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NURSE MED SURGE: Chapter 56 part #1. Questions, Answers and the Rationale

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A patient reports severe mid-epigastric pain radiating to the left flank and back. The nurse notes generalized jaundice and a gray-blue discoloration of the patient's abdomen and periumbilical area. T... he nurse suspects which cause of acute pain in this patient? Pancreatitis Biliary colic Cholecystitis Gastroenteritis p. 1199 A patient who has undergone a laparoscopic cholecystectomy is complaining of upper chest and shoulder pain. What action by the nurse is most appropriate? A patient who has undergone a laparoscopic cholecystectomy is complaining of upper chest and shoulder pain. What action by the nurse is most appropriate? Administer heat Place arm in a sling Tell the patient to rest the arm Encourage range-of-motion exercises p. 1196 A patient diagnosed with gastroesophageal reflux disease (GERD) reports a sensation of fluid in the throat that does not have the bitter taste previously experienced with reflux. What symptom is this patient experiencing? A patient diagnosed with gastroesophageal reflux disease (GERD) reports a sensation of fluid in the throat that does not have the bitter taste previously experienced with reflux. What symptom is this patient experiencing? Pyrosis Dyspepsia Water brash Odynophagia p. 1088 A patient reports having seven to nine bloody stools per day. The nurse finds that the patient has fever, tachycardia, anemia, and abdominal pain. The patient's laboratory reports indicate elevated C-reactive protein. Which classification of ulcerative colitis should the nurse suspect? Mild Severe Moderate Fulminant p. 1150 The nurse is providing postoperative teaching to a patient scheduled for a laparoscopic cholecystectomy. What instructions should be included? "Introduce high-fat foods one at a time." "The sutures will be removed in 14 days." "You will be back to normal activities within 4 weeks." "You will not be able to eat regular food for 24 to 48 hours." The nurse is preparing the patient for magnetic resonance enterography (MRE). What intervention slows down the bowel activity and motility in the patient in preparation for the MRE? Positioning the patient in prone position Having the patient drink a contrast medium Teaching the patient to fast 4 to 6 hours prior to the test Administering two subcutaneous injections of glucagon p. 1152 The nurse is assessing an older patient with diverticulitis. Which instructions given by the nurse will be beneficial to this patient? Select all that apply. "Refrain from drinking alcohol." "Use mild laxatives three times a day." "Refrain from physical activities like bending." "Add tomatoes and strawberries in your diet." "Eat a high-fiber diet during severe abdominal pain." What symptoms are suggestive of a sliding hiatal hernia? Select all that apply. Belching Heartburn Difficulty in swallowing Feeling of fullness after eating Backward flow of food into the throat Worsening of symptoms when lying down p. 1093 A patient with an internal/external biliary drainage tube contacts the health care provider's office to report jaundice and leakage around the catheter site. What instructions should the nurse provide? "Reconnect the drainage bag." "Take your ursodeoxycholic acid." "Go to the emergency department." "Go to the lab to have your bilirubin level checked." p. 1195 The patient presents to the emergency department with acute gastritis. The nurse suspects which organism is most likely the culprit? The patient presents to the emergency department with acute gastritis. The nurse suspects which organism is most likely the culprit? Streptococcus Escherichia coli Helicobacter pylori Staphylococcus aureus p. 1104 A patient who has a medical history of ankylosing spondylitis reports a constant, unpleasant, and urgent sensation to defecate and lower abdominal colicky pain that is relieved after defecation. Which finding may support the patient's condition? A patient who has a medical history of ankylosing spondylitis reports a constant, unpleasant, and urgent sensation to defecate and lower abdominal colicky pain that is relieved after defecation. Which finding may support the patient's condition? Presence of fecalith Oxygen saturation of 72 percent Serum albumin levels of 1.9 g/dL Presence of Escherichia coli in feces p. 1150 What postoperative measures are typically implemented for patients who have undergone abdominal surgery for peritonitis? Monitoring vital signs every 2 hours Irrigating the drain via sterile technique Maintaining the patient in supine position Monitoring respiratory rate every 3 hours What statement about type A gastritis is most accurate? It is associated with pernicious anemia. It is most often caused by pylori infection. It can occur due to exposure to benzene or lead. It has an autosomal recessive pattern of inheritance. p. 1104 A patient has been diagnosed with Stage 4 metastatic pancreatic cancer. Which management strategy is typical for this type of cancer? A patient has been diagnosed with Stage 4 metastatic pancreatic cancer. Which management strategy is typical for this type of cancer? Curative Palliative Preventive No treatment p. 1206 The nurse is teaching a patient about extracorporeal shockwave lithotripsy. What statement by the patient indicates a need for further teaching? The nurse is teaching a patient about extracorporeal shockwave lithotripsy. What statement by the patient indicates a need for further teaching? "I will sit in 12 inches of water." "The stones will pass through my digestive system." "The shockwaves will turn the big stones into small stones." "I may need to take ursodeoxycholic acid after this procedure." p. 1195 What is the most common cause of right lower quadrant pain? What is the most common cause of right lower quadrant pain? Sepsis Peritonitis Appendicitis Gastroenteritis A patient is diagnosed with a malignant gastric tumor in the proximal portion of the stomach. Which surgical intervention does the nurse anticipate will be performed on this patient? A patient is diagnosed with a malignant gastric tumor in the proximal portion of the stomach. Which surgical intervention does the nurse anticipate will be performed on this patient? Total gastrectomy Gastroenterostomy Subtotal gastrectomy Pancreatoduodenectomy p. 1117 While assessing a patient with peritonitis, which finding would make the nurse suspect that the inflammation has progressed? While assessing a patient with peritonitis, which finding would make the nurse suspect that the inflammation has progressed? Slow heart rate Sunken abdomen Absence of bowel sounds Increased intestinal motility p. 1145 A patient receiving chenodiol for cholelithiasis has just received teaching about the medication. What statement by the patient indicates the teaching was effective? A patient receiving chenodiol for cholelithiasis has just received teaching about the medication. What statement by the patient indicates the teaching was effective? "Diarrhea is a normal side effect of this medication." "I should take the medication on an empty stomach." "I will need to have gallbladder ultrasound every 6 months for a year." "I will need to take this medication for the rest of my life, or until I have my gallbladder removed." p. 1195 Which measures can promote perineal comfort in the patient with an anorectal abscess? Select all that apply. Which measures can promote perineal comfort in the patient with an anorectal abscess? Select all that apply. Use of warm sitz baths Avoiding psyllium mucilloid Gently rubbing the perineal area to dry Using stool softeners and high-fiber diet Applying topical analgesic cream to the perineal area p. 1165 Which immediate order should the nurse expect from the primary health care provider who, while assessing a patient with gastroenteritis, observes increased peristaltic movements? Which immediate order should the nurse expect from the primary health care provider who, while assessing a patient with gastroenteritis, observes increased peristaltic movements? Avoid oral use of loperamide. Administer oral dose of 4 mg loperamide. Administer oral dose of 10 mg loperamide. Administer initial oral dose of 16 mg loperamide. p. 1149 A patient has been diagnosed with gastritis. What statement about this disorder is accurate? A patient has been diagnosed with gastritis. What statement about this disorder is accurate? Gastritis is a tumor of the gastric mucosa. Gastritis is caused by release of prostaglandin. Gastritis is the inflammation of gastric mucosa. Gastritis is a tumor that is associated with pylori infection. p. 1103 The nurse is caring for a patient recently diagnosed with gastric cancer who is symptomatic. What prognosis does the nurse anticipate for this patient? The nurse is caring for a patient recently diagnosed with gastric cancer who is symptomatic. What prognosis does the nurse anticipate for this patient? Fair prognosis Poor prognosis Good prognosis Excellent prognosis p. 1115 Which site has an increased risk of being affected by cancer in patients with Barrett's esophagus related to gastroesophageal reflux disease (GERD)? Which site has an increased risk of being affected by cancer in patients with Barrett's esophagus related to gastroesophageal reflux disease (GERD)? Body Cardia Fundus Pylorus Test-Taking Tip: A list of clinical manifestations and histopathological findings are presented in the question. Answer only after interpreting the histopathological findings. p. 1115 • Correct (6) A patient has undergone a restorative proctocolectomy with ileal pouch-anal anastomosis. What should the nurse instruct the patient to avoid? A patient has undergone a restorative proctocolectomy with ileal pouch-anal anastomosis. What should the nurse instruct the patient to avoid? Corn Wheat Asparagus Fiber-rich foods p. 1155 A patient who has had acute mid-epigastric pain for 3 days has elevated glucose, bilirubin, serum lipase, and a threefold increase in alanine aminotransferase. The serum amylase is normal. What does the nurse suspect about the possible cause of this patient's pain? A patient who has had acute mid-epigastric pain for 3 days has elevated glucose, bilirubin, serum lipase, and a threefold increase in alanine aminotransferase. The serum amylase is normal. What does the nurse suspect about the possible cause of this patient's pain? It is not caused by pancreatitis. It may be caused by pancreatitis. It is caused by acute biliary pancreatitis. It is caused by hepatobiliary inflammation only. p. 1200 A patient is diagnosed with dumping syndrome. Which foods should be restricted in this patient's diet? A patient is diagnosed with dumping syndrome. Which foods should be restricted in this patient's diet? Eggs Canned fruits Peanut butter Sweetened juice p. 1118 What finding is most concerning for a patient who has just undergone an open cholecystectomy? What finding is most concerning for a patient who has just undergone an open cholecystectomy? Output of 25 mL/hr Reddened incision site Pain of 7/10 at the incision site Respiratory rate of 8 breaths/minute p. 1196 A patient with ulcerative colitis is scheduled for an ileostomy. Which preoperative information should the nurse provide to the patient and family members? A patient with ulcerative colitis is scheduled for an ileostomy. Which preoperative information should the nurse provide to the patient and family members? Empty the pouch before eating. Change the pouch during active times. Change the entire pouch system every 4 to 9 days. Empty the pouch when it is one-third to one-half full. p. 1157 The nurse is teaching a patient with chronic pancreatitis about pancreatic-enzyme replacement therapy. Which statement by the patient indicates a correct understanding of the teaching? The nurse is teaching a patient with chronic pancreatitis about pancreatic-enzyme replacement therapy. Which statement by the patient indicates a correct understanding of the teaching? "I should mix the capsule contents with high-protein foods." "I should drink a minimum amount of water after taking the medication." "If I can't swallow the capsule, I may break it open and chew the contents." "I may spread the capsule contents over applesauce, mashed fruit, or rice cereal." • • Which diagnostic test is useful for providing an accurate staging of gastric cancer? Which diagnostic test is useful for providing an accurate staging of gastric cancer? Computed tomography (CT) Endoscopic ultrasound (EUS) Magnetic resonance imaging (MRI) Positron emission tomography (PET) p. 1116 The health care provider has ordered a fecal occult blood test (FOBT) for a patient. What does the nurse instruct the patient to avoid for a few days before and during the sample collection? Select all that apply. The health care provider has ordered a fecal occult blood test (FOBT) for a patient. What does the nurse instruct the patient to avoid for a few days before and during the sample collection? Select all that apply. Milk Warfarin Vitamin C Red meat Vitamin B 12 Nonsteroidal anti-inflammatory drugs (NSAIDs) p. 1068 A patient with suspected appendicitis reports having abdominal pain around the umbilicus for the past 2 days, associated with decreased hunger and episodes of vomiting. Which nursing statement and patient response helps in confirming the diagnosis? A patient with suspected appendicitis reports having abdominal pain around the umbilicus for the past 2 days, associated with decreased hunger and episodes of vomiting. Which nursing statement and patient response helps in confirming the diagnosis? Nurse: “Have you eaten in restaurants within the past two days?” Patient response: “Yes, once at a fast-food restaurant.” Nurse: “Do you have an allergy toward milk and milk products?” Patient response: “Yes.” Nurse: “Were you traveling recently?” Patient response: “Yes, two week ago.” Nurse: “When did the pain and vomiting begin?” Patient response: “The pain started 2 days ago, and yesterday I started vomiting.” p. 1147 While assessing a patient with colorectal cancer, the primary health care provider finds some masses when palpating the abdomen. Which assessment test would be used to confirm if there are masses in the abdomen? While assessing a patient with colorectal cancer, the primary health care provider finds some masses when palpating the abdomen. Which assessment test would be used to confirm if there are masses in the abdomen? Colonoscopy Sigmoidoscopy Magnetic resonance imaging A double contrast barium enema p. 1129 What clinical manifestations of refeeding syndrome may appear when tube feeding is started for a patient in a starvation state? What clinical manifestations of refeeding syndrome may appear when tube feeding is started for a patient in a starvation state? Diarrhea Vomiting Seizures Abdominal distention p. 1221 What may occur following bariatric surgery if too much liquid is ingested? What may occur following bariatric surgery if too much liquid is ingested? Oliguria Vomiting Back pain Abdominal pain p. 1230 Which vitamin may be especially important for a patient who is alcoholic with liver disease? Which vitamin may be especially important for a patient who is alcoholic with liver disease? Folate Niacin Thiamine Vitamin D p. 1179 The nurse is teaching a patient about self-management of gastritis. Which piece of education is appropriate? The nurse is teaching a patient about self-management of gastritis. Which piece of education is appropriate? "Drink decaffeinated coffee." "Eat tomato products and onions." "Use complementary and alternative therapies." "Take aspirin instead of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain." p. 1104 Which organ is usually affected in chronic atrophic gastritis? Which organ is usually affected in chronic atrophic gastritis? Glands of the antrum Deeply located glands Body of the stomach only Fundus of the stomach only p. 1104 A patient with colorectal cancer is scheduled for a double-barrel colostomy. What is the most accurate statement about this type of ostomy? A patient with colorectal cancer is scheduled for a double-barrel colostomy. What is the most accurate statement about this type of ostomy? Double-barrel stomas are the least common. An external rod is used to provide support during healing. The proximal stoma is also referred to as a mucous fistula. The distal stoma is the functioning stoma and eliminates stool. p. 1131 Which laboratory parameters should the nurse assess in the patient who presents with symptoms of diverticulitis? Select all that apply. Which laboratory parameters should the nurse assess in the patient who presents with symptoms of diverticulitis? Select all that apply. Hematocrit Hemoglobin Serum albumin Serum potassium White blood cell (WBC) count p. 1163 A patient is diagnosed with constipation-predominant irritable bowel syndrome. What medication does the nurse anticipate will be prescribed by the primary health care provider? A patient is diagnosed with constipation-predominant irritable bowel syndrome. What medication does the nurse anticipate will be prescribed by the primary health care provider? Rifaximin Linaclotide Loperamide Amitriptyline p. 1136 Which factors place a patient at risk for gastrointestinal (GI) problems? Select all that apply. Which factors place a patient at risk for gastrointestinal (GI) problems? Select all that apply. Socioeconomic status Eating a high-fiber diet Some herbal preparations Smoking a half-pack of cigarettes per day Use of nonsteroidal anti-inflammatory drugs (NSAIDs) p. 1065 Which is a correct statement differentiating Crohn's disease (CD) from ulcerative colitis (UC)? Which is a correct statement differentiating Crohn's disease (CD) from ulcerative colitis (UC)? Patients with UC may experience hemorrhage. Very few complications are associated with CD. The peak incidence of UC is between 15 and 40 years of age. Patients with CD experience about 20 loose, bloody stools daily. p. 1150 What measures can be taken to decrease the incidence of dehiscence after open bariatric surgery? What measures can be taken to decrease the incidence of dehiscence after open bariatric surgery? Apply an abdominal binder Limit turning and repositioning Assess underneath the patient's skin folds Ensure that the patient has an extra wide bed p. 1230 The nurse is caring for a patient with a nasogastric tube (NGT) who has undergone open-approach surgery for gastric cancer. What manifestation indicates acute gastric dilation because of a clogged NGT? The nurse is caring for a patient with a nasogastric tube (NGT) who has undergone open-approach surgery for gastric cancer. What manifestation indicates acute gastric dilation because of a clogged NGT? Hiccups Bradycardia Hypertension Hypogastric pain p. 1117 What is the major side effect of phendimetrazine, a sympathomimetic that is often used to suppress appetite? What is the major side effect of phendimetrazine, a sympathomimetic that is often used to suppress appetite? Nausea Loose stools Blurred vision Abdominal cramps p. 1229 While assessing a patient with gastroenteritis, the nurse suspects that the patient has severe dehydration. Which findings support the nurse's suspicion? Select all that apply. While assessing a patient with gastroenteritis, the nurse suspects that the patient has severe dehydration. Which findings support the nurse's suspicion? Select all that apply. Fever Polyuria Hypertension Poor skin turgor Dry mucous membranes p. 1149 Which describes internal hemorrhoids? Which describes internal hemorrhoids? They are noticeable to the eye. They lie below the anal sphincter. They cannot be seen upon inspection. They fall down and protrude through the anus. p. 1139 Which activity by the nurse will best relieve symptoms associated with ascites? Which activity by the nurse will best relieve symptoms associated with ascites? Administering oxygen Elevating the head of the bed Administering intravenous fluids Monitoring serum albumin levels p. 1179 In which position will the nurse place a patient who has had bariatric surgery in order to reduce the risk of sleep apnea? In which position will the nurse place a patient who has had bariatric surgery in order to reduce the risk of sleep apnea? Fowler's Side-lying Semi-Fowler's Trendelenburg p. 1230 The patient presents to the emergency department with severe abdominal pain. The nurse is reviewing the patient's lab results. What laboratory findings would prompt the nurse to suspect a diagnosis of acute pancreatitis? Select all that apply. The patient presents to the emergency department with severe abdominal pain. The nurse is reviewing the patient's lab results. What laboratory findings would prompt the nurse to suspect a diagnosis of acute pancreatitis? Select all that apply. Decreased bilirubin Increased serum amylase Decreased serum glucose Decreased serum calcium Increased alanine aminotransferase p. 1200 What pathophysiologic finding is typically seen in chronic atrophic gastritis? What pathophysiologic finding is typically seen in chronic atrophic gastritis? Prominent rugae Intestinal metaplasia Excessive inflammation Thickened gastric mucosa p. 1115 Which disorder in older adults may have a direct association with mucosa-associated lymphoid tissue (MALT) lymphoma? Which disorder in older adults may have a direct association with mucosa-associated lymphoid tissue (MALT) lymphoma? Uremia Crohn's disease Atrophic gastritis Graft versus host disease p. 1104 • Correct (6) A patient reports pain in the right upper quadrant (RUQ) after a high-fat meal. Which organ does the nurse expect to be affected? A patient reports pain in the right upper quadrant (RUQ) after a high-fat meal. Which organ does the nurse expect to be affected? Spleen Stomach Appendix Gallbladder p. 1067 The nurse is reviewing the medications prescribed for a patient with peptic ulcer disease (PUD). Which drug is the patient taking to treat Helicobacter pylori infection? The nurse is reviewing the medications prescribed for a patient with peptic ulcer disease (PUD). Which drug is the patient taking to treat Helicobacter pylori infection? Nizatidine Pantoprazole Metronidazole Aluminum hydroxide p. 1111 The nurse is explaining postoperative care to a patient scheduled for a hemorrhoidectomy. What teaching does the nurse include? The nurse is explaining postoperative care to a patient scheduled for a hemorrhoidectomy. What teaching does the nurse include? "Urinary incontinence can be a complication." "A high-fiber diet should be restricted for a few weeks." "Sitz baths should be given three to four times each day." "Stimulant laxatives should be taken to promote bowel movements." p. 1140 The nurse is caring for an older adult male patient who reports stomach pain and heartburn. Which characteristic is most significant in determining whether the patient's ulceration is gastric or duodenal in origin? The nurse is caring for an older adult male patient who reports stomach pain and heartburn. Which characteristic is most significant in determining whether the patient's ulceration is gastric or duodenal in origin? The patient is a man older than 50 years. Pain is worsened by the ingestion of food. The patient has a malnourished appearance. Pain occurs 1½ to 3 hours after a meal, usually at night. p. 1110 Which statement accurately describes the laparoscopic sleeve gastrectomy (LSG) procedure? Which statement accurately describes the laparoscopic sleeve gastrectomy (LSG) procedure? An adjustable band is used to create a small proximal pouch. The stomach, duodenum, and part of the jejunum are bypassed surgically. LSG is a common surgery that involves biliopancreatic diversion. The portion of the stomach that secretes ghrelin is surgically removed. p. 1229 Which medication is most likely to be prescribed by the primary health care provider for the condition depicted in the figure below? Which medication is most likely to be prescribed by the primary health care provider for the condition depicted in the figure below? <img src="https://eolscontent.elsevier.com/1069FQX38FT/image/2208_iggy_ch57_fig3.png" alt="2208_iggy_ch57_fig3.png"/> Infliximab Tinidazole Adalimumab Ciprofloxacin • Incorrect (25) The nurse is caring for a patient diagnosed with esophageal cancer who is experiencing diarrhea after conventional esophageal surgery. The nurse anticipates that the health care provider will request which medication to manage diarrhea? The nurse is caring for a patient diagnosed with esophageal cancer who is experiencing diarrhea after conventional esophageal surgery. The nurse anticipates that the health care provider will request which medication to manage diarrhea? Loperamide Mesalamine Minocycline Pantoprazole p. 1100 The nurse has placed a nasogastric (NG) tube in a patient with upper gastrointestinal bleeding to administer gastric lavage. The patient asks the nurse about the purpose of the NG tube for the procedure. What is the nurse's best response? The nurse has placed a nasogastric (NG) tube in a patient with upper gastrointestinal bleeding to administer gastric lavage. The patient asks the nurse about the purpose of the NG tube for the procedure. What is the nurse's best response? "Saline goes down the tube to help clean out your stomach." "Medication goes down the tube to help clean out your stomach." "We'll start feeding you through it once your stomach is cleaned out." "The provider requested the tube to be placed just in case it was needed." p. 1113 Which layer of the gastric wall is first affected by adenocarcinoma? Which layer of the gastric wall is first affected by adenocarcinoma? Serosa Submucosa Gastric mucosa Muscularisexterna p. 1115 The nurse is caring for a patient with esophageal cancer who has received photodynamic therapy (PDT) using porfimer sodium. What instructions does the nurse include in teaching the patient about porfimer sodium? Select all that apply. The nurse is caring for a patient with esophageal cancer who has received photodynamic therapy (PDT) using porfimer sodium. What instructions does the nurse include in teaching the patient about porfimer sodium? Select all that apply. Monitor for hypertension Avoid sunlight for 2 weeks Cover all exposed body areas Tissue particles may be found in the sputum Follow a clear liquid diet for 3 to 5 days after the procedure p. 1098 Which surgery may be performed on a patient with regional lymph node involvement in colon cancer? Which surgery may be performed on a patient with regional lymph node involvement in colon cancer? Colostomy Colectomy Colon resection Abdominoperineal resection p. 1130 A patient with peptic ulcer disease (PUD) asks the nurse whether licorice and slippery elm might be useful in managing the disease. What is the nurse's best response? A patient with peptic ulcer disease (PUD) asks the nurse whether licorice and slippery elm might be useful in managing the disease. What is the nurse's best response? "No, they probably won't be useful. You should use only prescription medications in your treatment plan." "These herbs could be helpful. However, you should talk with your provider before adding them to your treatment regimen." "Yes, these are known to be effective in managing this disease, but make sure you research the herbs thoroughly before taking them." "No, herbs are not useful for managing this disease. You can use any type of over-the-counter drugs though. They have been shown to be safe." p. 1113 The nurse is observing a co-worker who is caring for a patient with a nasogastric tube following esophageal surgery. Which actions by the co-worker require the nurse to intervene? Select all that apply. The nurse is observing a co-worker who is caring for a patient with a nasogastric tube following esophageal surgery. Which actions by the co-worker require the nurse to intervene? Select all that apply. Securing the tube Keeping the bed flat Providing mouth care every 8 hours Checking tube placement every 12 hours Placing the patient upright when taking sips of water p. 1100 Which chemotherapy medications may be prescribed to a patient after surgery for colorectal cancer? Select all that apply. Which chemotherapy medications may be prescribed to a patient after surgery for colorectal cancer? Select all that apply. Alosetron Oxaliplatin Leucovorin Capecitabine Lubiprostone p. 1130 Which patient has the highest risk of mortality associated with esophageal cancer? Which patient has the highest risk of mortality associated with esophageal cancer? 32-year-old Asian male 68-year-old Hispanic female 52-year-old Caucasian female 44-year-old African-American female p. 1096 A patient developed impaired skin integrity, fatigue, anorexia, and nausea following the treatment of gastric cancer. The nurse understands which therapy is likely responsible for these side effects? A patient developed impaired skin integrity, fatigue, anorexia, and nausea following the treatment of gastric cancer. The nurse understands which therapy is likely responsible for these side effects? Chemotherapy Surgical resection Radiation therapy Combination chemotherapy p. 1116 The nurse is planning the care of a female patient with severe diarrhea-predominant irritable bowel syndrome (IBS-D). Which nursing invention is most appropriate for the patient? The nurse is planning the care of a female patient with severe diarrhea-predominant irritable bowel syndrome (IBS-D). Which nursing invention is most appropriate for the patient? Avoid psyllium hydrophilic mucilloid. Report symptoms of constipation early if taking alosetron. Avoid calcium-rich foods if the patient is lactose intolerant. Take lubiprostone on an empty stomach to control diarrhea. p. 1137 What teaching should be provided for a patient diagnosed with esophageal diverticula? What teaching should be provided for a patient diagnosed with esophageal diverticula? Avoid bending Wear tight clothing Exercise after meals Keep head elevated for 1 hour after meals p. 1101 What is an appropriate intervention for a patient with irritable bowel syndrome (IBS)? What is an appropriate intervention for a patient with irritable bowel syndrome (IBS)? Take 30 to 40 g of fiber each day. Chew gum to decrease gastric acid. Drink 8 to 10 glasses of prune juice. Eat a light breakfast and a heavy dinner. p. 1136 What risk factors are associated with the development of gastroesophageal reflux disease (GERD)? Select all that apply. What risk factors are associated with the development of gastroesophageal reflux disease (GERD)? Select all that apply. Ascites Obesity Seizures Pregnancy Wearing tight girdles Continuous severe vomiting p. 1088 Which nursing intervention is beneficial for a patient with a hiatal hernia? Which nursing intervention is beneficial for a patient with a hiatal hernia? Advising to exercise strenuously twice a day Elevating the head of the bed to 6 inches at night Having the patient sleep in a semi-Fowler's position Recommending wearing tight clothing around the abdomen p. 1093 A 50-year-old patient comes to an outpatient clinic for a colonoscopy and asks how often the procedure needs to be performed. What does the nurse tell the patient? A 50-year-old patient comes to an outpatient clinic for a colonoscopy and asks how often the procedure needs to be performed. What does the nurse tell the patient? Every 3 years Every 5 years Every 10 years Every 15 years p. 1128 The nurse is caring for a patient with peptic ulcer disease (PUD). What signs and symptoms in the patient suggest a surgical emergency? Select all that apply. The nurse is caring for a patient with peptic ulcer disease (PUD). What signs and symptoms in the patient suggest a surgical emergency? Select all that apply. Black, tarry stool Assuming the knee-chest position Tender, rigid, board-like abdomen Sudden, sharp pain in the mid-epigastrium Vomiting of bright red or coffee-ground blood pp. 1108-1109 Which symptoms are consistent with a diagnosis of irritable bowel syndrome (IBS)? Select all that apply. Which symptoms are consistent with a diagnosis of irritable bowel syndrome (IBS)? Select all that apply. Fatigue Insomnia Vomiting Abdominal pain Weight changes p. 1136 The nurse is assessing a patient with gastroesophageal reflux disease (GERD). Which findings does the nurse expect to observe? Select all that apply. The nurse is assessing a patient with gastroesophageal reflux disease (GERD). Which findings does the nurse expect to observe? Select all that apply. Dyspepsia Flatulence Regurgitation Excessive salivation Blood-tinged sputum p. 1088 What patient population is more susceptible to direct inguinal hernias? What patient population is more susceptible to direct inguinal hernias? Older adults Obese patients Newborn babies Pregnant women p. 1138 What are risk factors for colorectal cancer? Select all that apply. What are risk factors for colorectal cancer? Select all that apply. Age >50 years Diet high in caffeine Family history of cancer History of Crohn's disease Heavy alcohol consumption p. 1127 The nurse is caring for a patient with a suspected diagnosis of pernicious anemia. What test does the nurse anticipate being ordered for this patient? The nurse is caring for a patient with a suspected diagnosis of pernicious anemia. What test does the nurse anticipate being ordered for this patient? The Schilling test Ultrasonography Bile acid breath test Lactose tolerance test p. 1141 Which of the following is a common sign of malabsorption syndrome? Which of the following is a common sign of malabsorption syndrome? Melena Steatorrhea Constipation Hematochezia p. 1141 A patient has been recently diagnosed with gastric cancer. What signs and symptoms suggest that the cancer is at a late stage? Select all that apply. A patient has been recently diagnosed with gastric cancer. What signs and symptoms suggest that the cancer is at a late stage? Select all that apply. Indigestion Retrosternal pain Feeling of fullness Nausea and vomiting Enlarged lymph nodes Iron deficiency anemia p. 1116 A patient with esophageal cancer is prescribed targeted therapy as a nonsurgical treatment option. Which drug is the most commonly used in targeted therapy for esophageal cancer? A patient with esophageal cancer is prescribed targeted therapy as a nonsurgical treatment option. Which drug is the most commonly used in targeted therapy for esophageal cancer? Oxiplatin Paclitaxel Trastuzumab 5-Fluorouracil (5-FU) p. 1097 • Correct (5) The nurse is working with the dietitian to plan a menu for a patient who has persistent difficulty swallowing. What is a suitable breakfast selection for this patient? The nurse is working with the dietitian to plan a menu for a patient who has persistent difficulty swallowing. What is a suitable breakfast selection for this patient? Scrambled eggs and toast Oatmeal and orange juice Puréed fruit and English muffin Cream of wheat and applesauce p. 1097 A patient is being evaluated in the emergency department (ED) for a possible small-bowel obstruction. Which signs and/or symptoms does the nurse expect to assess? A patient is being evaluated in the emergency department (ED) for a possible small-bowel obstruction. Which signs and/or symptoms does the nurse expect to assess? Cramping intermittently, metabolic acidosis, and minimal vomiting Intermittent lower abdominal cramping, obstipation, and metabolic alkalosis Metabolic acidosis, upper abdominal distention, and intermittent cramping Upper abdominal distention, metabolic alkalosis, and great amount of vomiting p. 1122 A patient presents to the emergency department with pain in the left lower quadrant of the abdomen. The patient reports nausea after eating, diarrhea, and abdominal bloating. What diagnosis does the nurse suspect? A patient presents to the emergency department with pain in the left lower quadrant of the abdomen. The patient reports nausea after eating, diarrhea, and abdominal bloating. What diagnosis does the nurse suspect? Hemorrhoids Umbilical hernia Intestinal obstruction Irritable bowel syndrome (IBS) p. 1136 Which diagnostic test, in addition to biopsy, yields a definitive diagnosis for gastric cancer? Which diagnostic test, in addition to biopsy, yields a definitive diagnosis for gastric cancer? Computed tomography (CT) Endoscopic ultrasound (EUS) Positron emission tomography (PET) Esophagogastroduodenoscopy (EGD) p. 1116 Which patient assessment data frequently correlates with a diagnosis of chronic gastritis? Which patient assessment data frequently correlates with a diagnosis of chronic gastritis? Hematemesis Gastric hemorrhage Frequent use of corticosteroids Treatment with radiation therapy What antidiarrheal drug prescribed for a patient with diarrhea-predominant irritable bowel syndrome should not be taken with psychoactive or antihistamines drugs? Psyllium Alosetron Loperamide Lubiprostone p. 1137 What is characteristic of mechanical obstruction? What is characteristic of mechanical obstruction? The bowel is physically blocked. There is no physical obstruction. Peristalsis is decreased or absent. Movement of intestinal contents is slowed. p. 1122 What are the key features of chronic gastritis? Select all that apply. What are the key features of chronic gastritis? Select all that apply. Heartburn Hematemesis Pernicious anemia Gastric hemorrhage Nausea and vomiting Intolerance to fatty food p.1105 A patient is admitted with chronic peptic ulcer disease (PUD). What sign or symptom is suggestive of a pyloric obstruction? A patient is admitted with chronic peptic ulcer disease (PUD). What sign or symptom is suggestive of a pyloric obstruction? Hyperkalemia Metabolic acidosis Nausea and vomiting Tender and board-like abdomen p. 1109 A patient with gastric cancer is scheduled to undergo surgery to remove the tumor once 5 pounds of body weight has been regained. The patient is not drinking the vanilla-flavored enteral supplements that have been prescribed. Which is the highest priority nursing intervention for this patient? A patient with gastric cancer is scheduled to undergo surgery to remove the tumor once 5 pounds of body weight has been regained. The patient is not drinking the vanilla-flavored enteral supplements that have been prescribed. Which is the highest priority nursing intervention for this patient? Ask the patient's family to try to persuade the patient to drink the supplements Ask the patient if a change in flavor would make the supplement more palatable Explain to the patient the importance of drinking the enteral supplements prescribed Inform the patient that a nasogastric tube may be necessary if he or she fails to comply p. 1117 A health care provider advises esophagogastroduodenoscopy (EGD) to a patient suspected of having gastric cancer. Why is this test advised for this patient? A health care provider advises esophagogastroduodenoscopy (EGD) to a patient suspected of having gastric cancer. Why is this test advised for this patient? To evaluate the nodal metastasis To provide a definitive diagnosis To determine the depth of the tumor To determine the extent of the tumor p. 1116 The patient presents to the emergency department with acute gastritis. The nurse suspects which organism is most likely the culprit? The patient presents to the emergency department with acute gastritis. The nurse suspects which organism is most likely the culprit? Streptococcus Escherichia coli Helicobacter pylori Staphylococcus aureus p. 1104 The nurse is planning care for a male patient who has undergone a hernia repair. The patient reports difficulty voiding. What does the nurse instruct the patient to do? The nurse is planning care for a male patient who has undergone a hernia repair. The patient reports difficulty voiding. What does the nurse instruct the patient to do? Allow water to run when attempting to void. Drink at least 500 to 1000 mL of fluids daily. Report a urine output of less than 60 mL/hour. Sit in a squatting position to stimulate voiding. p. 1139 What statement about type A gastritis is most accurate? What statement about type A gastritis is most accurate? It is associated with pernicious anemia. It is most often caused by pylori infection. It can occur due to exposure to benzene or lead. It has an autosomal recessive pattern of inheritance. p. 1104 The nurse is caring for a patient who has experienced two days of obstipation. What does the nurse understand about this patient? The nurse is caring for a patient who has experienced two days of obstipation. What does the nurse understand about this patient? The patient has not passed stool in two days. The patient has not been able to eat in two days. The patient has been vomiting for two days in a row. The patient has been having diarrhea for the past two days. p. 1123 A patient has been diagnosed with gastritis. What statement about this disorder is accurate? A patient has been diagnosed with gastritis. What statement about this disorder is accurate? Gastritis is a tumor of the gastric mucosa. Gastritis is caused by release of prostaglandin. Gastritis is the inflammation of gastric mucosa. Gastritis is a tumor that is associated with pylori infection. p. 1103 A patient is diagnosed with a malignant gastric tumor in the proximal portion of the stomach. Which surgical intervention does the nurse anticipate will be performed on this patient? A patient is diagnosed with a malignant gastric tumor in the proximal portion of the stomach. Which surgical intervention does the nurse anticipate will be performed on this patient? Total gastrectomy Gastroenterostomy Subtotal gastrectomy Pancreatoduodenectomy p. 1117 The nurse is caring for a patient recently diagnosed with gastric cancer who is symptomatic. What prognosis does the nurse anticipate for this patient? The nurse is caring for a patient recently diagnosed with gastric cancer who is symptomatic. What prognosis does the nurse anticipate for this patient? Fair prognosis Poor prognosis Good prognosis Excellent prognosis p. 1115 Which site has an increased risk of being affected by cancer in patients with Barrett's esophagus related to gastroesophageal reflux disease (GERD)? Which site has an increased risk of being affected by cancer in patients with Barrett's esophagus related to gastroesophageal reflux disease (GERD)? Body Cardia Fundus Pylorus p. 1115 The nurse is teaching a patient about self-management of gastritis. Which piece of education is appropriate? The nurse is teaching a patient about self-management of gastritis. Which piece of education is appropriate? "Drink decaffeinated coffee." "Eat tomato products and onions." "Use complementary and alternative therapies." "Take aspirin instead of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain." p. 1104 Which factors cause malabsorption syndrome? Select all that apply. Which factors cause malabsorption syndrome? Select all that apply. Chronic diarrhea Bile salt deficiencies Presence of bacteria Elevated enzyme values Increase in gastric surface area p. 1141 Which organ is usually affected in chronic atrophic gastritis? Which organ is usually affected in chronic atrophic gastritis? Glands of the antrum Deeply located glands Body of the stomach only Fundus of the stomach only p. 1104 Which are the most common types of abdominal hernias? Select all that apply. Which are the most common types of abdominal hernias? Select all that apply. Femoral hernia Umbilical hernia Reducible hernia Direct inguinal hernia Spermatic cord hernia Indirect inguinal hernia pp. 1137-1138 Which diagnostic test is useful for providing an accurate staging of gastric cancer? Which diagnostic test is useful for providing an accurate staging of gastric cancer? Computed tomography (CT) Endoscopic ultrasound (EUS) Magnetic resonance imaging (MRI) Positron emission tomography (PET) p. 1116 Which disorder in older adults may have a direct association with mucosa-associated lymphoid tissue (MALT) lymphoma? Which disorder in older adults may have a direct association with mucosa-associated lymphoid tissue (MALT) lymphoma? Uremia Crohn's disease Atrophic gastritis Graft versus host disease p. 1104 The nurse has placed a nasogastric (NG) tube in a patient with upper gastrointestinal bleeding to administer gastric lavage. The patient asks the nurse about the purpose of the NG tube for the procedure. What is the nurse's best response? The nurse has placed a nasogastric (NG) tube in a patient with upper gastrointestinal bleeding to administer gastric lavage. The patient asks the nurse about the purpose of the NG tube for the procedure. What is the nurse's best response? "Saline goes down the tube to help clean out your stomach." "Medication goes down the tube to help clean out your stomach." "We'll start feeding you through it once your stomach is cleaned out." "The provider requested the tube to be placed just in case it was needed." STUDY TIP: Avoid planning other activities that will add stress to your life between now and the time you take the licensure examination. Enough will happen spontaneously; do not plan to add to it. p. 1113 A patient with peptic ulcer disease (PUD) asks the nurse whether licorice and slippery elm might be useful in managing the disease. What is the nurse's best response? A patient with peptic ulcer disease (PUD) asks the nurse whether licorice and slippery elm might be useful in managing the disease. What is the nurse's best response? "No, they probably won't be useful. You should use only prescription medications in your treatment plan." "These herbs could be helpful. However, you should talk with your provider before adding them to your treatment regimen." "Yes, these are known to be effective in managing this disease, but make sure you research the herbs thoroughly before taking them." "No, herbs are not useful for managing this disease. You can use any type of over-the-counter drugs though. They have been shown to be safe." p. 1113 The nurse is caring for a patient with a nasogastric tube (NGT) who has undergone open-approach surgery for gastric cancer. What manifestation indicates acute gastric dilation because of a clogged NGT? The nurse is caring for a patient with a nasogastric tube (NGT) who has undergone open-approach surgery for gastric cancer. What manifestation indicates acute gastric dilation because of a clogged NGT? Hiccups Bradycardia Hypertension Hypogastric pain p. 1117 What pathophysiologic finding is typically seen in chronic atrophic gastritis? What pathophysiologic finding is typically seen in chronic atrophic gastritis? Prominent rugae Intestinal metaplasia Excessive inflammation Thickened gastric mucosa p. 1115 What information about intestinal polyps is most accurate? What information about intestinal polyps is most accurate? Intestinal polyps are frequently malignant. Malignant polyps are attached to the intestinal wall by a thin stem. Villous adenomas pose a greater cancer risk than tubular adenomas. Cancer occurs in familial adenomatous polyposis (FAP) by the third decade of life. p. 1126 Which statement will the nurse include in the teaching plan about postoperative care for a patient who underwent a hernia repair? Which statement will the nurse include in the teaching plan about postoperative care for a patient who underwent a hernia repair? "You should have a shower daily." "You should eat foods low in fiber." "You should apply ice packs to the surgical area." "You should not sit for long hours after the surgery." p. 1139 The nurse is caring for a patient with peptic ulcer disease (PUD). What signs and symptoms in the patient suggest a surgical emergency? Select all that apply. The nurse is caring for a patient with peptic ulcer disease (PUD). What signs and symptoms in the patient suggest a surgical emergency? Select all that apply. Black, tarry stool Assuming the knee-chest position Tender, rigid, board-like abdomen Sudden, sharp pain in the mid-epigastrium Vomiting of bright red or coffee-ground blood pp. 1108-1109 What are the key features of chronic gastritis? Select all that apply. What are the key features of chronic gastritis? Select all that apply. Heartburn Hematemesis Pernicious anemia Gastric hemorrhage Nausea and vomiting Intolerance to fatty food p.1105 Which layer of the gastric wall is first affected by adenocarcinoma? Which layer of the gastric wall is first affected by adenocarcinoma? Serosa Submucosa Gastric mucosa Muscularisexterna p. 1115 • Correct (1) Which drug does the primary health care provider prescribe to a patient with irritable bowel syndrome complaining of abdominal pain and constipation? Which drug does the primary health care provider prescribe to a patient with irritable bowel syndrome complaining of abdominal pain and constipation? Alosetron Loperamide Fesoterodine Lubiprostone Rationale The patient complains of abdominal pain and constipation, which indicates constipation-predominant irritable bowel syndrome (IBS-C). Lubiprostone increases fluid in the intestines and promotes bowel elimination. Alosetron is a selective serotonin receptor antagonist and is used to treat diarrhea-predominant irritable bowel syndrome (IBS-D). Loperamide is an antidiarrheal agent, which is used to treat IBS-D. Fesoterodine is a muscarinic-receptor antagonist and it inhibits intestinal motility. It is used to treat diarrhea.. Which statement is most accurate about colorectal cancer (CRC)? Which statement is most accurate about colorectal cancer (CRC)? Gross blood is common in CRC of the right side of the colon. Hematochezia is common in CRC involving the transverse colon. "Gas pains" and cramping are common in CRC of the rectosigmoid colon. A palpable mass in the lower right quadrant is common in CRC of the ascending colon The nurse case manager is discussing community resources with a patient who has colorectal cancer (CRC) and is scheduled for a colostomy. Which referral is of greatest value to this patient initially? The nurse case manager is discussing community resources with a patient who has colorectal cancer (CRC) and is scheduled for a colostomy. Which referral is of greatest value to this patient initially? Hospice Hospital chaplain Home health nursing agency Certified Wound, Ostomy, and Continence Nurse (CWOCN Which is a functioning stoma? Which is a functioning stoma? End stoma Loop stoma Distal stoma Proximal stoma A patient's stool sample showed microscopic amounts of blood content. After assessing the patient's history, the nurse concludes that the patient may have tumors in the colon. Which finding in the patient's history enabled the nurse to reach this conclusion? A patient's stool sample showed microscopic amounts of blood content. After assessing the patient's history, the nurse concludes that the patient may have tumors in the colon. Which finding in the patient's history enabled the nurse to reach this conclusion? Anemia Appendicitis Abdominal pain Endometrial cancer Aside from chemotherapeutic agents, what other medications does the nurse expect to administer to a patient with advanced colorectal cancer for relief of symptoms? Aside from chemotherapeutic agents, what other medications does the nurse expect to administer to a patient with advanced colorectal cancer for relief of symptoms? Steroids and analgesics Analgesics and antiemetics Analgesics and benzodiazepines Steroids and anti-inflammatory medications What is the mechanism of action for the chemotherapeutic drug cetuximab? What is the mechanism of action for the chemotherapeutic drug cetuximab? It blocks factors that promote cancer cell growth. It destroys the cancer's cell wall, which will kill the cell. It decreases blood flow to rapidly dividing cancer cells. It stimulates the body's immune system and stunts cancer growth. A patient with irritable bowel syndrome (IBS) has a stool culture positive for Pseudomonas aeruginosa. Which statement about this finding is correct? Probiotics may be ordered to help alleviate GI symptoms. Pathogens, such as P. aeruginosa, are known to cause IBS. The presence of pathogens indicates that diarrhea will be more likely. Antibiotics will be necessary to treat and ultimately cure the symptoms. A patient with irritable bowel syndrome (IBS) is constipated. The nurse instructs the patient about a management plan. Which patient statement shows an accurate understanding of the nurse's teaching? A patient with irritable bowel syndrome (IBS) is constipated. The nurse instructs the patient about a management plan. Which patient statement shows an accurate understanding of the nurse's teaching? "I need to go for a walk every evening." "A drink of diet soda with dinner is OK for me." "Maintaining a low-fiber diet will manage my constipation." "Watching the amount of fluid that I drink with meals is very important." The home health nurse is teaching a patient about the care of a new colostomy. Which patient statement demonstrates a correct understanding of the instructions? The home health nurse is teaching a patient about the care of a new colostomy. Which patient statement demonstrates a correct understanding of the instructions? "I need to check for leakage underneath my colostomy." "If the skin around the stoma is red or scratched, it will heal soon." "A dark or purplish-looking stoma is normal and should not concern me." "I should strive for a very tight fit when applying the barrier around the stoma The Certified Wound, Ostomy, and Continence Nurse (CWOCN) is teaching a patient with colorectal cancer how to care for a newly created colostomy. Which patient statement reflects a correct understanding of the necessary self-management skills? The Certified Wound, Ostomy, and Continence Nurse (CWOCN) is teaching a patient with colorectal cancer how to care for a newly created colostomy. Which patient statement reflects a correct understanding of the necessary self-management skills? "If I have any leakage, I'll put a towel over it." "I can get my spouse to change the bag for me." "I will make certain that I always have an extra bag available." "I need to call my home health nurse to come out if I have any problems." A patient with a family history of colorectal cancer (CRC) regularly sees a health care provider for early detection of any signs of cancer. Which laboratory result may be an indication of CRC in this patient? A patient with a family history of colorectal cancer (CRC) regularly sees a health care provider for early detection of any signs of cancer. Which laboratory result may be an indication of CRC in this patient? Elevated hemoglobin levels Negative test for occult blood Elevated carcinoembryonic antigen Decrease in liver function test result The nurse is caring for a patient who is to be discharged after a bowel resection and the creation of a colostomy. Which patient statement demonstrates that additional instruction from the nurse is needed? The nurse is caring for a patient who is to be discharged after a bowel resection and the creation of a colostomy. Which patient statement demonstrates that additional instruction from the nurse is needed? "I can drive my car in about 2 weeks." "I should avoid drinking carbonated sodas." "Stool softeners will help me avoid straining." "It may take 6 weeks to see the effects of some foods on my bowel patterns." A patient diagnosed with irritable bowel syndrome (IBS) is discharged home with a variety of medications for IBS symptoms. Upon returning to the clinic, the patient states, "Most of my symptoms have improved, except for the diarrhea." What does the nurse anticipate will be prescribed for this patient? A patient diagnosed with irritable bowel syndrome (IBS) is discharged home with a variety of medications for IBS symptoms. Upon returning to the clinic, the patient states, "Most of my symptoms have improved, except for the diarrhea." What does the nurse anticipate will be prescribed for this patient? Antidiarrheal agent Serotonin antagonist Tricyclic antidepressant Muscarinic receptor agonist What instructions should the nurse provide when educating a group of people about risk factors for preventing colorectal cancer? Select all that apply. What instructions should the nurse provide when educating a group of people about risk factors for preventing colorectal cancer? Select all that apply. Modify your dietary habits. Refrain from eating brassica vegetables. Undergo colorectal diagnostic testing regularly. Initiate screening at 60 years of age if there is a family history of the disease. Be informed about the hazards of smoking, excessive alcohol, and physical inactivity. A patient with colorectal cancer (CRC) was started on 5-fluorouracil (5-FU) and is experiencing fatigue, diarrhea, and mouth ulcers. A relatively new chemotherapeutic agent, oxaliplatin, has been added to the treatment regimen. What does the nurse tell the patient about the diarrhea and mouth ulcers? A patient with colorectal cancer (CRC) was started on 5-fluorouracil (5-FU) and is experiencing fatigue, diarrhea, and mouth ulcers. A relatively new chemotherapeutic agent, oxaliplatin, has been added to the treatment regimen. What does the nurse tell the patient about the diarrhea and mouth ulcers? "You have these as a result of the radiation treatment." "A combination of chemotherapeutic agents has caused them." "GI problems are symptoms of the advanced stage of your disease." "5-FU cannot discriminate between your cancer and your healthy cells." A patient underwent a colostomy formation and was discharged from the hospital. Which complications should the patient be aware of and immediately report to the primary health care provider? Select all that apply. A patient underwent a colostomy formation and was discharged from the hospital. Which complications should the patient be aware of and immediately report to the primary health care provider? Select all that apply. Leakage Unusual bleeding Edematous stoma Mucocutaneous separation Reddish pink and moist stoma A patient underwent a colostomy formation. What instructions should the nurse provide to the patient and family members about home care management? Select all that apply. A patient underwent a colostomy formation. What instructions should the nurse provide to the patient and family members about home care management? Select all that apply. Use aspirin tablets in the pouch. Measure the size of the stoma regularly. Use moisturizing soap for cleaning the area. Refrain from eating asparagus, broccoli, eggs, fish, and garlic. Include buttermilk, cranberry juice, parsley, and yogurt in the diet. A patient who reports unintentional weight loss, dark or bright-colored red stools, and a family history of colorectal cancer is admitted to the hospital. Which information should the nurse obtain from this patient? Select all that apply. A patient who reports unintentional weight loss, dark or bright-colored red stools, and a family history of colorectal cancer is admitted to the hospital. Which information should the nurse obtain from this patient? Select all that apply. Experiencing fatigue History of appendicitis History of gastroenteritis Use of tobacco or alcohol Experiencing abdominal fullne Which interventions should the nurse provide during the postoperative care of a patient who underwent a colostomy formation? Select all that apply. Which interventions should the nurse provide during the postoperative care of a patient who underwent a colostomy formation? Select all that apply. Place a colostomy pouch over the stoma. Establish and maintain an intravenous line. Advance the diet slowly from solids to liquids. Assess the color and integrity of the stoma frequently. Assess for a dry stoma during initial postoperative period. The primary health care provider prescribes alosetron to a patient with irritable bowel syndrome. What complications should the nurse instruct the patient to report immediately? Select all that apply. The primary health care provider prescribes alosetron to a patient with irritable bowel syndrome. What complications should the nurse instruct the patient to report immediately? Select all that apply. Rectal bleeding Darkened urine Bloody diarrhea Decrease in fatigue Decrease in abdominal pain Which statement is most accurate about colorectal cancer (CRC)? Which statement is most accurate about colorectal cancer (CRC)? Gross blood is common in CRC of the right side of the colon. Hematochezia is common in CRC involving the transverse colon. "Gas pains" and cramping are common in CRC of the rectosigmoid colon. A palpable mass in the lower right quadrant is common in CRC of the ascending colon. Aside from chemotherapeutic agents, what other medications does the nurse expect to administer to a patient with advanced colorectal cancer for relief of symptoms? Aside from chemotherapeutic agents, what other medications does the nurse expect to administer to a patient with advanced colorectal cancer for relief of symptoms? Steroids and analgesics Analgesics and antiemetics Analgesics and benzodiazepines Steroids and anti-inflammatory medications A patient underwent a colostomy formation. What instructions should the nurse provide to the patient and family members about home care management? Select all that apply. A patient underwent a colostomy formation. What instructions should the nurse provide to the patient and family members about home care management? Select all that apply. Use aspirin tablets in the pouch. Measure the size of the stoma regularly. Use moisturizing soap for cleaning the area. Refrain from eating asparagus, broccoli, eggs, fish, and garlic. Include buttermilk, cranberry juice, parsley, and yogurt in the diet. A patient who reports unintentional weight loss, dark or bright-colored red stools, and a family history of colorectal cancer is admitted to the hospital. Which information should the nurse obtain from this patient? Select all that apply. A patient who reports unintentional weight loss, dark or bright-colored red stools, and a family history of colorectal cancer is admitted to the hospital. Which information should the nurse obtain from this patient? Select all that apply. Experiencing fatigue History of appendicitis History of gastroenteritis Use of tobacco or alcohol Experiencing abdominal fullnes A patient is in the first postoperative day after a partial colectomy with colostomy. The nurse notes that the stoma is reddish-pink and moist with edema and a small amount of bleeding. Which nursing action is correct? A patient is in the first postoperative day after a partial colectomy with colostomy. The nurse notes that the stoma is reddish-pink and moist with edema and a small amount of bleeding. Which nursing action is correct? Report these findings to the surgeon immediately. Apply an absorbent pressure dressing to the stoma. Recognize these as normal, early postoperative findings. Turn the patient to the unaffected side to prevent bleedin What does the nurse advise a patient diagnosed with irritable bowel syndrome (IBS) to take during periods of constipation? What does the nurse advise a patient diagnosed with irritable bowel syndrome (IBS) to take during periods of constipation? Saline laxatives Stimulant laxatives Bulk-forming laxatives Stool-softening agent The nurse is caring for a patient who is 2 days postoperative for a colostomy placement. Which assessment finding does the nurse report to the health care provider? The nurse is caring for a patient who is 2 days postoperative for a colostomy placement. Which assessment finding does the nurse report to the health care provider? Dark red and firm stoma Slightly edematous stoma Reddish-pink and moist stoma Small amount of bleeding from the stoma A patient asks the nurse, "Can you tell me some foods to include in my diet so that I can reduce my chances of getting colorectal cancer?" Which dietary selection does the nurse suggest? A patient asks the nurse, "Can you tell me some foods to include in my diet so that I can reduce my chances of getting colorectal cancer?" Which dietary selection does the nurse suggest? Steak with pasta Spaghetti with tomato sauce Steamed broccoli with turkey Tuna salad with wheat crackers A patient suspected of having irritable bowel syndrome (IBS) is scheduled for a hydrogen breath test. What does the nurse tell the patient about this test? A patient suspected of having irritable bowel syndrome (IBS) is scheduled for a hydrogen breath test. What does the nurse tell the patient about this test? "The test will take between 30 and 45 minutes to complete." "If you have IBS, hydrogen levels will be increased in your breath samples." "You must have nothing to drink (except water) for 24 hours before the test." "During the test, you will drink small amounts of an antacid as directed by the technician A patient has a new colostomy after a partial colectomy for colon cancer in which the surgeon was able to completely remove the colorectal tumor. The patient is crying and keeps saying, "Nothing will ever be the same." Which action by the nurse is best? A patient has a new colostomy after a partial colectomy for colon cancer in which the surgeon was able to completely remove the colorectal tumor. The patient is crying and keeps saying, "Nothing will ever be the same." Which action by the nurse is best? Ask the patient to describe feelings about having a colostomy. Teach the patient how to care for and manage the colostomy. Provide information about colon cancer survivor support groups. Reassure the patient that the surgery was successful and that cure is likely. What should the nurse inquire about when taking the history of a patient suspected of irritable bowel syndrome? Select all that apply. What should the nurse inquire about when taking the history of a patient suspected of irritable bowel syndrome? Select all that apply. Any blood in the stools Drugs the patient is taking Family history of colon cancer Any gastrointestinal infections Weight change, fatigue, and malaise A patient with CRC had colostomy surgery performed yesterday. The patient is very anxious about caring for the colostomy and states that the health care provider's instructions "seem overwhelming." What does the nurse do first for this patient? A patient with CRC had colostomy surgery performed yesterday. The patient is very anxious about caring for the colostomy and states that the health care provider's instructions "seem overwhelming." What does the nurse do first for this patient? Instructs the patient about complete care of the colostomy Encourages the patient to look at and touch the colostomy stoma Schedules a visit from a patient who has a colostomy and is successfully caring for it Suggests that the patient involve family members in the care of the colostomy A patient with colorectal cancer (CRC) is scheduled for colostomy surgery. Which comment from the nurse is most therapeutic for this patient? A patient with colorectal cancer (CRC) is scheduled for colostomy surgery. Which comment from the nurse is most therapeutic for this patient? "Why are you so afraid of having this procedure done?" "Tell me what worries you the most about this procedure." "Don't worry. You will get used to the colostomy eventually." "Are you afraid of what your spouse will think of the colostomy?" A patient recently diagnosed with irritable bowel syndrome (IBS) asks the nurse what dietary changes will help with IBS. What does the nurse suggest? A patient recently diagnosed with irritable bowel syndrome (IBS) asks the nurse what dietary changes will help with IBS. What does the nurse suggest? Consuming 30-40 g of fiber per day Drinking 3-4 cups of fluids each day Increasing consumption of dairy products Consuming no more than one protein serving per da A patient with irritable bowel syndrome (IBS) has been prescribed a tricyclic antidepressant. What does the nurse teach this patient about taking this drug? A patient with irritable bowel syndrome (IBS) has been prescribed a tricyclic antidepressant. What does the nurse teach this patient about taking this drug? "Take the medication at nighttime to prevent daytime sleepiness." "If pain usually occurs after eating, take the drug 30-45 minutes before meals." "This medication will be useful for preventing diarrheal symptoms of IBS." "Use the medication as needed for depressive symptoms associated with IBS." A patient reports pain in the left lower quadrant of the abdomen. On assessment, the nurse finds hypersensitivity of internal organs and hypoactive bowel sounds. Which medication would be beneficial to the patient? A patient reports pain in the left lower quadrant of the abdomen. On assessment, the nurse finds hypersensitivity of internal organs and hypoactive bowel sounds. Which medication would be beneficial to the patient? Rifaximin Alosetron Loperamide Lubiprostone The nurse is teaching a patient about skin care around a colostomy. Which statement made by the patient indicates effective learning? The nurse is teaching a patient about skin care around a colostomy. Which statement made by the patient indicates effective learning? "I should clean the skin around the stoma using moisturizing soaps." "I should refrain from using antifungal cream to treat a fungal rash." "I should apply a skin sealant and allow it to dry before applying the pouch." "I should refrain from using both stoma powder and a paste if the skin becomes raw." After an abdominoperineal resection, a 75-year-old patient is referred to a home health agency. Which staff member does the nurse manager assign to perform the initial assessment on this patient? After an abdominoperineal resection, a 75-year-old patient is referred to a home health agency. Which staff member does the nurse manager assign to perform the initial assessment on this patient? LPN/LVN with 20 years of experience in the home health agency Social worker who is experienced with case management of older patients LPN/LVN who has worked with many home health patients after colostomy surgeries RN who is new to the agency with 5 years experience in the emergency department (ED) A male patient's sister was recently diagnosed with colorectal cancer (CRC), and his brother died of CRC 5 years ago. He asks the nurse whether he will inherit the disease too. How does the nurse respond? A male patient's sister was recently diagnosed with colorectal cancer (CRC), and his brother died of CRC 5 years ago. He asks the nurse whether he will inherit the disease too. How does the nurse respond? "Have you asked your health care provider what he or she thinks your chances are?" "It is hard to know what can predispose a person to develop a certain disease." "No. Just because they both had CRC doesn't mean that you will have it, too." "The only way to know whether you are predisposed to CRC is by genetic testing." The nurse is caring for a 56-year-old patient who has no familial adenomatous polyposis (FAP) or other risk factors related to colorectal cancer. When the nurse teaches the patient about cancer screenings, what does the nurse advise? The nurse is caring for a 56-year-old patient who has no familial adenomatous polyposis (FAP) or other risk factors related to colorectal cancer. When the nurse teaches the patient about cancer screenings, what does the nurse advise? "It is recommended you get a colonoscopy every 10 years." "You should get a fecal occult blood test performed every 2 years." "Your provider will want you to do a sigmoidoscopy annually." "You should screen for this cancer by doing a double-contrast barium enema every 10 years." The nurse is teaching a patient with irritable bowel syndrome about self-management. Which statement made by the patient indicates the need for further teaching? The nurse is teaching a patient with irritable bowel syndrome about self-management. Which statement made by the patient indicates the need for further teaching? "I should drink 2 to 3 cups of liquid every day." "I should eat regular meals and chew food slowly." "I should include 30 to 40 g of fiber in my diet every day." "I should perform exercises regularly and manage stress. • Which patient does the medical-surgical unit charge nurse assign to an LPN/LVN? Which patient does the medical-surgical unit charge nurse assign to an LPN/LVN? 41-year-old who needs assistance with choosing a site for a colostomy stoma 47-year-old who needs to receive "whole gut" lavage before a colon resection 56-year-old who has obstipation and a recent emesis of foul-smelling liquid 51-year-old who has recently arrived on the unit after having an open herniorrhaphy p. 1130 After assessing a patient who presents with abdominal pain, the nurse suspects colon cancer. Which statements by the patient may support the nurse's suspicion? Select all that apply. After assessing a patient who presents with abdominal pain, the nurse suspects colon cancer. Which statements by the patient may support the nurse's suspicion? Select all that apply. "I have cramping gas pains." "I have normal colored stools." "I have increased activity levels." "I have difficulty in passing stools." "I have incomplete bowel movements." p. 1128 The nurse is caring for a patient who is 2 days postoperative for a colostomy placement. Which assessment finding does the nurse report to the health care provider? The nurse is caring for a patient who is 2 days postoperative for a colostomy placement. Which assessment finding does the nurse report to the health care provider? Dark red and firm stoma Slightly edematous stoma Reddish-pink and moist stoma Small amount of bleeding from the stoma p. 1132 A patient asks the nurse, "Can you tell me some foods to include in my diet so that I can reduce my chances of getting colorectal cancer?" Which dietary selection does the nurse suggest? A patient asks the nurse, "Can you tell me some foods to include in my diet so that I can reduce my chances of getting colorectal cancer?" Which dietary selection does the nurse suggest? Steak with pasta Spaghetti with tomato sauce Steamed broccoli with turkey Tuna salad with wheat crackers p. 1128 A patient suspected of having irritable bowel syndrome (IBS) is scheduled for a hydrogen breath test. What does the nurse tell the patient about this test? A patient suspected of having irritable bowel syndrome (IBS) is scheduled for a hydrogen breath test. What does the nurse tell the patient about this test? "The test will take between 30 and 45 minutes to complete." "If you have IBS, hydrogen levels will be increased in your breath samples." "You must have nothing to drink (except water) for 24 hours before the test." "During the test, you will drink small amounts of an antacid as directed by the technician." p. 1136 A patient has a new colostomy after a partial colectomy for colon cancer in which the surgeon was able to completely remove the colorectal tumor. The patient is crying and keeps saying, "Nothing will ever be the same." Which action by the nurse is best? A patient has a new colostomy after a partial colectomy for colon cancer in which the surgeon was able to completely remove the colorectal tumor. The patient is crying and keeps saying, "Nothing will ever be the same." Which action by the nurse is best? Ask the patient to describe feelings about having a colostomy. Teach the patient how to care for and manage the colostomy. Provide information about colon cancer survivor support groups. Reassure the patient that the surgery was successful and that cure is likely. p. 1134 What should the nurse inquire about when taking the history of a patient suspected of irritable bowel syndrome? Select all that apply. What should the nurse inquire about when taking the history of a patient suspected of irritable bowel syndrome? Select all that apply. Any blood in the stools Drugs the patient is taking Family history of colon cancer Any gastrointestinal infections Weight change, fatigue, and malaise p. 1136 A patient with colorectal cancer (CRC) is scheduled for colostomy surgery. Which comment from the nurse is most therapeutic for this patient? A patient with colorectal cancer (CRC) is scheduled for colostomy surgery. Which comment from the nurse is most therapeutic for this patient? "Why are you so afraid of having this procedure done?" "Tell me what worries you the most about this procedure." "Don't worry. You will get used to the colostomy eventually." "Are you afraid of what your spouse will think of the colostomy?" p. 1133 A patient recently diagnosed with irritable bowel syndrome (IBS) asks the nurse what dietary changes will help with IBS. What does the nurse suggest? A patient recently diagnosed with irritable bowel syndrome (IBS) asks the nurse what dietary changes will help with IBS. What does the nurse suggest? Consuming 30-40 g of fiber per day Drinking 3-4 cups of fluids each day Increasing consumption of dairy products Consuming no more than one protein serving per day p. 1136 A patient with irritable bowel syndrome (IBS) has been prescribed a tricyclic antidepressant. What does the nurse teach this patient about taking this drug? A patient with irritable bowel syndrome (IBS) has been prescribed a tricyclic antidepressant. What does the nurse teach this patient about taking this drug? "Take the medication at nighttime to prevent daytime sleepiness." "If pain usually occurs after eating, take the drug 30-45 minutes before meals." "This medication will be useful for preventing diarrheal symptoms of IBS." "Use the medication as needed for depressive symptoms associated with IBS." p. 1137 The nurse is teaching a patient about skin care around a colostomy. Which statement made by the patient indicates effective learning? The nurse is teaching a patient about skin care around a colostomy. Which statement made by the patient indicates effective learning? "I should clean the skin around the stoma using moisturizing soaps." "I should refrain from using antifungal cream to treat a fungal rash." "I should apply a skin sealant and allow it to dry before applying the pouch." "I should refrain from using both stoma powder and a paste if the skin becomes raw." A male patient's sister was recently diagnosed with colorectal cancer (CRC), and his brother died of CRC 5 years ago. He asks the nurse whether he will inherit the disease too. How does the nurse respond? A male patient's sister was recently diagnosed with colorectal cancer (CRC), and his brother died of CRC 5 years ago. He asks the nurse whether he will inherit the disease too. How does the nurse respond? "Have you asked your health care provider what he or she thinks your chances are?" "It is hard to know what can predispose a person to develop a certain disease." "No. Just because they both had CRC doesn't mean that you will have it, too." "The only way to know whether you are predisposed to CRC is by genetic testing." The nurse is caring for a 56-year-old patient who has no familial adenomatous polyposis (FAP) or other risk factors related to colorectal cancer. When the nurse teaches the patient about cancer screenings, what does the nurse advise? The nurse is caring for a 56-year-old patient who has no familial adenomatous polyposis (FAP) or other risk factors related to colorectal cancer. When the nurse teaches the patient about cancer screenings, what does the nurse advise? "It is recommended you get a colonoscopy every 10 years." "You should get a fecal occult blood test performed every 2 years." "Your provider will want you to do a sigmoidoscopy annually." "You should screen for this cancer by doing a double-contrast barium enema every 10 years." p. 1128 The nurse is teaching a patient with irritable bowel syndrome about self-management. Which statement made by the patient indicates the need for further teaching? The nurse is teaching a patient with irritable bowel syndrome about self-management. Which statement made by the patient indicates the need for further teaching? "I should drink 2 to 3 cups of liquid every day." "I should eat regular meals and chew food slowly." "I should include 30 to 40 g of fiber in my diet every day." "I should perform exercises regularly and manage stress." p. 1136 Which patient does the medical-surgical unit charge nurse assign to an LPN/LVN? Which patient does the medical-surgical unit charge nurse assign to an LPN/LVN? 41-year-old who needs assistance with choosing a site for a colostomy stoma 47-year-old who needs to receive "whole gut" lavage before a colon resection 56-year-old who has obstipation and a recent emesis of foul-smelling liquid 51-year-old who has recently arrived on the unit after having an open herniorrhaphy p. 1130 After assessing a patient who presents with abdominal pain, the nurse suspects colon cancer. Which statements by the patient may support the nurse's suspicion? Select all that apply. After assessing a patient who presents with abdominal pain, the nurse suspects colon cancer. Which statements by the patient may support the nurse's suspicion? Select all that apply. "I have cramping gas pains." "I have normal colored stools." "I have increased activity levels." "I have difficulty in passing stools." "I have incomplete bowel movements." p. 1128 The nurse is caring for a patient who is 2 days postoperative for a colostomy placement. Which assessment finding does the nurse report to the health care provider? The nurse is caring for a patient who is 2 days postoperative for a colostomy placement. Which assessment finding does the nurse report to the health care provider? Dark red and firm stoma Slightly edematous stoma Reddish-pink and moist stoma Small amount of bleeding from the stoma p. 1132 A patient asks the nurse, "Can you tell me some foods to include in my diet so that I can reduce my chances of getting colorectal cancer?" Which dietary selection does the nurse suggest? A patient asks the nurse, "Can you tell me some foods to include in my diet so that I can reduce my chances of getting colorectal cancer?" Which dietary selection does the nurse suggest? Steak with pasta Spaghetti with tomato sauce Steamed broccoli with turkey Tuna salad with wheat crackers p. 1128 A patient has a new colostomy after a partial colectomy for colon cancer in which the surgeon was able to completely remove the colorectal tumor. The patient is crying and keeps saying, "Nothing will ever be the same." Which action by the nurse is best? A patient has a new colostomy after a partial colectomy for colon cancer in which the surgeon was able to completely remove the colorectal tumor. The patient is crying and keeps saying, "Nothing will ever be the same." Which action by the nurse is best? Ask the patient to describe feelings about having a colostomy. Teach the patient how to care for and manage the colostomy. Provide information about colon cancer survivor support groups. Reassure the patient that the surgery was successful and that cure is likely. p. 1134 What should the nurse inquire about when taking the history of a patient suspected of irritable bowel syndrome? Select all that apply. What should the nurse inquire about when taking the history of a patient suspected of irritable bowel syndrome? Select all that apply. Any blood in the stools Drugs the patient is taking Family history of colon cancer Any gastrointestinal infections Weight change, fatigue, and malaise p. 1136 A patient with colorectal cancer (CRC) is scheduled for colostomy surgery. Which comment from the nurse is most therapeutic for this patient? A patient with colorectal cancer (CRC) is scheduled for colostomy surgery. Which comment from the nurse is most therapeutic for this patient? "Why are you so afraid of having this procedure done?" "Tell me what worries you the most about this procedure." "Don't worry. You will get used to the colostomy eventually." "Are you afraid of what your spouse will think of the colostomy?" p. 1133 A patient with irritable bowel syndrome (IBS) has been prescribed a tricyclic antidepressant. What does the nurse teach this patient about taking this drug? A patient with irritable bowel syndrome (IBS) has been prescribed a tricyclic antidepressant. What does the nurse teach this patient about taking this drug? "Take the medication at nighttime to prevent daytime sleepiness." "If pain usually occurs after eating, take the drug 30-45 minutes before meals." "This medication will be useful for preventing diarrheal symptoms of IBS." "Use the medication as needed for depressive symptoms associated with IBS." p. 1137 A male patient's sister was recently diagnosed with colorectal cancer (CRC), and his brother died of CRC 5 years ago. He asks the nurse whether he will inherit the disease too. How does the nurse respond? A male patient's sister was recently diagnosed with colorectal cancer (CRC), and his brother died of CRC 5 years ago. He asks the nurse whether he will inherit the disease too. How does the nurse respond? "Have you asked your health care provider what he or she thinks your chances are?" "It is hard to know what can predispose a person to develop a certain disease." "No. Just because they both had CRC doesn't mean that you will have it, too." "The only way to know whether you are predisposed to CRC is by genetic testing." p. 1127 The nurse is caring for a 56-year-old patient who has no familial adenomatous polyposis (FAP) or other risk factors related to colorectal cancer. When the nurse teaches the patient about cancer screenings, what does the nurse advise? The nurse is caring for a 56-year-old patient who has no familial adenomatous polyposis (FAP) or other risk factors related to colorectal cancer. When the nurse teaches the patient about cancer screenings, what does the nurse advise? "It is recommended you get a colonoscopy every 10 years." "You should get a fecal occult blood test performed every 2 years." "Your provider will want you to do a sigmoidoscopy annually." "You should screen for this cancer by doing a double-contrast barium enema every 10 years." p. 1128 The nurse is teaching a patient with irritable bowel syndrome about self-management. Which statement made by the patient indicates the need for further teaching? The nurse is teaching a patient with irritable bowel syndrome about self-management. Which statement made by the patient indicates the need for further teaching? "I should drink 2 to 3 cups of liquid every day." "I should eat regular meals and chew food slowly." "I should include 30 to 40 g of fiber in my diet every day." "I should perform exercises regularly and manage stress." p. 1136 • Correct (5) A patient with CRC had colostomy surgery performed yesterday. The patient is very anxious about caring for the colostomy and states that the health care provider's instructions "seem overwhelming." What does the nurse do first for this patient? A patient with CRC had colostomy surgery performed yesterday. The patient is very anxious about caring for the colostomy and states that the health care provider's instructions "seem overwhelming." What does the nurse do first for this patient? Instructs the patient about complete care of the colostomy Encourages the patient to look at and touch the colostomy stoma Schedules a visit from a patient who has a colostomy and is successfully caring for it Suggests that the patient involve family members in the care of the colostomy p. 1133 After an abdominoperineal resection, a 75-year-old patient is referred to a home health agency. Which staff member does the nurse manager assign to perform the initial assessment on this patient? After an abdominoperineal resection, a 75-year-old patient is referred to a home health agency. Which staff member does the nurse manager assign to perform the initial assessment on this patient? LPN/LVN with 20 years of experience in the home health agency Social worker who is experienced with case management of older patients LPN/LVN who has worked with many home health patients after colostomy surgeries RN who is new to the agency with 5 years experience in the emergency department (ED) Test-Taking Tip: Relax during the last hour before an exam. Your brain needs some recovery time to function effectively. p. 1130 A patient suspected of having irritable bowel syndrome (IBS) is scheduled for a hydrogen breath test. What does the nurse tell the patient about this test? A patient suspected of having irritable bowel syndrome (IBS) is scheduled for a hydrogen breath test. What does the nurse tell the patient about this test? "The test will take between 30 and 45 minutes to complete." "If you have IBS, hydrogen levels will be increased in your breath samples." "You must have nothing to drink (except water) for 24 hours before the test." "During the test, you will drink small amounts of an antacid as directed by the technician." Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the stem of the item that are the same or similar in nature to those in one or two of the options. Example: If the item relates to and identifies stroke rehabilitation as its focus and only one of the options contains the word stroke in relation to rehabilitation, you are safe in identifying this choice as the correct response. p. 1136 A patient recently diagnosed with irritable bowel syndrome (IBS) asks the nurse what dietary changes will help with IBS. What does the nurse suggest? A patient recently diagnosed with irritable bowel syndrome (IBS) asks the nurse what dietary changes will help with IBS. What does the nurse suggest? Consuming 30-40 g of fiber per day Drinking 3-4 cups of fluids each day Increasing consumption of dairy products Consuming no more than one protein serving per day p. 1136 The nurse is teaching a patient about skin care around a colostomy. Which statement made by the patient indicates effective learning? The nurse is teaching a patient about skin care around a colostomy. Which statement made by the patient indicates effective learning? "I should clean the skin around the stoma using moisturizing soaps." "I should refrain from using antifungal cream to treat a fungal rash." "I should apply a skin sealant and allow it to dry before applying the pouch." "I should refrain from using both stoma powder and a paste if the skin becomes raw." The nurse sees a note in a patient's medical record that the patient has IBS-M. What does this mean? The nurse sees a note in a patient's medical record that the patient has IBS-M. What does this mean? The patient has IBS with mostly diarrhea. The patient has IBS with mainly constipation. The patient has IBS with a mix of diarrhea and constipation. The patient has IBS with motility changes of alternating diarrhea and constipation Which laboratory test may be used to identify bacterial overgrowth and malabsorption of nutrients in the small intestine? Which laboratory test may be used to identify bacterial overgrowth and malabsorption of nutrients in the small intestine? Occult blood test Serum albumin test Hydrogen breath test Complete blood count tes What is a behavioral illness that is known to relate to irritable bowel syndrome (IBS)? What is a behavioral illness that is known to relate to irritable bowel syndrome (IBS)? Anxiety Schizophrenia Bipolar disorder Attention deficit-hyperactivity disorder (ADHD) What is the most accurate statement about the incidence of intestinal regions affected by colorectal cancer (CRC)? What is the most accurate statement about the incidence of intestinal regions affected by colorectal cancer (CRC)? Incidence in the sigmoid colon is 25%. Incidence in the rectal portion of the colon is around 22%. Incidence in the descending colon is higher than in any other part of the colon. Incidence in the transverse colon is more than in the ascending colon and cecum. Which complication occurs due to increasing growth of the colorectal tumor in a patient? Which complication occurs due to increasing growth of the colorectal tumor in a patient? Fistula formation in the colon Abscesses formation in the mouth Tumor spreading to two layers of the bowel wall Bowel obstruction or perforation with resultant peritoniti A patient with colorectal cancer (CRC) was started on 5-fluorouracil (5-FU) and is experiencing fatigue, diarrhea, and mouth ulcers. A relatively new chemotherapeutic agent, oxaliplatin, has been added to the treatment regimen. What does the nurse tell the patient about the diarrhea and mouth ulcers? A patient with colorectal cancer (CRC) was started on 5-fluorouracil (5-FU) and is experiencing fatigue, diarrhea, and mouth ulcers. A relatively new chemotherapeutic agent, oxaliplatin, has been added to the treatment regimen. What does the nurse tell the patient about the diarrhea and mouth ulcers? "You have these as a result of the radiation treatment." "A combination of chemotherapeutic agents has caused them." "GI problems are symptoms of the advanced stage of your disease." "5-FU cannot discriminate between your cancer and your healthy cells." In home colostomy care, what is the purpose of stoma paste? In home colostomy care, what is the purpose of stoma paste? To enhance adherence of the appliance To facilitate less painful removal of the adhesive To prevent fungal infection around the stoma site To prevent the adjacent skin from becoming raw A patient with a rectal tumor is scheduled for surgery. Which surgical procedure does the nurse anticipate the surgeon will perform? A patient with a rectal tumor is scheduled for surgery. Which surgical procedure does the nurse anticipate the surgeon will perform? Cecostomy Sigmoid colectomy Left descending colostomy Resection with anastomosi Which statement about irritable bowel syndrome (IBS) is most accurate? Which statement about irritable bowel syndrome (IBS) is most accurate? In Asia, women are twice as likely to have IBS than men. Pain is most common in the left upper quadrant of the abdomen. Patients with IBS have a decreased amount of hydrogen during exhalation. IBS is associated with both primary and secondary mental health disorders. The primary health care provider prescribes bevacizumab for a patient who underwent surgical resection for colorectal cancer. Which is an expected outcome of this medication? Block growth factors that promote cancer cell growth Interrupt the DNA production of cells and destroy them Control pain, hemorrhage, bowel obstruction, or metastasis to the lung Reduce blood flow to the growing tumor cells, thereby depriving the nutrients for growth [Show More]

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