Question 1

A nurse cares for a client who states,"My husband is repulsed by my colostomy and refuses to be intimate with me." How should the nurse respond?

Accepted Answer

A)   "Let's talk to the ostomy nurse to help you and your husband work through this."
B)   "You could try to wear longer lingerie that will better hide the ostomy appliance."
C)   "You should empty the pouch first so it will be less noticeable for your husband."
D)   "If you are not careful, you can hurt the stoma if you engage in sexual activity." A

Question 2

A nurse assesses a client who is recovering from a hemorrhoidectomy that was done the day before.The nurse notes that the client has lower abdominal distention accompanied by dullness to percussion over the distended area.Which action should the nurse take?

Accepted Answer

A)   Assess the client's heart rate and blood pressure.
B)   Determine when the client last voided.
C)   Ask if the client is experiencing flatus.
D)   Auscultate all quadrants of the client's abdomen. B

Question 3

A nurse cares for a client who has a family history of colon cancer.The client states,"My father and my brother had colon cancer.What is the chance that I will get cancer?" How should the nurse respond?

Accepted Answer

A)   "If you eat a low-fat and low-fiber diet, your chances decrease significantly."
B)   "You are safe.This is an autosomal dominant disorder that skips generations."
C)   "Preemptive surgery and chemotherapy will remove cancer cells and prevent cancer."
D)   "You should have a colonoscopy more frequently to identify abnormal polyps early." D

Question 4

A nurse plans care for a client who is recovering from an inguinal hernia repair.Which interventions should the nurse include in this client's plan of care? (Select all that apply.)

Accepted Answer

A)   Encouraging ambulation three times a day
B)   Encouraging normal urination
C)   Encouraging deep breathing and coughing
D)   Providing ice bags and scrotal support
E)   Forcibly reducing the hernia

Question 5

A nurse assesses a client with irritable bowel syndrome (IBS).Which questions should the nurse include in this client's assessment? (Select all that apply.)

Accepted Answer

A)   "Which food types cause an exacerbation of symptoms?"
B)   "Where is your pain and what does it feel like?"
C)   "Have you lost a significant amount of weight lately?"
D)   "Are your stools soft, watery, and black in color?"
E)   "Do you experience nausea associated with defecation?"

Question 6

After teaching a client with irritable bowel syndrome (IBS),a nurse assesses the client's understanding.Which menu selection indicates that the client correctly understands the dietary teaching?

Accepted Answer

A)   Ham sandwich on white bread, cup of applesauce, glass of diet cola
B)   Broiled chicken with brown rice, steamed broccoli, glass of apple juice
C)   Grilled cheese sandwich, small banana, cup of hot tea with lemon
D)   Baked tilapia, fresh green beans, cup of coffee with low-fat milk

Question 7

A nurse cares for a client who has a nasogastric (NG)tube.Which actions should the nurse take? (Select all that apply.)

Accepted Answer

A)   Assess for proper placement of the tube every 4 hours.
B)   Flush the tube with water every hour to ensure patency.
C)   Secure the NG tube to the client's upper lip.
D)   Disconnect suction when auscultating bowel peristalsis.
E)   Monitor the client's skin around the tube site for irritation.

Question 8

A nurse assesses a client with a mechanical bowel obstruction who reports intermittent abdominal pain.An hour later the client reports constant abdominal pain.Which action should the nurse take next?

Accepted Answer

A)   Administer intravenous opioid medications.
B)   Position the client with knees to chest.
C)   Insert a nasogastric tube for decompression.
D)   Assess the client's bowel sounds.

Question 9

A nurse cares for a client who has a new colostomy.Which action should the nurse take?

Accepted Answer

A)   Empty the pouch frequently to remove excess gas collection.
B)   Change the ostomy pouch and wafer every morning.
C)   Allow the pouch to completely fill with stool prior to emptying it.
D)   Use surgical tape to secure the pouch and prevent leakage.

Question 10

A nurse cares for a client newly diagnosed with colon cancer who has become withdrawn from family members.Which action should the nurse take?

Accepted Answer

A)   Contact the provider and recommend a psychiatric consult for the client.
B)   Encourage the client to verbalize feelings about the diagnosis.
C)   Provide education about new treatment options with successful outcomes.
D)   Ask family and friends to visit the client and provide emotional support.

Question 11

An emergency room nurse cares for a client who has been shot in the abdomen and is hemorrhaging heavily.Which action should the nurse take first?

Accepted Answer

A)   Send a blood sample for a type and crossmatch.
B)   Insert a large intravenous line for fluid resuscitation.
C)   Obtain the heart rate and blood pressure.
D)   Assess and maintain a patent airway.

Question 12

A nurse teaches a client who is recovering from a colon resection.Which statement should the nurse include in this client's plan of care?

Accepted Answer

A)   "You may experience nausea and vomiting for the first few weeks."
B)   "Carbonated beverages can help decrease acid reflux from anastomosis sites."
C)   "Take a stool softener to promote softer stools for ease of defecation."
D)   "You may return to your normal workout schedule, including weight lifting."

Question 13

A nurse assesses a client who is prescribed 5-fluorouracil (5-FU)chemotherapy intravenously for the treatment of colon cancer.Which assessment finding should alert the nurse to contact the health care provider?

Accepted Answer

A)   White blood cell (WB
C)   count of 1500/mm3
B)   Fatigue
C)   Nausea and diarrhea
D)   Mucositis and oral ulcers

Question 14

A nurse assesses a male client with an abdominal hernia.Which abdominal hernias are correctly paired with their physiologic processes? (Select all that apply.)

Accepted Answer

A)   Indirect inguinal hernia - An enlarged plug of fat eventually pulls the peritoneum and often the bladder into a sac
B)   Femoral hernia - A peritoneum sac pushes downward and may descend into the scrotum
C)   Direct inguinal hernia - A peritoneum sac passes through a weak point in the abdominal wall
D)   Ventral hernia - Results from inadequate healing of an incision
E)   Incarcerated hernia - Contents of the hernia sac cannot be reduced back into the abdominal cavity

Question 15

A nurse cares for a client who is recovering from a hemorrhoidectomy.The client states,"I need to have a bowel movement." Which action should the nurse take?

Accepted Answer

A)   Obtain a bedside commode for the client to use.
B)   Stay with the client while providing privacy.
C)   Make sure the call light is in reach to signal completion.
D)   Gather supplies to collect a stool sample for the laboratory.

Question 16

A nurse cares for a client who had a colostomy placed in the ascending colon 2 weeks ago.The client states,"The stool in my pouch is still liquid." How should the nurse respond?

Accepted Answer

A)   "The stool will always be liquid with this type of colostomy."
B)   "Eating additional fiber will bulk up your stool and decrease diarrhea."
C)   "Your stool will become firmer over the next couple of weeks."
D)   "This is abnormal.I will contact your health care provider."

Question 17

A nurse cares for a middle-aged male client who has irritable bowel syndrome (IBS).The client states,"I have changed my diet and take bulk-forming laxatives,but my symptoms have not gotten better.I heard about a drug called Amitiza.Do you think it might help?" How should the nurse respond?

Accepted Answer

A)   "This drug is still in the research phase and is not available for public use yet."
B)   "Unfortunately, lubiprostone is approved only for use in women."
C)   "Lubiprostone works well.I will recommend this prescription to your provider."
D)   "This drug should not be used with bulk-forming laxatives."

Question 18

A nurse inserts a nasogastric (NG)tube for an adult client who has a bowel obstruction.Which actions does the nurse perform correctly? (Select all that apply.)

Accepted Answer

A)   Performs hand hygiene and positions the client in high-Fowler's position, with pillows behind the head and shoulders
B)   Instructs the client to extend the neck against the pillow once the NG tube has reached the oropharynx
C)   Checks for correct placement by checking the pH of the fluid aspirated from the tube
D)   Secures the NG tube by taping it to the client's nose and pinning the end to the pillowcase
E)   Connects the NG tube to intermittent medium suction with an anti-reflux valve on the air vent

Question 19

A nurse assessing a client with colorectal cancer auscultates high-pitched bowel sounds and notes the presence of visible peristaltic waves.Which action should the nurse take?

Accepted Answer

A)   Ask if the client is experiencing pain in the right shoulder.
B)   Perform a rectal examination and assess for polyps.
C)   Contact the provider and recommend computed tomography.
D)   Administer a laxative to increase bowel movement activity.

Question 20

A nurse cares for a client who has been diagnosed with a small bowel obstruction.Which assessment findings should the nurse correlate with this diagnosis? (Select all that apply.)

Accepted Answer

A)   Serum potassium of 2.8 mEq/L
B)   Loss of 15 pounds without dieting
C)   Abdominal pain in upper quadrants
D)   Low-pitched bowel sounds
E)   Serum sodium of 121 mEq/L

Exam 56: Care of Patients with Noninflammatory Intestinal Disorders