Colonoscopy w/ Bowel Perforation (case study)
Questions with Correct Answers
The nurse interviews Mr. Jones regarding his elimination patterns.
1. What client information indicates to the nurse a need for additional
assessment?
A. Increased flatulence.
B. Bowel movement every other day.
C. Blood on paper when constipated.
D. Stool has narrowed in diameter. Correct Answer-D.
Stool that is narrower in diameter, particularly "ribbon-like" stool, can
be an indication of left-sided colon cancer.
The primary healthcare provider (HCP) prescribes a screening
colonoscopy.
The client asks the nurse, "Why do I need a colonoscopy? I feel fine."
2. How should the nurse respond?
A. "It's a recommended routine screening for colon cancer."
B. "To determine the existence of Crohn's disease."
C. "The physician ordered the procedure."
D. "To evaluate preexisting hemorrhoids." Correct Answer-A.
,The American Cancer Society recommends a colonoscopy every 10
years, starting at age 50, for everyone at average risk to screen for
colorectal cancer. Some individuals may require earlier or more frequent
screenings depending on their personal risk factors.
Colonoscopy Preparation
The nurse provides preparatory teaching for the prescribed colonoscopy.
It includes dietary restrictions, bowel preparation, and procedural
expectations.
3. Which foods should the nurse instruct the client to eat 24 hours prior
to the procedure?
A. Whole grain toast and yogurt.
B. Fresh apple and raw broccoli.
C. Jello and clear broth.
D. Roast beef and scrambled eggs. Correct Answer-C.
The client should consume clear liquids 24 hours before the procedure to
have a clear colon to aid visualization.
Two liters of polyethylene glycol (GoLYTELY) solution is prescribed
for the client to consume the day before the procedure.
4. When instructing the client about the use of polyethylene glycol
(GoLYTELY), what result should the nurse tell Mr. Jones to expect?
, A. Frequent, watery stool.
B. Black, tarry feces.
C. Gastric reflux.
D. Metallic taste in mouth. Correct Answer-A.
Polyethylene glycol (GoLYTELY) is a saline and osmotic laxative
solution that causes retention of fluid in the intestinal lumen from the
osmotic effect. Its purpose is to clean out all feces from the colon. By
the end of the preparation, most clients are expelling almost clear,
watery stool.
Mr. Jones shares with the nurse that his friend who had the procedure
complained of experiencing a lot of gas afterwards. He asks what he can
do to prevent this from happening to him.
5. How should the nurse respond?
A. Reassure him that everyone has gas and that no one thinks anything
of it.
B. Explain that this is a normal expectation following a colonoscopy.
C. Emphasize the importance of adequate bowel preparation to prevent
it.
D. Suggest that his friend must have experienced a minor complication.
Correct Answer-B.
The gas experienced by the client following a colonoscopy is largely due
to air that is pumped into the colon during the procedure. The gas should
be expelled normally to prevent painful distention.
Questions with Correct Answers
The nurse interviews Mr. Jones regarding his elimination patterns.
1. What client information indicates to the nurse a need for additional
assessment?
A. Increased flatulence.
B. Bowel movement every other day.
C. Blood on paper when constipated.
D. Stool has narrowed in diameter. Correct Answer-D.
Stool that is narrower in diameter, particularly "ribbon-like" stool, can
be an indication of left-sided colon cancer.
The primary healthcare provider (HCP) prescribes a screening
colonoscopy.
The client asks the nurse, "Why do I need a colonoscopy? I feel fine."
2. How should the nurse respond?
A. "It's a recommended routine screening for colon cancer."
B. "To determine the existence of Crohn's disease."
C. "The physician ordered the procedure."
D. "To evaluate preexisting hemorrhoids." Correct Answer-A.
,The American Cancer Society recommends a colonoscopy every 10
years, starting at age 50, for everyone at average risk to screen for
colorectal cancer. Some individuals may require earlier or more frequent
screenings depending on their personal risk factors.
Colonoscopy Preparation
The nurse provides preparatory teaching for the prescribed colonoscopy.
It includes dietary restrictions, bowel preparation, and procedural
expectations.
3. Which foods should the nurse instruct the client to eat 24 hours prior
to the procedure?
A. Whole grain toast and yogurt.
B. Fresh apple and raw broccoli.
C. Jello and clear broth.
D. Roast beef and scrambled eggs. Correct Answer-C.
The client should consume clear liquids 24 hours before the procedure to
have a clear colon to aid visualization.
Two liters of polyethylene glycol (GoLYTELY) solution is prescribed
for the client to consume the day before the procedure.
4. When instructing the client about the use of polyethylene glycol
(GoLYTELY), what result should the nurse tell Mr. Jones to expect?
, A. Frequent, watery stool.
B. Black, tarry feces.
C. Gastric reflux.
D. Metallic taste in mouth. Correct Answer-A.
Polyethylene glycol (GoLYTELY) is a saline and osmotic laxative
solution that causes retention of fluid in the intestinal lumen from the
osmotic effect. Its purpose is to clean out all feces from the colon. By
the end of the preparation, most clients are expelling almost clear,
watery stool.
Mr. Jones shares with the nurse that his friend who had the procedure
complained of experiencing a lot of gas afterwards. He asks what he can
do to prevent this from happening to him.
5. How should the nurse respond?
A. Reassure him that everyone has gas and that no one thinks anything
of it.
B. Explain that this is a normal expectation following a colonoscopy.
C. Emphasize the importance of adequate bowel preparation to prevent
it.
D. Suggest that his friend must have experienced a minor complication.
Correct Answer-B.
The gas experienced by the client following a colonoscopy is largely due
to air that is pumped into the colon during the procedure. The gas should
be expelled normally to prevent painful distention.
