Question 1

After teaching a client who has a new colostomy,the nurse provides feedback based on the client's ability to complete self-care activities.Which statement should the nurse include in this feedback?

Accepted Answer

A)   "I realize that you had a tough time today, but it will get easier with practice."
B)   "You cleaned the stoma well.Now you need to practice putting on the appliance."
C)   "You seem to understand what I taught you today.What else can I help you with?"
D)   "You seem uncomfortable.Do you want your daughter to care for your ostomy?" B

Question 2

A nurse cares for a client who is prescribed mesalamine (Asacol)for ulcerative colitis.The client states,"I am having trouble swallowing this pill." Which action should the nurse take?

Accepted Answer

A)   Contact the clinical pharmacist and request the medication in suspension form.
B)   Empty the contents of the capsule into applesauce or pudding for administration.
C)   Ask the health care provider to prescribe the medication as an enema instead.
D)   Crush the pill carefully and administer it in applesauce or pudding. C

Question 3

A nurse cares for a teenage girl with a new ileostomy.The client states,"I cannot go to prom with an ostomy." How should the nurse respond?

Accepted Answer

A)   "Sure you can.Purchase a prom dress one size larger to hide the ostomy appliance."
B)   "The pouch won't be as noticeable if you avoid broccoli and carbonated drinks prior to the prom."
C)   "Let's talk to the enterostomal therapist about options for ostomy supplies and dress styles."
D)   "You can remove the pouch from your ostomy appliance when you are at the prom so that it is less noticeable." C

Question 4

After teaching a client who has diverticulitis,a nurse assesses the client's understanding.Which statement made by the client indicates a need for additional teaching?

Accepted Answer

A)   "I'll ride my bike or take a long walk at least three times a week."
B)   "I must try to include at least 25 grams of fiber in my diet every day."
C)   "I will take a laxative nightly at bedtime to avoid becoming constipated."
D)   "I should use my legs rather than my back muscles when I lift heavy objects."

Question 5

A nurse teaches a client who has viral gastroenteritis.Which dietary instruction should the nurse include in this client's teaching?

Accepted Answer

A)   "Drink plenty of fluids to prevent dehydration."
B)   "You should only drink 1 liter of fluids daily."
C)   "Increase your protein intake by drinking more milk."
D)   "Sips of cola or tea may help to relieve your nausea."

Question 6

A nurse assesses a client who has ulcerative colitis and severe diarrhea.Which assessment should the nurse complete first?

Accepted Answer

A)   Inspection of oral mucosa
B)   Recent dietary intake
C)   Heart rate and rhythm
D)   Percussion of abdomen

Question 7

After teaching a client with an anal fissure,a nurse assesses the client's understanding.Which client actions indicate that the client correctly understands the teaching? (Select all that apply.)

Accepted Answer

A)   Taking a warm sitz bath several times each day
B)   Utilizing a daily enema to prevent constipation
C)   Using bulk-producing agents to aid elimination
D)   Self-administering anti-inflammatory suppositories
E)   Taking a laxative each morning

Question 8

A nurse teaches a client how to avoid becoming ill with Salmonella infection again.Which statements should the nurse include in this client's teaching? (Select all that apply.)

Accepted Answer

A)   "Wash leafy vegetables carefully before eating or cooking them."
B)   "Do not ingest water from the garden hose or the pool."
C)   "Wash your hands before and after using the bathroom."
D)   "Be sure meat is cooked to the proper temperature."
E)   "Avoid eating eggs that are sunny side up or undercooked."

Question 9

After teaching a client with diverticular disease,a nurse assesses the client's understanding.Which menu selection made by the client indicates the client correctly understood the teaching?

Accepted Answer

A)   Roasted chicken with rice pilaf and a cup of coffee with cream
B)   Spaghetti with meat sauce, a fresh fruit cup, and hot tea
C)   Garden salad with a cup of bean soup and a glass of low-fat milk
D)   Baked fish with steamed carrots and a glass of apple juice

Question 10

After teaching a client with a parasitic gastrointestinal infection,a nurse assesses the client's understanding.Which statements made by the client indicate that the client correctly understands the teaching? (Select all that apply.)

Accepted Answer

A)   "I'll have my housekeeper keep my toilet clean."
B)   "I must take a shower or bathe every day."
C)   "I should have my well water tested."
D)   "I will ask my sexual partner to have a stool test."
E)   "I must only eat raw vegetables from my own garden."

Question 11

A nurse assesses a client with Crohn's disease and colonic strictures.Which clinical manifestation should alert the nurse to urgently contact the health care provider?

Accepted Answer

A)   Distended abdomen
B)   Temperature of 100.0° F (37.8° 
C)  
C)   Loose and bloody stool
D)   Lower abdominal cramps

Question 12

A nurse teaches a community group about food poisoning and gastroenteritis.Which statements should the nurse include in this group's teaching? (Select all that apply.)

Accepted Answer

A)   "Rotavirus is more common among infants and younger children."
B)   "Escherichia coli diarrhea is transmitted by contact with infected animals."
C)   "To prevent E.coli infection, don't drink water when swimming."
D)   "Clients who have botulism should be quarantined within their home."
E)   "Parasitic diseases may not show up for 1 to 2 weeks after infection."

Question 13

After teaching a client who was hospitalized for Salmonella food poisoning,a nurse assesses the client's understanding.Which statement made by the client indicates a need for additional teaching?

Accepted Answer

A)   "I will let my husband do all of the cooking for my family."
B)   "I'll take the ciprofloxacin until the diarrhea has resolved."
C)   "I should wash my hands with antibacterial soap before each meal."
D)   "I must place my dishes into the dishwasher after each meal."

Question 14

A nurse cares for a client who has a Giardia infection.Which medication should the nurse anticipate being prescribed for this client?

Accepted Answer

A)   Metronidazole (Flagyl) 
B)   Ciprofloxacin (Cipro) 
C)   Sulfasalazine (Azulfidine) 
D)   Ceftriaxone (Rocephin)

Question 15

A nurse assesses a client who is recovering from an ileostomy placement.Which clinical manifestation should alert the nurse to urgently contact the health care provider?

Accepted Answer

A)   Pale and bluish stoma
B)   Liquid stool
C)   Ostomy pouch intact
D)   Blood-smeared output

Question 16

A nurse cares for a client who has food poisoning resulting from a Clostridium botulinum infection.Which assessment should the nurse complete first?

Accepted Answer

A)   Heart rate and rhythm
B)   Bowel sounds
C)   Urinary output
D)   Respiratory rate

Question 17

A nurse teaches a community group ways to prevent Escherichia coli infection.Which statements should the nurse include in this group's teaching? (Select all that apply.)

Accepted Answer

A)   "Wash your hands after any contact with animals."
B)   "It is not necessary to buy a meat thermometer."
C)   "Stay away from people who are ill with diarrhea."
D)   "Use separate cutting boards for meat and vegetables."
E)   "Avoid swimming in backyard pools and using hot tubs."

Question 18

A nurse cares for a client with ulcerative colitis.The client states,"I feel like I am tied to the toilet.This disease is controlling my life." How should the nurse respond?

Accepted Answer

A)   "Let's discuss potential factors that increase your symptoms."
B)   "If you take the prescribed medications, you will no longer have diarrhea."
C)   "To decrease distress, do not eat anything before you go out."
D)   "You must retake control of your life.I will consult a therapist to help."

Question 19

After teaching a client with perineal excoriation caused by diarrhea from acute gastroenteritis,a nurse assesses the client's understanding.Which statement by the client indicates a need for additional teaching?

Accepted Answer

A)   "I'll rinse my rectal area with warm water after each stool and apply zinc oxide ointment."
B)   "I will clean my rectal area thoroughly with toilet paper after each stool and then apply aloe vera gel."
C)   "I must take a sitz bath three times a day and then pat my rectal area gently but thoroughly to make sure I am dry."
D)   "I shall clean my rectal area with a soft cotton washcloth and then apply vitamin A and D ointment."

Question 20

After teaching a client who is prescribed adalimumab (Humira)for severe ulcerative colitis,the nurse assesses the client's understanding.Which statement made by the client indicates a need for additional teaching?

Accepted Answer

A)   "I will avoid large crowds and people who are sick."
B)   "I will take this medication with my breakfast each morning."
C)   "Nausea and vomiting are common side effects of this drug."
D)   "I must wash my hands after I play with my dog."

Exam 57: Care of Patients with Inflammatory Intestinal Disorders