MDC 2 Final Exam NCLEX Practice Questions Lower GI D/Os and Malnutrition Questions And Answers.

The nurse is teaching a patient with a newly created colostomy about foods to limit or avoid because of flatulence or odors. Which foods are included? Select all that apply. a.Broccoli b.Buttermilk c.Mushrooms d.Onions e.Peas f.Yogurt a.Broccoli c.Mushrooms d.Onions e.Peas A patient who has colorectal cancer is scheduled for a colostomy. Which referral is initially of greatest value to this patient? a.Certified Wound, Ostomy, and Continence Nurse (CWOCN) b.Home health nursing agency c.Hospice d.Hospital chaplain a.Certified Wound, Ostomy, and Continence Nurse (CWOCN) A patient with an intestinal obstruction has pain that changes from a "colicky" intermittent type to constant discomfort. What does the nurse do first? a.Administers medication for pain b.Changes the nasogastric suction level from "intermittent" to "constant" c.Positions the patient in high-Fowler's position d.Prepares the patient for emergency surgery d.Prepares the patient for emergency surgery What does the nurse advice a patient diagnosed with irritable bowel syndrome (IBS) to take during periods of constipation? a.Bulk-forming laxatives b.Saline laxatives c.Stimulant laxatives d.Stool-softening agents a.Bulk-forming laxatives A 24-year-old male is scheduled for a minimally invasive inguinal hernia repair (MIIHR). Which patient statement indicates a need for further teaching about this procedure? a."I may have trouble urinating immediately after the surgery." b."I will need to stay in the hospital overnight." c."I will not eat after midnight the day of the surgery." d."My chances of having complications after this procedure are slim." b."I will need to stay in the hospital overnight." A male patient's sister was recently diagnosed with colorectal cancer (CRC), and his brother died of CRC 5 years ago. The patient asks the nurse whether he will inherit the disease too. How does the nurse respond? a."Have you asked your primary health care provider what he or she thinks your chances are?" b."It is hard to know what can predispose a person to develop a certain disease." c."No. Just because they both had CRC doesn't mean that you will have it, too." d."The only way to know whether you are predisposed to CRC is by genetic testing." d."The only way to know whether you are predisposed to CRC is by genetic testing." The Certified Wound, Ostomy, and Continence Nurse 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? a."I will have my spouse change the bag for me." b."If I have any leakage, I'll put a towel over it." c."I can put aspirin tablets in the pouch in order to reduce odor" d."I will apply a non-alcoholic skin sealant around the stoma and allow it to dry prior to applying the bag." d."I will apply a non-alcoholic skin sealant around the stoma and allow it to dry prior to applying the bag." A patient with a family history of colorectal cancer (CRC) regularly sees a primary health care provider for early detection of any signs of cancer. Which laboratory result may be an indication of CRC in this patient? a.Decrease in liver function test results b.Elevated carcinoembryonic antigen c.Elevated hemoglobin levels d.Negative test for occult blood b.Elevated carcinoembryonic antigen A patient is being evaluated in the emergency department (ED) for a possible small bowel obstruction. Which signs/symptoms does the nurse expect to assess? a.Cramping intermittently, metabolic acidosis, and minimal vomiting b.Intermittent lower abdominal cramping, obstipation, and metabolic alkalosis c.Metabolic acidosis, upper abdominal distention, and intermittent cramping d.Upper abdominal distention, metabolic alkalosis, and a great amount of vomiting d.Upper abdominal distention, metabolic alkalosis, and a great amount of vomiting 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."During the test, you will drink small amounts of an antacid as directed by the technician." b."If you have IBS, hydrogen levels may be increased in your breath samples and can be an indication that you have IBS." c."The test will take between 30 and 45 minutes to complete." d."You must have nothing to drink (except water) for 24 hours before the test." b."If you have IBS, hydrogen levels may be increased in your breath samples and can be an indication that you have IBS." A 67-year-old male patient, with no surgical history, reports pain in the inguinal area that occurs when he coughs. A bulge that can be pushed back into the abdomen is found in his inguinal area. What type of hernia does he have? a.Femoral b.Reducible c.Strangulated d.Incarcerated b.Reducible The RN on the medical-surgical unit receives a shift report about four patients. Which patient does the nurse assess first? a.A 34-year-old who has returned to the unit after a colon resection with a new colostomy stoma, which is pink and moist. b.A 36-year-old admitted after a motor vehicle collision (MVC) with areas of ecchymosis on the abdomen in a "lap-belt" pattern c.A 40-year-old with a reducible inguinal hernia asking questions about surgery. d.A 51-year-old with familial adenomatous polyposis (FAP) who is scheduled for a colonoscopy b.A 36-year-old admitted after a motor vehicle collision (MVC) with areas of ecchymosis on the abdomen in a "lap-belt" pattern A patient at risk for colorectal cancer asks the nurse, "Can you tell me some foods to include in my diet so that I can reduce my chances of getting this disease?" Which dietary selection does the nurse suggest? a.Steak with pasta b.Spaghetti with tomato sauce c.Steamed broccoli with turkey d.Tuna salad with wheat crackers c.Steamed broccoli with turkey Aside from chemotherapeutic agents, what other medications does the nurse expect to administer to a patient with advanced colorectal cancer for relief of symptoms? a.Analgesics and antiemetics b.Analgesics and benzodiazepines c.Steroids and analgesics d.Steroids and anti-inflammatory medications a.Analgesics and antiemetics A patient with a bowel obstruction is ordered a Salem sump nasogastric tube (NGT). After the nurse inserts the tube, which nursing intervention is the highest priority for this patient? a.Attaching the tube to low intermittent suction b.Auscultating for bowel sounds and peristalsis while the suction runs c.Connecting the tube to low continuous suction d.Flushing the tube with 30 mL of normal saline every 24 hours c.Connecting the tube to low continuous suction A male patient in a long-term care facility is 2 days postoperative after an open repair of an indirect inguinal hernia. Which nursing action does the RN delegate to unlicensed assistive personnel (UAP)? a.Assessing the patient's incision for signs of infection b.Assisting the patient to stand to void c.Instructing the patient in how to deep-breathe d.Monitoring the patient's pain level b.Assisting the patient to stand to void A 21-year-old with a stab wound to the abdomen has come to the emergency department (ED). Once stabilized, the patient is admitted to the medical-surgical unit. What does the admitting nurse do first for this patient? a.Administer pain medication. b.Assess skin temperature and color. c.Check on the amount of urine output. d.Take vital signs. d.Take vital signs. 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? a."A dark or purplish-looking stoma is normal and would not concern me." b."If the skin around the stoma is red or scratched, it will heal soon." c."I need to check for leakage underneath my colostomy." d."I need to strive for a very tight fit when applying the barrier around the stoma." c."I need to check for leakage underneath my colostomy." A patient with colorectal cancer had colostomy surgery performed yesterday. The patient is very anxious about caring for the colostomy and states that the primary health care provider's instructions "seem overwhelming." What does the nurse do first for this patient? a.Encourage the patient to look at and touch the colostomy stoma b.Instruct the patient about complete care of the colostomy c.Schedule a visit from a patient who has a colostomy and is successfully caring for it d.Suggest that the patient involve family members in the care of the colostomy a.Encourage the patient to look at and touch the colostomy stoma 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."A cup (236 mL) of caffeinated coffee with cream & sugar at dinner is OK for me." b."I need to go for a walk every evening." c."Maintaining a low-fiber diet will manage my constipation." d."Limiting the amount of fluid that I drink with meals is very important." b."I need to go for a walk every evening." 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? a."I can drive my car in about 2 weeks." b."I need to avoid drinking carbonated sodas." c."It may take 6 weeks to see the effects of some foods on my bowel patterns." d."Stool softeners will help me avoid straining." a."I can drive my car in about 2 weeks." A patient with malabsorption syndrome asks the nurse, "What did I do to cause this disorder to develop?" How does the nurse respond? a."An excessive intake of alcohol is associated with it, so your substance abuse could have contributed to its development." b."It is inherited, so it could run in your family." c."It might be caused by a virus, so you could have gotten it almost anywhere." d."There are a variety of things that can cause malabsorption syndrome to occur. You may have a deficiency is certain enzymes, a bacteria or changes in the lining of your intestines." d."There are a variety of things that can cause malabsorption syndrome to occur. You may have a deficiency is certain enzymes, a bacteria or changes in the lining of your intestines." The nurse is teaching a group of patients with irritable bowel syndrome (IBS) about complementary and alternative therapies. What does the nurse suggest as possible treatment modalities? Select all that apply. a.Acupuncture b.Decreasing physical activities c.Meditation d.Peppermint oil capsules e.Yoga a.Acupuncture c.Meditation d.Peppermint oil capsules e.Yoga The nurse is teaching a patient who has undergone a hemorrhoidectomy about a follow-up plan of care. Which patient statement demonstrates a correct understanding of the nurse's instructions? a."I would take Ex-Lax after the surgery to 'keep things moving'." b."I will need to eat a diet high in fiber." c."Limiting my fluids will help me with constipation." d."To help with the pain, I'll apply ice to the surgical area." b."I will need to eat a diet high in fiber." A patient with colorectal cancer is scheduled for colostomy surgery. Which comment from the nurse is most therapeutic for this patient? a."Are you afraid of what your spouse will think of the colostomy?" b."Don't worry. You will get used to the colostomy eventually." c."Tell me what worries you the most about this procedure." d."Why are you so afraid of having this procedure done?" c."Tell me what worries you the most about this procedure." A patient is diagnosed with irritable bowel syndrome (IBS). What factors does the nurse suspect as possibly contributing to the patient's condition? Select all that apply. a.Antihistamines b.Caffeinated drinks c.Stress d.Sleeping pills e.Combinations of genetic, immunological, and hormonal factors b.Caffeinated drinks c.Stress e.Combinations of genetic, immunological, and hormonal factors Which patient does the charge nurse assign to an experienced LPN/LVN? a.A 28-year-old who requires teaching about how to catheterize a Kock ileostomy b.A 30-year-old who must receive neomycin sulfate (Mycifradin) before a colectomy c.A 34-year-old with ulcerative colitis (UC) who has a white blood cell count of 23,000/mm3 (23 × 109/L) d.A 38-year-old with gastroenteritis who is receiving IV fluids at 250 mL/hr b.A 30-year-old who must receive neomycin sulfate (Mycifradin) before a colectomy A patient is scheduled for discharge after surgery for inflammatory bowel disease. The patient's spouse will be assisting home health services with the patient's care. What is most important for the home health nurse to assess in the patient and the spouse with regard to the patient's home care? a.Ability of the patient and spouse to perform incision care and dressing changes b.Effective coping mechanisms for the patient and spouse after the surgical experience c.Knowledge about the patient's requested pain medications d.Understanding of the importance of keeping scheduled follow-up appointments a.Ability of the patient and spouse to perform incision care and dressing changes A patient returns to the unit after having an exploratory abdominal laparotomy. How does the nurse position this patient after the patient is situated in bed? a.High Fowler's b.Lateral Sims' (side-lying) c.Semi-Fowler's d.Supine c.Semi-Fowler's A male patient with a long history of ulcerative colitis experienced massive bleeding and had emergency surgery for creation of an ileostomy. He is very concerned that sexual intercourse with his wife will be impossible because of his new ileostomy pouch. How does the nurse respond? a."A change in position may be what is needed for you to have intercourse with your wife." b."Have you considered going to see a marriage counselor with your wife?" c."What has your wife said about your pouch system?" d."You must get clearance from your primary health care provider before you attempt to have intercourse." a."A change in position may be what is needed for you to have intercourse with your wife." The RN receives a change-of-shift report about four patients. Which patient does the nurse assess first? a.A 20-year-old with ulcerative colitis (UC) who had six liquid stools during the previous shift b.A 25-year-old who has just been admitted with possible appendicitis and has a temperature of 102°F (37.9°C) c.A 56-year-old who had a colon resection earlier in the day and whose colostomy bag does not have any stool in it d.A 60-year-old admitted with acute gastroenteritis who is reporting severe cramping and nausea b.A 25-year-old who has just been admitted with possible appendicitis and has a temperature of 102°F (37.9°C) A patient diagnosed with ulcerative colitis (UC) is to be discharged on loperamide (Imodium) for symptomatic management of diarrhea. What does the nurse include in the teaching about this medication? a."Be aware of the signs/symptoms of toxic megacolon that we discussed." b."If diarrhea increases, you must let your primary health care provider know." c."You must avoid pregnancy." d."You will need to decrease your dose of sulfasalazine (Azulfidine)." a."Be aware of the signs/symptoms of toxic megacolon that we discussed." An obese patient is discharged 10 days after being hospitalized for peritonitis, which resulted in an exploratory laparotomy. Which assessment finding by the patient's home health nurse requires immediate action? a.Pain when coughing b.States, "I am too tired to walk very much" c.States, "I feel like the incision is splitting open" d.Temperature of 100.8°F (38.2°C). c.States, "I feel like the incision is splitting open" A patient is admitted with severe viral gastroenteritis caused by norovirus. The patient asks the nurse, "How did I get this disease?" Which answer by the nurse is correct? a."You may have contracted it from an infected infant." b."You may have consumed contaminated food or water." c."You may have come into contact with an infected animal." d."You may have had contact with the blood of an infected person." b."You may have consumed contaminated food or water." A patient with a history of osteoarthritis has a 10-inch (25.5 cm) incision following a colon resection. The incision has become infected, and the wound requires extensive irrigation and packing. What aspect of the patient's care does the nurse make certain to discuss with the primary health care provider before the patient's discharge? a.Having a home health consultation for wound care b.Requesting an antianxiety medication c.Requesting pain medication for the patient's osteoarthritis d.Placing the patient in a skilled nursing facility for rehabilitation a.Having a home health consultation for wound care A patient who had surgery for inflammatory bowel disease is being discharged. The case manager will arrange for home health care follow-up. The patient tells the nurse that family members will also be helping with care. What information is critically important for the nurse to provide to these collaborating members? a.A list of medical supply facilities where wound care supplies may be purchased b.Proper handwashing techniques to avoid cross-contamination of the patient's wound c.The amount of pain medication that the patient is allowed to take in each dose d.Written and oral instructions regarding signs/symptoms to report to the primary health care provider d.Written and oral instructions regarding signs/symptoms to report to the primary health care provider A nurse is teaching a patient with Crohn's disease about managing the disease with the drug adalimumab (Humira). Which instruction does the nurse emphasize to the patient? a."Avoid large crowds and anyone who is sick." b."Do not take the medication if you are allergic to foods with fatty acids." c."Expect difficulty with wound healing while you are taking this drug." d."Monitor your blood pressure and report any significant decrease in it." a."Avoid large crowds and anyone who is sick." A patient with an exacerbation of ulcerative colitis has been prescribed Vivonex PLUS. The patient asks the nurse how this is helpful for improving signs/symptoms. How does the nurse reply? a."It is absorbed quickly and allows the affected part of the GI tract to rest and heal." b."It provides key nutrients and extra calories to promote healing." c."It is bland and reduces the secretion of gastric acids." d."It does not contain caffeine or other GI tract stimulants." a."It is absorbed quickly and allows the affected part of the GI tract to rest and heal." A patient has been newly diagnosed with ulcerative colitis (UC). What does the nurse teach the patient about diet and lifestyle choices? a."Drinking carbonated beverages will help with your abdominal distress." b."It's OK to smoke cigarettes, but you should limit them to ½ pack per day." c."Lactose-containing foods should be reduced or eliminated from your diet." d."Raw vegetables and high-fiber foods may help to diminish your symptoms." c."Lactose-containing foods should be reduced or eliminated from your diet." A patient with ulcerative colitis (UC) has stage 1 of a restorative proctocolectomy with ileo-anal anastomosis (RPC-IPAA) procedure performed. The patient asks the nurse, "How long do people with this procedure usually have a temporary ileostomy?" How does the nurse respond? a."It is usually ready to be closed in about 1 to 2 months." b."You need to talk to your primary health care provider about how long you will have this temporary ileostomy." c."The period of time is indefinite—I am sorry that I cannot say." d."You will probably have it for 6 months or longer, until things heal." a."It is usually ready to be closed in about 1 to 2 months." A Certified Wound, Ostomy, and Continence Nurse (CWOCN) is teaching a patient about caring for a new ileostomy. What information is most important to include? a."After surgery, output from your ileostomy may be a loose, dark-green liquid with some blood present." b."Call your primary health care provider if your stoma has a bluish or pale look." c."Notify the primary health care provider if output from your stoma has a sweetish odor." d."Remember that you must wear a pouch system at all times." b."Call your primary health care provider if your stoma has a bluish or pale look."