Question 1

When assessing the colour of a new stoma in the postoperative period, which of the following findings should cause the nurse to suspect anemia?

Accepted Answer

A) Light red to rose 
B) Pale pink 
C) Blanching, dark red to purple 
D) Dark red

Question 2

After the nurse has completed teaching a client with newly diagnosed celiac disease, which of the following breakfast choices by the client indicates good understanding of the information?

Accepted Answer

A) Corn tortilla with eggs 
B) Bagel with cream cheese 
C) Oatmeal with non-fat milk 
D) Whole wheat toast with butter

Question 3

The nurse is conducting preoperative preparation for a client scheduled for an abdominal-perineal resection. Which of the following actions should the nurse implement?

Accepted Answer

A) Give IV antibiotics starting 24 hours before surgery to reduce the number of bowel bacteria. 
B) Teach the client that activities such as sitting at the bedside will be started the first postoperative day. 
C) Instruct the client that another surgery in 8-12 weeks will be used to create an ileal-anal reservoir. 
D) Administer polyethylene glycol lavage solution (GoLYTELY) to ensure that the bowel is empty before the surgery.

Question 4

A client is admitted to the emergency department with severe abdominal pain with rebound tenderness. The vital signs include temperature 38.3°C (100.9°F), pulse 130, respirations 34, and blood pressure (BP) 84/50. Which of the following interventions should the nurse implement first?

Accepted Answer

A) Administer IV ketorolac 5 mg. 
B) Draw blood for a complete blood count (CB
C) . 
C) Obtain a computed tomography (CT) scan of the abdomen. 
D) Infuse 1 000 mL of lactated Ringer's solution over 30 minutes.

Question 5

The nurse is providing discharge teaching for a client who has had a herniorrhaphy to repair an incarcerated inguinal hernia. Which of the following information should be included in the teaching?

Accepted Answer

A) Encourage the client to cough. 
B) Provide sitz baths several times daily. 
C) Avoid use of acetaminophen for pain. 
D) Apply a scrotal support and encourage deep breathing.

Question 6

The nurse is providing client teaching about recommended dietary choices for a client with an acute exacerbation of inflammatory bowel disease (IBD). Which of the following diet choices by the client indicates a need for more teaching?

Accepted Answer

A) Scrambled eggs 
B) White toast and jam 
C) Oatmeal with cream 
D) Pancakes with syrup

Question 7

Which of the following nursing actions should be included in the plan of care for a male client with bowel irregularity and a new diagnosis of irritable bowel syndrome (IBS)?

Accepted Answer

A) Encourage the client to express feelings and ask questions about IBS. 
B) Suggest that the client increase the intake of milk and other dairy products. 
C) Educate the client about the use of Tegaserod to reduce symptoms. 
D) Teach the client to avoid using nonsteroidal anti-inflammatory drugs (NSAIDs).

Question 8

The nurse is teaching a client who has chronic constipation about the use of psyllium. Which of the following information should the nurse include?

Accepted Answer

A) Absorption of fat-soluble vitamins may be reduced by fibre-containing laxatives. 
B) Dietary sources of fibre should be eliminated to prevent excessive gas formation. 
C) Use of this type of laxative to prevent constipation does not cause adverse effects. 
D) Large amounts of fluid should be taken to prevent impaction or bowel obstruction.

Question 9

The nurse is providing teaching to a client with a new ileostomy. Which of the following daily drainage amounts should the nurse inform the client is expected after the bowel adjusts to the ileostomy?

Accepted Answer

A) 400 mL 
B) 600 mL 
C) 800 mL 
D) 1 000 mL

Question 10

The nurse is caring for a client with Crohn's disease who develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. Which of the following information should the nurse teach the client?

Accepted Answer

A) To clean the perianal area carefully after any stools 
B) About fistula formation between the bowel and bladder 
C) To empty the bladder before and after sexual intercourse 
D) About the effects of corticosteroid use on immune function

Question 11

A client calls the clinic and tells the nurse about a new onset of severe and frequent, diarrhea. Which of the following actions should the nurse anticipate for this client?

Accepted Answer

A) Collect a stool specimen. 
B) Prepare for colonoscopy. 
C) Schedule a barium enema. 
D) Have blood cultures drawn.

Question 12

A client with a gunshot wound to the abdomen undergoes surgery, and a colostomy is formed as illustrated. Which of the following information should the nurse include in client teaching?

Accepted Answer

A) This type of colostomy is usually temporary. 
B) Soft, formed stool can be expected as drainage. 
C) Stool will be expelled from both ostomy stomas. 
D) Irrigations can regulate drainage from the stomas.

Question 13

The nurse is caring for a client following an exploratory laparotomy and bowel resection who has a nasogastric tube to suction and symptoms of nausea and stomach distension. Which of the following actions should the nurse take first?

Accepted Answer

A) Auscultate for hypotonic bowel sounds. 
B) Notify the client's health care provider. 
C) Reposition the tube and check for placement. 
D) Remove the tube and replace it with a new one.

Question 14

A client is brought to the emergency department with a knife impaled in the abdomen following a domestic fight. During the initial assessment of the client, which of the following actions should the nurse implement?

Accepted Answer

A) Assess the BP and pulse. 
B) Remove the knife to assess the wound. 
C) Determine the presence of Rovsing sign. 
D) Insert a urinary catheter and assess for hematuria.

Question 15

The nurse is caring for a client who has a new diagnosis of Crohn's disease after having frequent diarrhea and a weight loss of 4.5 kg over 2 months. Which of the following topics should the nurse plan to include in the teaching plan?

Accepted Answer

A) Medication use 
B) Fluid restriction 
C) Enteral nutrition 
D) Activity restrictions

Question 16

The nurse is teaching a client with ulcerative colitis about sulphasalazine. Which of the following client statements indicates that the teaching has been effective?

Accepted Answer

A) "I will need to take this medication for at least one year." 
B) "I will need to avoid contact with people who are sick." 
C) "The medication will need to be tapered if I need surgery." 
D) "The medication will prevent infections that cause the diarrhea."

Question 17

Which of the following prescribed interventions should the nurse implement first when caring for a client who has just diagnosed with peritonitis caused by a ruptured diverticulum?

Accepted Answer

A) Administer morphine sulphate 4 mg IV. 
B) Infuse metronidazole 500 mg IV. 
C) Send the client for a computerized tomography scan. 
D) Insert a nasogastric (NG) tube and connect it to intermittent low suction.

Question 18

The nurse is preparing a 50-year-old client for an annual physical examination. Which of the following diagnostic tests should the nurse teach to the client?

Accepted Answer

A) Endoscopy 
B) Fecal occult blood test 
C) Computerized tomography screening 
D) Carcinoembryonic antigen (CE
A)  testing

Question 19

The nurse is performing an admission assessment for a client with abdominal pain and palpates the left lower quadrant and the client indicates right lower quadrant pain. Which of the following descriptors should the nurse use to document this finding?

Accepted Answer

A) Rebound pain 
B) Cullen sign 
C) Rovsing sign 
D) McBurney point

Question 20

The nurse is obtaining a history for a female client who is being evaluated for acute lower abdominal pain and vomiting. Which of the following questions is most useful in determining the cause of the client's symptoms?

Accepted Answer

A) "Is it possible that you are pregnant?" 
B) "Can you tell me more about the pain?" 
C) "What type of foods do you usually eat?" 
D) "What is your usual elimination pattern?"

Exam 45: Nursing Management Lower Gastro-intestinal Problems