Lower GI Practice Questions PDF

Preview

Summary

Review Sheet...

Description

Spring 2019 Lower GI 1. A patient was admitted to the hospital with a diagnosis of Crohn’s Disease. Which of the following signs should the nurse expect the patient to manifest? Select all that apply. A. B. C. D. E.

Right lower quadrant abdominal pain Passage of fatty, loose stools Presence of blood in the urine Body malaise Anorexia

2. During the acute phase of ulcerative colitis, which of the following nursing diagnosis should be the priority? A. B. C. D.

Risk for impaired skin integrity Imbalance nutrition: Less than body requirements Risk for deficient fluid volume Activity Intolerance

3. Which of the following snack choices made by the client with ulcerative colitis indicate a need for further teaching from the nurse? A. B. C. D.

Ripe banana Applesauce Plain saltine crackers Mixed Nuts

4. A patient is receiving prednisolone during the acute exacerbation of Crohn’s disease. Which of the following statements of the patient would require immediate intervention by the nurse? A. “I feel nauseated whenever you give me the prednisolone.” B. “The number of my bowel movements decreased since being on prednisolone for 2 days.” C. “My throat feels scratchy. I feel like I may be coming down with something.” D. “The doctor said this medication helps decrease the inflammation of my bowels.” 5. The nurse is providing care for a patient following a total colectomy with ileostomy creation 36 hours ago. Which of the following assessment findings should the nurse immediately report to the physician? A. Stoma appears to be pink and shiny. B. Temperature of 102F C. Absence of fecal drainage in ileostomy pouch.

D. Hypoactive bowel sounds on all abdominal quadrants. 6. A patient admitted with complaints of lower abdominal pain, cramping and diarrhea is diagnosed as having diverticulitis. When planning care for this patient, the nurse should include the following interventions: Select all that apply. A. B. C. D. E.

Place patient on NPO, graduating to liquids during the acute phase. Observe patient for signs of obstruction and hemorrhage. Administer broad spectrum antibiotics as prescribed. Educate patient on eating high-fiber, low-fat diet during maintenance phase. Insert rectal catheter to facilitate decrease in cramping and ease in defecation.

7. When caring for a patient with diverticulitis, the nurse expects the patient to complain of pain in which abdominal quadrant? A. B. C. D.

Right upper quadrant Right lower quadrant Left upper quadrant Left lower quadrant

8. What symptoms may be suggestive of an intestinal obstruction in a patient with an ileostomy? A. B. C. D.

Continuous flow of liquid stools and belching Hypervolemia and hyperkalemia Muscle spasms and numbness of the extremities Nausea and abdominal distention

9. A patient was admitted for sudden onset of abdominal pain and tenderness. Abdominal xray indicated that the sigmoid colon was twisted counter-clockwise. The nurse knows that this condition is referred to as A. B. C. D.

Hernia Volvulus Intussusception Adhesion

10. A patient was admitted with the diagnosis of small bowel obstruction. Which assessment findings should the nurse expect the patient to manifest? Select all that apply. A. B. C. D. E.

Crampy abdominal pain Projectile vomiting Abdominal distention Pyuria Borborygmi

11. Which of the following physician’s orders for a patient admitted for large bowel obstruction should the nurse question? A. B. C. D.

Place patient on NPO. Prepare patient for barium enema. Insert NGT and attach to intermittent low suction. Assess abdomen for change in status of bowel sounds.

12. Following a left hemicolectomy for large bowel obstruction, which of the following assessment findings requires the nurse’s immediate intervention? A. B. C. D.

Absence of bowel sounds. Board-like rigidity of the abdomen. Incisional pain score of 8/10. Minimal NGT drainage output.

13. The nurse is caring for a patient admitted with a suspected bowel obstruction. The nurse auscultating the abdomen listens for which type of bowel sounds that are consistent with the patient’s clinical picture? A. B. C. D.

Low-pitched and rumbling above the area of obstruction High-pitched and hypoactive below the area of obstruction Low-pitched and hyperactive below the area of obstruction High-pitched and hyperactive above the area of obstruction

14. The nurse is preparing to insert a nasogastric (NG) tube into a patient with a suspected small intestinal obstruction that is vomiting. The patient asks the nurse why this procedure is necessary. What response by the nurse is most appropriate? A. “The tube will help to drain the stomach contents and prevent further vomiting.” B. “The tube will push past the area that is blocked and thus help to stop the vomiting.” C. “The tube is just a standard procedure before many types of surgery to the abdomen.” D. “The tube will let us measure your stomach contents so we can give you the right IV fluid replacement.” 15. A patient with suspected bowel obstruction had a nasogastric tube inserted at 4:00 AM. The nurse shares in the morning report that the day shift staff should check the tube for patency at what times? A. B. C. D.

7:00 AM, 10:00 AM, and 1:00 PM 8:00 AM, 12:00 PM, and 4:00 PM 9:00 AM and 3:00 PM 9:00 AM, 12:00 PM, and 3:00 PM

16. A colectomy is scheduled for a patient with ulcerative colitis. The nurse should plan to include which prescribed measure in the preoperative preparation of this patient?

A. Instruction on irrigating a colostomy B. Administration of a cleansing enema C. A high-fiber diet the day before surgery D. Administration of IV antibiotics for bowel preparation 17. What information would have the highest priority for the nurse to include in preoperative teaching for a patient scheduled for a colectomy? A. B. C. D.

How to care for the wound How to deep breathe and cough The location and care of drains after surgery Which medications will be used during surgery

18. The nurse requests a patient scheduled for colectomy to sign the operative consent as directed in the physician’s preoperative orders. The patient states that the physician has not really explained very well what is involved in the surgical procedure. What is the most appropriate action by the nurse? A. Ask family members whether they have discussed the surgical procedure with the physician. B. Have the patient sign the form and state the physician will visit to explain the procedure before surgery. C. Explain the planned surgical procedure as well as possible and have the patient sign the consent form. D. Delay the patient’s signature on the consent and notify the physician about the conversation with the patient. 19. Two days after a colectomy for an abdominal mass, a patient reports gas pains and abdominal distention. The nurse plans care for the patient based on the knowledge that the symptoms are occurring as a result what event? A. B. C. D.

Impaired peristalsis Irritation of the bowel Nasogastric suctioning Inflammation of the incision site

20. The nurse is preparing to administer famotidine to a postoperative patient with a colostomy. The patient states they do not have heartburn. What response by the nurse would be the most appropriate? A. B. C. D.

“It will reduce the amount of acid in the stomach.” “It will prevent air from accumulating in the stomach, causing gas pains.” “It will prevent the heartburn that occurs as a side effect of general anesthesia.” “The stress of surgery is likely to cause stomach bleeding if you do not receive it.”

21. The wound, ostomy, and continence nurse (WOCN) selects the site where the ostomy will be placed. What should be included in site consideration? A. The patient must be able to see the site. B. The site should be outside the rectus muscle area. C. It is easier to seal the drainage bag to a protruding area. D. A waistline site will allow using a belt to hold the appliance in place. 22. When evaluating the patient’s understanding about the care of the ileostomy, which statement by the patient indicates the patient needs more teaching? A. B. C. D.

“I will be able to regulate when I have stools.” “I will be able to wear the pouch until it leaks.” “The drainage from my stoma can damage my skin.” “Dried fruit and popcorn must be chewed very well.”

23. When teaching the patient about the diet for diverticular disease, which foods should the nurse recommend? A. B. C. D.

White bread, cheese, and green beans Fresh tomatoes, pears, and corn flakes Oranges, baked potatoes, and raw carrots Dried beans, All Bran (100%) cereal, and raspberries

24. After an exploratory laparotomy, a patient on a clear liquid diet reports severe gas pains and abdominal distention. Which action by the nurse is most appropriate? A. Return the patient to NPO status. B. Place cool compresses on the abdomen. C. Encourage the patient to ambulate as ordered. D. Administer an as-needed dose of IV morphine sulfate. 25. Which clinical manifestations of inflammatory bowel disease does the nurse determine are common to both patients with ulcerative colitis (UC) and Crohn’s disease (select all that apply.)? A. B. C. D. E.

Restricted to rectum Strictures are common Bloody, diarrhea stools Cramping abdominal pain Lesions penetrate intestine

26. A patient is scheduled to receive “Colace 100 mg PO.” The patient asks to take the

medication in liquid form, and the nurse obtains an order for the change. The available syrup contains 150 mg/15 mL. Calculate how many milliliters the nurse should administer. _______________ mL...