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WorksheetsNCM 116 - SEMIFINAL EXAMINATION
Total questions: 50
Worksheet time: 25mins
The client with proctitis is asking the nurse about disease process. The nurse on duty correctly responds that the frequent cause is:
trauma
inflammation
infection
fistula formation
Proctitis is prevalent among the following group:
Middle Aged Males
Post Menopausal Females
Sexually Active Homosexuals
Older Heterosexuals
The most common pathogenic agents of Colonic enteritis are the following:
Treponema Pallidum and Chlamydia Trachomatis
Neisseria Gonorrhea and Herpes Simplex Virus
Shigella and Campylobacter Species
E. Histolytica and Dracunculus Medinensis
The patient is admitted with diagnosis of Herpes Simplex 1 and he is taking Acyclovir (Zorivax). Before taking the medication, the nurse must assess the patient for ______.
Flushing
Diarrhea
Orthostatic hypotension
Urticaria
The patient with inflammation of the mucosa of rectum is taking oral Erythromcin antibiotic. The nurse in charge of the patient must include health teachings about not giving the medication with fruit juices because.
It increases gastric acid secretions in the stomach which dilute the medication
Acids in fruit juices decrease the activity of the drug
It decreases gastric acid secretions in the stomach which alters the potency of the drug
Acids in fruit juices increase the activity of the drug
A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). What intervention by the nurse will determine the effectiveness of treatment?
Carrying out hematest on gastric fluids after the infusion is completed
Checking the frequency and consistency of bowel movements.
Monitoring the leukocyte count for 2 days after the infusion
Checking serum liver enzyme levels before and after the infusion
The nurse has given postprocedure instructions to a client who has undergone a colonoscopy. Which statement by the client indicates the need for further teaching?
"It is normal to feel gassy or bloated after the procedure."
"The abdominal muscles may be tender from the procedure."
"It is alright to drive once I've been home for an hour or so."
"Intake should be light at first and then progress to regular intake."
The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding if noted on assessment of the client, would the nurse report to the physician?
Hypotension
Bloody diarrhea
Rebound tenderness
A hemoglobin level of 12 mg/dl
The nurse is caring for a client postoperatively following creation of a colostomy. Which nursing diagnosis should the nurse include in the plan of care?
Sexual dysfunction
Body image, disturbed
Fear related to poor diagnosis
Nutrition: more than body requirements, imbalanced
The nurse is reviewing the record of a client with Crohn's disease. Which stool charactersitic should the nurse expect to note documented in the client's record?
Diarrhea
Chronic constipation
Constipation alternating with diarrhea
Stool constantly oozing from the rectum
The nurse is performing a colostomy irrigation on a client. During the irrigation, the client begins to complain of abdominal cramps. What is the appropriate nursing action?
Notify the physician
Stop the irrigation temporarily
Increase the height of the irrigation
Medicate for pain and resume the irrigation
The nurse is assessing the stoma prolapse in a client with a colostomy. What should the nurse observe if stoma prolapse occurs?
Protruding stoma
Sunken and hidden stoma
Narrowed and flattened stoma
Dark and bluish-colored stoma
The client had a new colostomy created from Hartmann procedure 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse?
This is a normal, expected event
The client is experiencing early signs of ischemic bowel
The client should not have the nasogastric tube removed
This indicates inadequate preoperative bowel preparation
The client with a new colostomy is concerned about the odor from stool in the ostomy drainage bag. The nurse teaches the client to include which food in the diet to reduce odor?
Eggs
Yogurt
Broccoli
Cucumbers
The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the appropriate nursing intervention?
Notify the physician
Administer the prescribed pain medication
Call and ask the operating room team to perform the surgery as soon as possible
Repositioning the client and apply a heating pad on warm setting to the client's abdomen
The client with Crohn's disease has a nursing diagnosis of pain, acute. The nurse should teach the client to avoid which action in managing this problem?
Massaging the abdomen
Using relaxation techniques
Using antispasmodic medication
Lying supine with legs straight
The client with ulcerative colitis has an order to begin a salicylate medication to reduce inflammation. What instruction should the nurse give the client regarding when to take this medication?
On arising
After meals
On an empty stomach
30 minutes before meals
A client is admitted with a diagnosis of acute diverticulitis. What nursing intervention is appropriate for this client?
Instruct the client to remain NPO
Encourage ambulation at least four times daily
Administer cholinergic medications to reduce pain
Encourage coughing and deep breathing every 2 hours
A client has just had a hemorrhoidectomy. What nursing intervention is appropriate for this client?
Instruct the client to limit fluid intake to avoid urinary retention
Instruct the client to eat low-fiber foods to decrease the bulk of the stool
Apply and maintain ice packs over the dressing until the packing is removed
Help the client to a fowler's position to place pressure on the rectal area and decrease bleeding
The nurse is participating in a health screening clinic and is preparing teaching materials about colorectal cancer. Which risk factor for colorectal cancer should the nurse include?
Age older than 30 years
High fiber, low-fat diet
Distant relative with colorectal cancer
Personal history of ulcerative colitis or gastrointestinal polyps
A nurse instruct the client with Diverticulitis to avoid high-fiber foods when inflammation occurs because:
Foods rich in fiber increase fluids in the intestine
Foods rich in fiber causes less absorption of nutrients
Foods rich in fiber irritate the mucosa further
Foods rich in fiber stimulates peristalsis
The patient admitted in the hospital with diagnosis of diverticulosis was given instruction to avoid foods that might cause inflammation. The nurse determines that the patient understood the instructions by avoiding the following foods EXCEPT.
Gas forming foods
Foods containing indigestible roughage
Soft high-fiber foods
Seeds or nuts
The patient with Ulcerative Colitis is likely to experience deficiency in_____.
Vitamin A
Vitamin B
Vitamin C
Vitamin K
WHich of the following findings in a 13 year old girl who has Crohn's disease would indicate that corticosteroid therapy has been effective?
Expansion of muscle mass
Iincrease in the number of stools
Moon-like appearance of the face
Decreased complaints of abdominal pain
A patient who had an excision of an anal fistula has sitz bath ordered. The nurse should instruct the patient that the purpose of the sitz bath is to
Prevent infection
Relax the anal sphincter
Localize the drainage
Promote comfort
A six year old child who has celiac disease is selecting food items from a hospital menu. Based on an understanding of celiac disease, a nurse would discourage the child from selecting which of the following foods?
Fried sweet potatoes
Corn meal muffin
Puffed rice cereal
Whole wheat toast
A six month old infant is suspected of having intussusception. A nurse should expect the child to undergo which of the following procedures?
Colonoscopy
Rectal biopsy
Barium enema
Cholangiography
A patient who has ulcerative colitis does not respond to the prescribed therapy and is admitted to the hospital for a total colectomy and creation of an ileostomy. Which of the following measures should be given priority in the patient's preoperative care plan?
Promoting the patient's acceptance of an ileostomy
Monitoring the patient's emotional state
Preventing the patient from developing pressure sores
Correcting the patient's fluid balance
A patient who has had an ileostomy says to the nurse, "I will have to be isolated for the rest of my life because no one will be able to stand this terrible odor." Which of the following responses by the nurse would most likely be reassuring?
"The odor will gradually become less noticeable."
"I can understand your concern, but remaining in isolation does not reduce the odor."
"There are techniques that can reduce the odor."
"The odor is a normal part of your condition and will not offend people."
The treatment plan for a 14 year old child who has ulcerative colitis includes chronic use of high-dose corticosteroids. Because of the use of this medication, the child is at risk for
Growth retardation
Peripheral neuropathy
Muscular degeneration
Hyperkalemia
A nurse would expect a patient who has ulcerative colitis to report which of the following manifestations of the disease?
Abdominal distention
Bloody diarrhea
Esophageal reflux
Flank pain
Lomotil is prescribed for a patient. When the patient returns to the clinic, the nurse should evaluate the therapeutic effectiveness of Lomotil by assessing the patient's
Weight
Number of daily bowel movements
Amount of daily food intake
Skin turgor
The patient is suspected f having necrotizing enterocolitis, which of the following assessments is essential that a nurse perform?
Probe the anus for patency
Percuss the liver to determine size
Palpate the abdomen for rebound tenderness
Check the stool for occult blood
When assessing a patient who has ulcerative colitis, a nurse would expect to identify a decrease in which of the following laboratory serum values?
Albumin
Calcium
Platelets
Prothrombin time
To which of the following nursing diagnosis would a nurse give priority in caring for a patient who has inflammatory bowel disease?
Social Isolation
Risk for Impaired Skin Integrity
Constipation
Altered Nutrition: Less than body requirements
A patient who has ulcerative colitis is scheduled for surgery for creation of an ileostomy. The patient asks a nurse why the surgery is necessary. The nurse would respond that the purpose is to
Removed the diseased portion of the bowel
Prevent the development of colon cancer
Limit the spread of disease in the intestine
Reduce the loss of nutrients from the gut
The patient returns to the unit following the surgical creation of a double-barreled colostomy. Which type of drainage from the patient's bowel would a nurse expect to find postoperatively?
Mucoid drainage from the distal stoma
Fecal material from the distal stoma
Black tarry stool from the rectum
Bright red blood from the rectum
A nurse obtains a diet history from a patient who has ulcerative colitis. The nurse should determine that the patient needs teaching if the patient indicated which of these foods as being part of the diet?
Celery
Bananas
White rice
Roast chicken
Because of an outbreak of Escherichia coli - related diarrhea in the community, a public health nurse should instruct parents about measures to prevent further occurence, which include
Cooking all chopped meats thoroughly
Drinking bottled mineral water
Sanitizing kitchen surfaces daily
Swimming in chlorine-treated water
Which of the following teaching instructions would a nurse include for a patient who has regional enteritis?
"Limit your dietary protein intake."
"Reduce exposure to air pollutants."
"Decrease your activity level."
"Avoid drinking fruit juices."
Which of the following statements would a nurse include in the preoperative instruction of a patient who is scheduled for an ileostomy?
"You will have one bowel movement per day."
"The stool drainage will be of liquid consistency."
"The pouch will be located on the left side of your abdomen."
"You will be taught how to irrigate your bowel through the stoma.'
Which of the following statements if made by the client who is scheduled for a sigmoid colostomy, would indicate to a nurse that the patient needs further instruction?
"I will have one formed bowel movement daily."
"I will have continuous drainage of liquid stool."
"The pouch will be located on the left side of my abdomen."
"I will be taught how to irrigate my bowel through the stoma."
Which of the following statements, if made by a patient who has diverticulosis, would indicate to a nurse that the patient is following the diet plan correctly?
"I eat meat five times a week.'
"I do not eat fried foods."
"I drink decaffeinated coffee."
"I eat a green salad every day."
A 10 year old boy is admitted to the hospital with a history of fever and right, lower quadrant abdominal pain. Which of the following comfort measures would be taken until a diagnosis is made?
Maintain the child in a recumbent position
Apply warm compresses to the affected area
Obtain an order for an age-appropriate analgesic
Distact the child with an age-appropriate video
When a 12 year old child has a diagnosis of appendicitis, which of the following manifestations would be most important for the nurse to follow up?
Tympanic temperature of 38.4 degrees celsius
Absence of stool for 24 hours
Nausea when exposed to food odors
Cessation of abdominal pain
When assessing a patient who underwent a colostomy several months ago, a nurse would expect the stoma to appear
Dry
Red
Edematous
Retracted
Which of the following snacks would be appropriate for a patient on a low-fat diet?
A slice of baked apple pie
Cheddar cheese and crackers
Vanilla yogurt
Mixed nuts
The nurse should monitor a patient who is receiving lactulose for which of the following adverse side effects?
Diarrhea
Petechiae
Polyuria
Flushing
Which of the following factors, if noted in a patient's history, would predispose the patient to the development of diverticulitis?
Occupational stress
Cigarrette smoking
Low-fiber diet
Sedentary lifestyle
Which of the following findings, if identified in a patient who is receiving Intravenous Ceftriaxone sodium (Rocephin) for the treatment of bacterial infections, indicates that the nurse should question using Rocephin?
Urinary frequency
Frontal headache
Back pain
Moderate itching
