Question 1

In caring for a client who is vomiting fecal material, the nurse should place the highest priority on which action?

Accepted Answer

A)   Administering parenteral fluids that contain electrolytes
B)   Encouraging the client to take small sips of water
C)   Giving the client frequent oral hygiene
D)   Preparing the client for surgery A

Question 2

A client with inflammatory bowel disease (IBD) takes sulfasalazine (Azulfadine) for management of manifestations. To counteract a side effect of this drug, the nurse would encourage the client to increase intake of

Accepted Answer

A)   any citrus fruits.
B)   bananas and apples.
C)   fish and seafood.
D)   peas and beans. D

Question 3

The nurse caring for a client with abdominal distention and vomiting that is fecal in nature should conduct further assessment aimed at discovering

Accepted Answer

A)   a distal, small intestinal obstruction.
B)   gastric ulceration.
C)   gastrointestinal (GI)  bleeding.
D)   ulceration of the esophagus. A

Question 4

A client with Crohn's disease is recovering from a fourth bowel resection and is being dismissed. The nurse determines that teaching goals have been met when the client indicates that s/he will watch for manifestations of

Accepted Answer

A)   chronic constipation.
B)   fatigue and weakness.
C)   Heberden's nodules.
D)   malabsorption syndrome.

Question 5

The nurse is instructing a client with a new colostomy on its care and notes that the stoma is large and dusky. The most appropriate nursing intervention at this time is to

Accepted Answer

A)   assess the client's reaction to the ostomy site.
B)   assist the client to irrigate the colostomy.
C)   notify the surgeon immediately.
D)   reassure the client that the stoma will decrease in size.

Question 6

A client recovering from a recent colostomy is very reluctant to participate in self-care. To initiate the client's interaction, the nurse should

Accepted Answer

A)   allow care to be deferred until the client will participate.
B)   evaluate the level to which the client can tolerate participation.
C)   insist the client become involved in self-care.
D)   provide the client with a mirror to observe the stoma.

Question 7

The nurse taking the history of an 80-year-old woman diagnosed with gastroenteritis would recognize that the most significant factor in determining potential for complications in this client is

Accepted Answer

A)   age.
B)   family history.
C)   gender.
D)   prior bouts of gastroenteritis.

Question 8

Until a diagnosis is made, the nurse caring for a client being evaluated for acute appendicitis should treat pain and discomfort with

Accepted Answer

A)   comfort touch and reassurance.
B)   frequently changing the client's position.
C)   narcotic pain medication.
D)   warm compresses applied to the belly.

Question 9

For an 83-year-old client admitted with obstruction of the large bowel, the nurse's most significant assessment during the nursing history in regard to development of an obstruction would be

Accepted Answer

A)   advanced age.
B)   poor appetite.
C)   previously treated colon cancer.
D)   well-controlled diabetes.

Question 10

A 13-year-old client with ulcerative colitis says, "I am so glad I will grow out of this disease. It's so embarrassing at school." Which action by the nurse would best address this statement?

Accepted Answer

A)   Ask the client to explain what he/she means.
B)   Encourage the client to become active in school activities or sports.
C)   Review the pathophysiology of ulcerative colitis.
D)   Tell the client about other people who live successfully with the disease.

Question 11

A client is admitted with dysentery caused by Clostridium difficile, or pseudomembranous colitis. To elicit the most helpful information about the cause of the dysentery, the nurse would ask the client

Accepted Answer

A)   "Are you taking any antibiotics?"
B)   "Do you ever go barefoot outside your home?"
C)   "Does anyone else in your family have bowel problems?"
D)   "Have you traveled in any foreign countries lately?"

Question 12

In caring for a client with Crohn's disease and the nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements related to diarrhea, the nurse would plan to observe for

Accepted Answer

A)   bradycardia.
B)   increased urine output.
C)   increasing blood pressure.
D)   manifestations of anemia.

Question 13

A client with ulcerative colitis has severe diarrhea. Further assessments by the nurse are aimed at early recognition of

Accepted Answer

A)   dehydration.
B)   hemorrhoids.
C)   metabolic alkalosis.
D)   nephrolithiasis.

Question 14

A client is admitted with appendicitis and is awaiting surgery. The client states, "Now instead of pain in just one spot, the pain is kind of all over my abdomen." Which action by the nurse takes priority?

Accepted Answer

A)   Assess the client's abdomen.
B)   Get a set of vital signs.
C)   Call the physician.
D)   Prepare the client for another x-ray.

Question 15

In advising a client on the care of an anal fissure caused by chronic constipation, the home health nurse would focus on

Accepted Answer

A)   avoiding long, hot baths.
B)   cleansing with peroxide after each bowel movement.
C)   keeping stools small by limiting fluid intake.
D)   the importance of a daily bowel movement.

Question 16

A nurse is caring for several clients. One client needs ostomy care. The nurse delegates ostomy care to the unlicensed assistive personnel for the client who

Accepted Answer

A)   has had the ostomy for several years, but whose arthritis makes self-care difficult.
B)   is afraid to touch the ostomy, causing the nurse to be frustrated and short-tempered.
C)   underwent ostomy surgery 3 days ago and has been stable with a red stoma.
D)   uses multiple brands and sizes of appliances and pouches.

Question 17

In counseling a client with ulcerative colitis for 25 years about health maintenance plans, the nurse would include the advice that the client should

Accepted Answer

A)   avoid red meat.
B)   obtain genetic counseling.
C)   reduce physical exercise.
D)   schedule regular proctoscopic examinations.

Question 18

A nurse is caring for a postoperative client who has developed peritonitis. An assessment finding that would require immediate action would be

Accepted Answer

A)   a decrease in blood pressure of more than 15 mm Hg.
B)   an increase in urine output of more than 300 ml/day.
C)   pulse deficit of more than 20 beats/minute.
D)   weight gain of more than 5 pounds.

Question 19

The nurse caring for a client with an intestinal malignancy assesses for bleeding, which would most likely be manifested by

Accepted Answer

A)   abdominal discomfort.
B)   hematemesis.
C)   hematochezia.
D)   hypotension.

Question 20

To help a client with a new ostomy integrate its appearance into the client's body image, the home health nurse would

Accepted Answer

A)   discourage the client's negative remarks about the stoma.
B)   discuss clothing options that will hide the appliance.
C)   limit family interaction in the client's stomal care.
D)   use humor and jokes regarding the ostomy.

Exam 33: Management of Clients with Intestinal Disorders