pathophysiology and manifestations of disorders of motility, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
25) A patient with peritonitis develops a temperature of 103°F (39.4°C), is restless, has blood pressure of 85/45 mmHg and has a urinary output of 76 mL in 8 hours. For which health problem should the nurse plan care for this patient?
1. Hypovolemic shock
2. Inflammation
3. Third spacing
4. Bowel dysfunction
Page Ref: 754
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 24.2 Describe the pathophysiology and manifestations of acute inflammatory and infectious bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with bowel disorders.
26) The nurse determines that a patient taking metronidazole (Flagyl) for a protozoan infection has been drinking alcohol while taking the medication. What assessment finding did the nurse use to make this clinical decision? Select all that apply.
1. Bruising
2. Flushing
3. Vomiting
4. Sore throat
5. Severe headache
Page Ref: 762
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 24.2 Describe the pathophysiology and manifestations of acute inflammatory and infectious bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with bowel disorders.
27) A patient recovering from surgery for a small bowel obstruction is prescribed enteral feedings. Which action should the nurse take to ensure the feedings are provided safely to the patient? Select all that apply.
1. Keep the head of the bed elevated 30 to 45 degrees.
2. Check for tube placement by flushing with normal saline.
3. Flush the tube with club soda after administering medications.
4. Measure external tube length after verifying placement with an x-ray.
5. Stop the tube feeding 10 minutes before changing the position to supine.
Page Ref: 755
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 24.2 Describe the pathophysiology and manifestations of acute inflammatory and infectious bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
28) The nurse instructs a patient with irritable bowel syndrome about the newly prescribed medication sulfasalazine (Azulfidine). Which patient statement indicates that teaching has been effective? Select all that apply.
1. "I should take this medication before meals."
2. "I should use sunscreen while taking this medication."
3. "I should not take any aspirin while taking this medication."
4. "I should restrict my fluid intake while taking this medication."
5. "I should not take any vitamin C while taking this medication."
Page Ref: 770
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
29) A patient has been experiencing diarrhea for several days. What should the nurse assess to determine if adverse effects are occurring within this patient? Select all that apply.
1. Skin turgor
2. Muscle tone
3. Serum potassium level
4. Serum magnesium level
5. Orthostatic blood pressure
Page Ref: 736
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.1 Describe the pathophysiology and manifestations of disorders of motility, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with bowel disorders.
30) The nurse suspects that a patient with ulcerative colitis has taken a dose of diphenoxylate (Lomotil) to help with diarrhea. What did the nurse assess to make this clinical decision? Select all that apply.
1. Fever
2. Tachycardia
3. Hypotension
4. Low urine output
5. Abdominal cramps
Page Ref: 774
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with bowel disorders.
31) A patient with chronic diarrhea has been advised by the healthcare provider to avoid foods containing sorbitol and mannitol. What should the nurse instruct the patient to avoid consuming for this health problem? Select all that apply.
1. Mints
2. Honey
3. Pear juice
4. Apple juice
5. Orange juice
Page Ref: 738
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 24.1 Describe the pathophysiology and manifestations of disorders of motility, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
32) After learning that a patient has abdominal pain that occurs at least 3 days per month over the last 3 months, the nurse suspects that a patient is experiencing irritable bowel syndrome. Which characteristic of the patient's abdominal pain did the nurse use to make this clinical decision? Select all that apply.
1. Relieved by eating
2. Improves with defecation
3. Associated with a change in stool form
4. Associated with a change in bowel frequency
5. Improves with physical activity and limiting food intake.
Page Ref: 745
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.1 Describe the pathophysiology and manifestations of disorders of motility, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with bowel disorders.
33) The nurse is caring for an older patient recovering from a bleeding ulcer. Which manifestation should the nurse use to determine whether the patient is experiencing peritonitis? Select all that apply.
1. Confusion
2. Bradycardia
3. Restlessness
4. Abdominal discomfort
5. Decreased urinary output
Page Ref: 754
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 24.2 Describe the pathophysiology and manifestations of acute inflammatory and infectious bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with bowel disorders.
34) A patient receiving long-term antibiotic therapy for an infected joint replacement begins to experience diarrhea, abdominal cramps, malaise, fever, and anorexia. What intervention should the nurse prepare to administer to this patient? Select all that apply.
1. Maintain nothing by mouth status.
2. Prepare to administer metronidazole.
3. Insert a nasogastric tube for feedings.
4. Collect all urine for a 24-hour specimen.
5. Discontinue the currently prescribed antibiotic.
Page Ref: 758
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 24.2 Describe the pathophysiology and manifestations of acute inflammatory and infectious bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with bowel disorders.
35) The nurse teaches a patient with Crohn disease about surgery to create a continent ileostomy. Which patient statement indicates that teaching has been effective? Select all that apply.
1. "I will need to change my diet."
2. "Stool will collect in an internal pouch."
3. "Stool will not leak through the stoma."
4. "I will use a catheter to drain the stool."
5. "I will need to change the bag every day."
Page Ref: 772
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
36) A patient with Crohn disease is instructed to ingest a low-residue diet. Which dietary choice indicates that the patient needs additional information about this eating plan? Select all that apply.
1. Corn flakes
2. Poppy seed roll
3. Tapioca pudding
4. Steamed broccoli
5. Whole grain bread
Page Ref: 774
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
37) An older patient is diagnosed with severe acute diverticulitis. What treatment should the nurse expect to be prescribed for this patient? Select all that apply.
1. Complete bed rest
2. Intravenous fluids
3. Nothing by mouth
4. Aspirin or NSAIDs for pain
5. Intravenous cefoxitin (Mefoxin)
Page Ref: 778
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 24.3 Describe the pathophysiology and manifestations of chronic inflammatory bowel disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with bowel disorders.
38) A patient with malabsorption syndrome is prescribed vitamin B12 injections. Which manifestation of this health problem should the nurse expect to improve with this vitamin supplement? Select all that apply.
1. Anemia
2. Cheilosis
3. Bone pain
4. Paresthesias
5. Muscle cramps
Page Ref: 781
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 24.4 Describe the pathophysiology and manifestations of malabsorption disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
39) A patient with a new descending colostomy is concerned because the stool is runny. Which food item should the nurse suggest to the patient to help thicken the stool? Select all that apply.
1. Peas
2. Pasta
3. Cheese
4. Bananas
5. Broccoli
Page Ref: 791
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 24.5 Describe the pathophysiology and manifestations of neoplastic disorders, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with bowel disorders.
Document Information
Connected Book
Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff
By LeMone, Burke, Gerene Bauldoff
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Chapter 22 Nursing Care Of Patients With Nutritional Disorders
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Chapter 24 Nursing Care Of Patients With Bowel Disorders
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