• A patient complains of gas pains and abdominal distention two days after a
small bowelresection. Which nursing action is best to take?
a. Encourage
... [Show More] the patient to ambulate.
b. Instill a mineral oil retention enema.
c. Administer the ordered IV morphine sulfate.
d. Offer the ordered promethazine (Phenergan) suppository.
ANS: A
Ambulation will improve peristalsis and help the patient eliminate flatus and
reduce gas pain.A mineral oil retention enema is helpful for constipation with
hard stool. A return-flow enema might be used to relieve persistent gas pains.
Morphine will further reduce peristalsis.
Promethazine (Phenergan) is used as an antiemetic rather than to decrease
gas pains ordistention.
DIF: Cognitive Level: Apply (application) REF:971
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
• A 58-year-old man with blunt abdominal trauma from a motor vehicle crash
undergoes peritoneal lavage. If the lavage returns brown fecal drainage, which
action will the nurse planto take next?
NURS 420 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions and
Answers New Update 2022/2023
NURS 420 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions and
Answers New Update 2022/2023
a. Auscultate the bowel sounds.
b. Prepare the patient for surgery.
c. Check the patient’s oral temperature.
d. Obtain information about the accident.
ANS: B
Return of brown drainage and fecal material suggests perforation of the bowel
and the need for immediate surgery. Auscultation of bowel sounds, checking the
temperature, and obtaininginformation about the accident are appropriate
actions, but the priority is to prepare to send thepatient for emergency surgery.
DIF: Cognitive Level: Apply (application) REF: 973
OBJ: Special Questions: Prioritization TOP: Nursing
Process: PlanningMSC: NCLEX: Physiological Integrity
• A 27-year-old female patient is admitted to the hospital for evaluation of right
lower quadrantabdominal pain with nausea and vomiting. Which action should
the nurse take?
a. Encourage the patient to sip clear liquids.
b. Assess the abdomen for rebound tenderness.
c. Assist the patient to cough and deep breathe.
d. Apply an ice pack to the right lower quadrant.
ANS: D
The patient’s clinical manifestations are consistent with appendicitis, and
application of an icepack will decrease inflammation at the area. Checking for
NURS 420 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions and
Answers New Update 2022/2023
NURS 420 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions and
Answers New Update 2022/2023
rebound tenderness frequently is unnecessary and uncomfortable for the patient.
The patient should be NPO in case immediate surgery is needed. The patient
will need to know how to cough and deep breathe postoperatively, but coughing
will increase pain at this time.
DIF: Cognitive Level: Apply (application) REF:974
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
• Which nursing action will be included in the plan of care for a 27-year-old
male patient withbowel irregularity and a new diagnosis of irritable bowel
syndrome (IBS)?
a. Encourage the patient to express concerns and ask questions about IBS.
b. Suggest that the patient increase the intake of milk and other dairy products.
c. Educate the patient about the use of alosetron (Lotronex) to reduce symptoms.
d. Teach the patient to avoid using nonsteroidal antiinflammatory drugs
(NSAIDs).
ANS: A
Because psychologic and emotional factors can affect the symptoms for IBS,
encouraging thepatient to discuss emotions and ask questions is an important
intervention. Alosetron has serious side effects, and is used only for female
patients who have not responded to other therapies. Although yogurt may be
beneficial, milk is avoided because lactose intolerance cancontribute to
NURS 420 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions and
Answers New Update 2022/2023
NURS 420 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions and
Answers New Update 2022/2023
symptoms in some patients. NSAIDs can be used by patients with IBS.
DIF: Cognitive Level: Apply (application) REF:981
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial
Integrity
• A patient being admitted with an acute exacerbation of ulcerative colitis
reports crampyabdominal pain and passing 15 or more bloody stools a day.
The nurse will plan to
a. administer IV metoclopramide (Reglan).
b. discontinue the patient’s oral food intake.
c. administer cobalamin (vitamin B12) injections.
d. teach the patient about total colectomy surgery.
NURS 420 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions and
Answers New Update 2022/2023
NURS 420 Chapter 43: Nursing Management: Lower
Gastrointestinal Problems Test Bank Questions and
Answers New Update 2022/2023
ANS: B
An initial therapy for an acute exacerbation of inflammatory bowel disease
(IBD) is to rest thebowel by making the patient NPO. Metoclopramide increases
peristalsis and will worsen symptoms. Cobalamin (vitamin B12) is absorbed in
the ileum, which is not affected by ulcerative colitis. Although total colectomy is
needed for some patients, there is no indication that this patient is a candidate.
DIF: Cognitive Level: Apply (application) REF: 971
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
• Which action will the nurse include in the plan of care for a 42-year-old patient
who is beingadmitted with Clostridiu [Show Less]