Care of Patients With Disorders of the Lower Gastrointestinal System CHAPTER 29 Go to your Evolve website (http://evolve.elsevier.com/deWit/ medsurg) for the following FREE learning resources: Animations, audio, and video . • Answers and rationales for questions and activities Glossary with pronunciations in English and Spanish • Interactive Review Questions and more! Review Questions for the NCLEX Examination 1. You encourage a patient with IBS to keep a food diary. What is the best nursing response to the patient regarding the importance of keeping the diary? 1. "The diary will monitor caloric intake." 2. "The diary will help identify foods that cause bloating." 3. "The diary will determine food preferences." 4. "The diary will reinforce the need for better food choices." NCLEX Client Need: Health Promotion and Maintenance 2. A 68-year-old patient complains of mild left lower abdominal pain that is accompanied by frequent diarrhea, slight fever, and rectal bleeding. Which treatment measure should you anticipate? 1. Administration of a bulk-forming stool softener 2. Increasing fluid intake 3. Encouraging solid foods 4. Increasing physical activity NCLEX Client Need: Physiological Integrity: Basic Care and Comfort 3. A patient who was admitted with a bowel obstruction is complaining of severe pain. Their abdominal girth has increased by 4 inches in the past hour and the blood pressure is now 80/50 mm Hg. List your actions in priority order. 1. Assess breathing. 2. Notify the health care provider. 3. Position to support blood pressure. 4. Ensure IV patency. NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 4. During a home visit, you provide verbal instructions to a patient with a possible blockage of an ostomy. What would be an appropriate instruction to give? 1. Massage the stoma. 2. Try different body positions. 3. Take a cold bath. 4. Begin a high-fiber diet. NCLEX Client Need: Physiological Integrity: Physiological Adaptation 5. You are caring for a patient who is postoperative after an ileostomy. Which order should you question? 1. Strict intake and output recording for 8 hours 2. Clear liquid diet 3. IV fluids 125 mL/h 4. Occlusive dressing over stoma NCLEX Client Need: Physiological Integrity: Physiological Adaptation 6. In caring for a patient with an ostomy, which statement is true regarding medication administration? 1. Time-release capsules can be given to patients with an ileostomy. 2. Enteric-coated tablets are adequately absorbed by patients with ileostomy. 3. Glycerin suppositories are readily evacuated in the distal colostomy stoma. 4. An antiemetic suppository can be effectively absorbed when inserted in the distal colostomy stoma. 711 NCLEX Client Need: Physiological Integrity: Pharmacological Therapies 7. A patient has a new colostomy. Which behavior is an early sign of acceptance of the change in body image? 1. The patient allows you to empty the colostomy bag. 2. The patient refuses to look at the ostomy site. 3. The patient holds and examines a new appliance bag. 4. The patient continues to ask for a bedpan to have a bowel movement. NCLEX Client Need: Psychosocial Integrity 8. A patient develops a paralytic ileus as a complication of peritonitis. Which patient comment suggests a return of peristalsis? 1. "I feel thirsty; may I have some water?" 2. "I would like to try to walk to the toilet." 3. "When will I be allowed to have solid food?" 4. "I am sorry to pass gas while you are here." NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 9. What would be included in the recommended diet for patients with IBD? (Select all that apply.) 1. Low fat 2. High fiber 3. High protein 4. Low calorie 5. Lactose avoidance NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 10. You admit a 23-year-old patient with possible appendicitis. You anticipate which sign(s) and/or symptom(s)? (Select all that apply.) 1. Increased red blood cell count 2. Abdominal tenderness 3. Anorexia and vomiting 4. Mild fever 5. Dark black stools NCLEX Client Need: Physiological Integrity: Physiological Adaptation

Comprehensive Medical Assisting: Administrative and Clinical Competencies (MindTap Course List)
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ISBN:9781305964792
Author:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa
Publisher:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa
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Care of Patients With Disorders of the Lower Gastrointestinal System CHAPTER 29
Go to
medsurg) for the following FREE learning resources:
. Animations, audio, and video
Answers and rationales for questions and activities
Glossary with pronunciations in English and Spanish
• Interactive Review Questions and more!
Review Questions for the NCLEX Examination
1. You encourage a patient with IBS to keep a food
diary. What is the best nursing response to the patient
regarding the importance of keeping the diary?
1. "The diary will monitor caloric intake."
2. "The diary will help identify foods that cause
bloating.
3. "The diary will determine food preferences."
4. "The diary will reinforce the need for better food
choices."
NCLEX Client Need: Health Promotion and Maintenance
2. A 68-year-old patient complains of mild left lower
abdominal pain that is accompanied by frequent
diarrhea, slight fever, and rectal bleeding. Which
treatment measure should you anticipate?
1. Administration of a bulk-forming stool softener
2. Increasing fluid intake
3. Encouraging solid foods
4. Increasing physical activity
NCLEX Client Need: Physiological Integrity: Basic Care and
Comfort
3. A patient who was admitted with a bowel obstruction
is complaining of severe pain. Their abdominal girth
has increased by 4 inches in the past hour and the
blood pressure is now 80/50 mm Hg. List your actions
in priority order.
1. Assess breathing.
2. Notify the health care provider.
3. Position to support blood pressure.
4. Ensure IV patency.
NCLEX Client Need: Physiological Integrity: Reduction of Risk
Potential
4. During a home visit, you provide verbal instructions to
a patient with a possible blockage of an ostomy. What
would be an appropriate instruction to give?
1. Massage the stoma.
2. Try different body positions.
3. Take a cold bath.
4. Begin a high-fiber diet.
NCLEX Client Need: Physiological Integrity: Physiological
Adaptation
5. You are caring for a patient who is postoperative after
an ileostomy. Which order should you question?
1. Strict intake and output recording for 8 hours
2. Clear liquid diet
3. IV fluids 125 ml/h
4. Occlusive dressing over stoma
NCLEX Client Need: Physiological Integrity: Physiological
Adaptation
711
6. In caring for a patient with an ostomy, which
statement is true regarding medication administration?
1. Time-release capsules can be given to patients with
an ileostomy.
2. Enteric-coated tablets are adequately absorbed by
patients with ileostomy.
3. Glycerin suppositories are readily evacuated in the
distal colostomy stoma.
4. An antiemetic suppository can be effectively
absorbed when inserted in the distal colostomy
stoma.
NCLEX Client Need: Physiological Integrity: Pharmacological
Therapies
7. A patient has a new colostomy. Which behavior is an
early sign of acceptance of the change in body image?
1. The patient allows you to empty the colostomy bag.
2. The patient refuses to look at the ostomy site.
3. The patient holds and examines a new appliance
bag.
4. The patient continues to ask for a bedpan to have a
bowel movement.
NCLEX Client Need: Psychosocial Integrity
8. A patient develops a paralytic ileus as a complication
of peritonitis. Which patient comment suggests a
return of peristalsis?
1. "I feel thirsty; may I have some water?"
2. "I would like to try to walk to the toilet."
3. "When will I be allowed to have solid food?"
4. "I am sorry to pass gas while you are here."
NCLEX Client Need: Physiological Integrity: Reduction of Risk
Potential
9. What would be included in the recommended diet for
patients with IBD? (Select all that apply.)
1. Low fat
2. High fiber
3. High protein
4. Low calorie
5. Lactose avoidance
NCLEX Client Need: Physiological Integrity: Reduction of Risk
Potential
10. You admit a 23-year-old patient with possible
appendicitis. You anticipate which sign(s) and/or
symptom(s)? (Select all that apply.)
1. Increased red blood cell count
2. Abdominal tenderness
3. Anorexia and vomiting
4. Mild fever
5. Dark black stools
NCLEX Client Need: Physiological Integrity: Physiological
Adaptation
Transcribed Image Text:Care of Patients With Disorders of the Lower Gastrointestinal System CHAPTER 29 Go to medsurg) for the following FREE learning resources: . Animations, audio, and video Answers and rationales for questions and activities Glossary with pronunciations in English and Spanish • Interactive Review Questions and more! Review Questions for the NCLEX Examination 1. You encourage a patient with IBS to keep a food diary. What is the best nursing response to the patient regarding the importance of keeping the diary? 1. "The diary will monitor caloric intake." 2. "The diary will help identify foods that cause bloating. 3. "The diary will determine food preferences." 4. "The diary will reinforce the need for better food choices." NCLEX Client Need: Health Promotion and Maintenance 2. A 68-year-old patient complains of mild left lower abdominal pain that is accompanied by frequent diarrhea, slight fever, and rectal bleeding. Which treatment measure should you anticipate? 1. Administration of a bulk-forming stool softener 2. Increasing fluid intake 3. Encouraging solid foods 4. Increasing physical activity NCLEX Client Need: Physiological Integrity: Basic Care and Comfort 3. A patient who was admitted with a bowel obstruction is complaining of severe pain. Their abdominal girth has increased by 4 inches in the past hour and the blood pressure is now 80/50 mm Hg. List your actions in priority order. 1. Assess breathing. 2. Notify the health care provider. 3. Position to support blood pressure. 4. Ensure IV patency. NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 4. During a home visit, you provide verbal instructions to a patient with a possible blockage of an ostomy. What would be an appropriate instruction to give? 1. Massage the stoma. 2. Try different body positions. 3. Take a cold bath. 4. Begin a high-fiber diet. NCLEX Client Need: Physiological Integrity: Physiological Adaptation 5. You are caring for a patient who is postoperative after an ileostomy. Which order should you question? 1. Strict intake and output recording for 8 hours 2. Clear liquid diet 3. IV fluids 125 ml/h 4. Occlusive dressing over stoma NCLEX Client Need: Physiological Integrity: Physiological Adaptation 711 6. In caring for a patient with an ostomy, which statement is true regarding medication administration? 1. Time-release capsules can be given to patients with an ileostomy. 2. Enteric-coated tablets are adequately absorbed by patients with ileostomy. 3. Glycerin suppositories are readily evacuated in the distal colostomy stoma. 4. An antiemetic suppository can be effectively absorbed when inserted in the distal colostomy stoma. NCLEX Client Need: Physiological Integrity: Pharmacological Therapies 7. A patient has a new colostomy. Which behavior is an early sign of acceptance of the change in body image? 1. The patient allows you to empty the colostomy bag. 2. The patient refuses to look at the ostomy site. 3. The patient holds and examines a new appliance bag. 4. The patient continues to ask for a bedpan to have a bowel movement. NCLEX Client Need: Psychosocial Integrity 8. A patient develops a paralytic ileus as a complication of peritonitis. Which patient comment suggests a return of peristalsis? 1. "I feel thirsty; may I have some water?" 2. "I would like to try to walk to the toilet." 3. "When will I be allowed to have solid food?" 4. "I am sorry to pass gas while you are here." NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 9. What would be included in the recommended diet for patients with IBD? (Select all that apply.) 1. Low fat 2. High fiber 3. High protein 4. Low calorie 5. Lactose avoidance NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 10. You admit a 23-year-old patient with possible appendicitis. You anticipate which sign(s) and/or symptom(s)? (Select all that apply.) 1. Increased red blood cell count 2. Abdominal tenderness 3. Anorexia and vomiting 4. Mild fever 5. Dark black stools NCLEX Client Need: Physiological Integrity: Physiological Adaptation
.
Care of Patients with Disorders of the Gallbladder, Liver, and Pancreas CHAPTER 30
Signs and symptoms of pancreatic cancer are weight
loss, anorexia, vomiting, and signs of pancreatic
dysfunction. Not smoking reduces the risk of pancreatic
cancer by 50%.
. Treatment of pancreatic cancer includes pain
management and chemotherapy and radiation, which
may improve food absorption, relieve pain, and alleviate
duct obstruction.
Additional Learning Resources
SG Go to your Study Guide for additional learning activities
to help you master this chapter content.
Go to your Evolve website (http://evolve.elsevier.com/deWit/
medsurg) for the following FREE learning resources:
. Animations, audio, and video
.
Answers and rationales for questions and activities
• Glossary with pronunciations in English and Spanish
Interactive Review Questions and more!
·
Review Questions for the NCLEX® Examination
1. Before being discharged to home, a patient who had
a laparoscopic cholecystectomy is given instructions
regarding pain control. Which patient statements
indicate successful teaching? (Select all that apply.)
1. "I will stay mobile and change positions frequently."
2. "Opioids are the best medication for relieving pain."
3. "I will continue my swimming routine for exercise,
and this will help my pain."
4. "Passing gas will relieve my pain."
5. "Pain will become less as the gas in my abdomen
is absorbed."
6. "I will take NSAIDs for pain control."
NCLEX Client Need: Health Promotion and Maintenance
2. If the patient has a history of chronic cholecystitis,
which comment is cause for the greatest concern?
1. "I have back pain at the level of the shoulder
blade."
2. "I had nausea after eating a hamburger and fries."
3. "I have generalized abdominal pain and fever."
4. "I have discomfort in the right upper part of my
abdomen."
NCLEX Client Need: Physiological Integrity: Physiological
Adaptation
3. You are caring for a 57-year-old patient with ascites
resulting from liver disease. You anticipate that the
health care provider will use which therapeutic regimen
to reduce portal hypertension?
1. Vascular shunting of the portal venous systems
2. Repeated abdominal paracentesis
3. Diet restrictions and nutrient supplementation
4. Fluid replacement therapy
NCLEX Client Need: Physiological Integrity: Reduction of Risk
Potential
737
4. A patient with high levels of serum ammonia asks,
"Why do I have to continue taking lactulose?" What is
the best response?
1. "It destroys ammonia-producing bacteria in the
intestines."
2. "It reduces intestinal absorption of ammonia."
3. "It corrects vitamin B, deficiency."
4. "It is used in preparation for a diagnostic test."
NCLEX Client Need: Physiological Integrity: Pharmacological
Therapies
5. You are caring for a patient who underwent a recent
liver transplantation. You reinforce the teaching related
to self-care. Which teaching topics are most important
to address before discharge? (Select all that apply.)
1. Reporting any kind of pain associated with fever
and changes in stool color
2. Location and meeting time of local support groups
3. Use of strict hand hygiene in changing dressings
4. The lifelong need to take antirejection medications
NCLEX Client Need: Physiological Integrity: Reduction of Risk
Potential
6. You are caring for a patient who underwent radical
pancreaticoduodenectomy. Which postoperative
complication would be the most likely to occur and
cause the greatest concern?
1. Hypoglycemia
2. Adhesions
3. Hemorrhage
4. Anorexia
NCLEX Client Need: Physiological Integrity: Reduction of Risk
Potential
7. Which instructions should be given to a patient
regarding preventing the spread of hepatitis A? (Select
all that apply.)
1. Bleach solutions must be used to clean the
bathroom.
2. Somebody else should be doing the cooking right
now.
3. No vaccination is available for hepatitis A.
4. Good hand hygiene reduces the likelihood of
passing the virus.
NCLEX Client Need: Safe and Effective Care Environment: Safety
and Infection Control
8. A patient has cirrhosis of the liver and ascites. You
should question which order?
1. Bed rest with bathroom privileges
2. Discontinue furosemide (Lasix) 80 mg
3. Give 2-g sodium diet
4. Fluid restriction 1500 mL/24 h
NCLEX Client Need: Physiological Integrity: Pharmacological
Therapies
9. A patient with acute pancreatitis has a bluish
discoloration around the umbilicus. What actions
should you take? (Place in priority order.)
1. Place head flat and feet elevated.
2. Notify health care provider.
3. Assess vital signs.
4. Verify patency of IV line.
NCLEX Client Need: Physiological Integrity: Physiological
Adaptation
Transcribed Image Text:. Care of Patients with Disorders of the Gallbladder, Liver, and Pancreas CHAPTER 30 Signs and symptoms of pancreatic cancer are weight loss, anorexia, vomiting, and signs of pancreatic dysfunction. Not smoking reduces the risk of pancreatic cancer by 50%. . Treatment of pancreatic cancer includes pain management and chemotherapy and radiation, which may improve food absorption, relieve pain, and alleviate duct obstruction. Additional Learning Resources SG Go to your Study Guide for additional learning activities to help you master this chapter content. Go to your Evolve website (http://evolve.elsevier.com/deWit/ medsurg) for the following FREE learning resources: . Animations, audio, and video . Answers and rationales for questions and activities • Glossary with pronunciations in English and Spanish Interactive Review Questions and more! · Review Questions for the NCLEX® Examination 1. Before being discharged to home, a patient who had a laparoscopic cholecystectomy is given instructions regarding pain control. Which patient statements indicate successful teaching? (Select all that apply.) 1. "I will stay mobile and change positions frequently." 2. "Opioids are the best medication for relieving pain." 3. "I will continue my swimming routine for exercise, and this will help my pain." 4. "Passing gas will relieve my pain." 5. "Pain will become less as the gas in my abdomen is absorbed." 6. "I will take NSAIDs for pain control." NCLEX Client Need: Health Promotion and Maintenance 2. If the patient has a history of chronic cholecystitis, which comment is cause for the greatest concern? 1. "I have back pain at the level of the shoulder blade." 2. "I had nausea after eating a hamburger and fries." 3. "I have generalized abdominal pain and fever." 4. "I have discomfort in the right upper part of my abdomen." NCLEX Client Need: Physiological Integrity: Physiological Adaptation 3. You are caring for a 57-year-old patient with ascites resulting from liver disease. You anticipate that the health care provider will use which therapeutic regimen to reduce portal hypertension? 1. Vascular shunting of the portal venous systems 2. Repeated abdominal paracentesis 3. Diet restrictions and nutrient supplementation 4. Fluid replacement therapy NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 737 4. A patient with high levels of serum ammonia asks, "Why do I have to continue taking lactulose?" What is the best response? 1. "It destroys ammonia-producing bacteria in the intestines." 2. "It reduces intestinal absorption of ammonia." 3. "It corrects vitamin B, deficiency." 4. "It is used in preparation for a diagnostic test." NCLEX Client Need: Physiological Integrity: Pharmacological Therapies 5. You are caring for a patient who underwent a recent liver transplantation. You reinforce the teaching related to self-care. Which teaching topics are most important to address before discharge? (Select all that apply.) 1. Reporting any kind of pain associated with fever and changes in stool color 2. Location and meeting time of local support groups 3. Use of strict hand hygiene in changing dressings 4. The lifelong need to take antirejection medications NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 6. You are caring for a patient who underwent radical pancreaticoduodenectomy. Which postoperative complication would be the most likely to occur and cause the greatest concern? 1. Hypoglycemia 2. Adhesions 3. Hemorrhage 4. Anorexia NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 7. Which instructions should be given to a patient regarding preventing the spread of hepatitis A? (Select all that apply.) 1. Bleach solutions must be used to clean the bathroom. 2. Somebody else should be doing the cooking right now. 3. No vaccination is available for hepatitis A. 4. Good hand hygiene reduces the likelihood of passing the virus. NCLEX Client Need: Safe and Effective Care Environment: Safety and Infection Control 8. A patient has cirrhosis of the liver and ascites. You should question which order? 1. Bed rest with bathroom privileges 2. Discontinue furosemide (Lasix) 80 mg 3. Give 2-g sodium diet 4. Fluid restriction 1500 mL/24 h NCLEX Client Need: Physiological Integrity: Pharmacological Therapies 9. A patient with acute pancreatitis has a bluish discoloration around the umbilicus. What actions should you take? (Place in priority order.) 1. Place head flat and feet elevated. 2. Notify health care provider. 3. Assess vital signs. 4. Verify patency of IV line. NCLEX Client Need: Physiological Integrity: Physiological Adaptation
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