Chapter 30 Rectal pain, itching, and bleeding
1. A 50-year-old female patient calls the clinic to report a new onset of severe diarrhea. The
nurse anticipates that the patient will need to
a. collect a stool specimen. b. prepare for colonoscopy. c. schedule a barium enema.
d. have blood cultures drawn. ANS: A
Acute diarrhea is usually caused by an infectious process, and stool specimens are obtained for
culture and examined for parasites or white blood cells. There is no indication that the patient
needs a colonoscopy, blood cultures, or a barium enema.
2. which information obtained by the nurse interviewing a 30-year-old male patient
is most important to communicate to the health care provider?
a. The patient has a history of constipation.
b. The patient has noticed blood in the stools. c. The patient had an appendectomy at age 27. d.
The patient smokes a pack/day of cigarettes.
ANS: B
Blood in the stools is a possible clinical manifestation of colorectal cancer and requires further assessment
by the health care provider. The other patient information will also be communicated to the health care
provider, but does not indicate an urgent need for further testing or intervention.
3. A new 19-year-old male patient has familial adenomatous polyposis (FAP). Which action will
the nurse in the gastrointestinal clinic include in the plan of care?
a. Obtain blood samples for DNA analysis.
b. Schedule the patient for yearly colonoscopy.
c. Provide preoperative teaching about total colectomy.
d. Discuss lifestyle modifications to decrease cancer risk. ANS: B
Patients with FAP should have annual colonoscopy starting at age 16 and usually have total
colectomy by age 25 to avoid developing colorectal cancer. DNA analysis is used to make the
diagnosis, but is not needed now for this patient. Lifestyle modifications will not decrease cancer risk for
this patient.
4. A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy
abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to
a. administer IV metoclopramide (Reglan). b. discontinue the patients oral food intake.
c. administer cobalamin (vitamin B12) injections. d. teach the patient about total colectomy
surgery.
ANS: B
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1. A 50-year-old female patient calls the clinic to report a new onset of severe diarrhea. The
nurse anticipates that the patient will need to
a. collect a stool specimen. b. prepare for colonoscopy. c. schedule a barium enema.
d. have blood cultures drawn. ANS: A
Acute diarrhea is usually caused by an infectious process, and stool specimens are obtained for
culture and examined for parasites or white blood cells. There is no indication that the patient
needs a colonoscopy, blood cultures, or a barium enema.
2. which information obtained by the nurse interviewing a 30-year-old male patient
is most important to communicate to the health care provider?
a. The patient has a history of constipation.
b. The patient has noticed blood in the stools. c. The patient had an appendectomy at age 27. d.
The patient smokes a pack/day of cigarettes.
ANS: B
Blood in the stools is a possible clinical manifestation of colorectal cancer and requires further assessment
by the health care provider. The other patient information will also be communicated to the health care
provider, but does not indicate an urgent need for further testing or intervention.
3. A new 19-year-old male patient has familial adenomatous polyposis (FAP). Which action will
the nurse in the gastrointestinal clinic include in the plan of care?
a. Obtain blood samples for DNA analysis.
b. Schedule the patient for yearly colonoscopy.
c. Provide preoperative teaching about total colectomy.
d. Discuss lifestyle modifications to decrease cancer risk. ANS: B
Patients with FAP should have annual colonoscopy starting at age 16 and usually have total
colectomy by age 25 to avoid developing colorectal cancer. DNA analysis is used to make the
diagnosis, but is not needed now for this patient. Lifestyle modifications will not decrease cancer risk for
this patient.
4. A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy
abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to
a. administer IV metoclopramide (Reglan). b. discontinue the patients oral food intake.
c. administer cobalamin (vitamin B12) injections. d. teach the patient about total colectomy
surgery.
ANS: B
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