Brunner and Suddarth's Textbook of
Medical-surgical Nursing- Chapter 41
Multiple Choice
Chapter 41: Management of Patients with Intestinal and Rectal Disorders
1. A nurse is working with a client who has chronic constipation. What should be included in client
teaching to promote normal bowel function?
A. Use glycerin suppositories on a regular basis.
B. Limit physical activity in order to promote bowel peristalsis.
C. Consume high-residue, high-fiber foods.
D. Resist the urge to defecate until the urge becomes intense. - correct answerC
Rationale: Goals for the client include restoring or maintaining a regular pattern of elimination by
responding to the urge to defecate, ensuring adequate intake of fluids and high-fiber foods, learning
about methods to avoid constipation, relieving anxiety about bowel elimination patterns, and avoiding
complications. Ongoing use of pharmacologic aids should not be promoted, due to the risk of
dependence. Increased mobility helps to maintain a regular pattern of elimination. The urge to defecate
should be heeded.
PTS: 1 REF: p. 1289 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
10. A 16-year-old presents at the emergency department reporting right lower quadrant pain and is
subsequently diagnosed with appendicitis. When planning this client's nursing care, the nurse should
prioritize what nursing diagnosis?
A. Imbalanced nutrition: Less than body requirements related to decreased oral intake
B. Risk for infection related to possible rupture of appendix
,C. Constipation related to decreased bowel motility and decreased fluid intake
D. Chronic pain related to appendicitis - correct answerB
Rationale: The client with a diagnosis of appendicitis has an acute risk of infection related to the
possibility of rupture. This immediate physiologic risk is a priority over nutrition and constipation,
though each of these concerns should be addressed by the nurse. The pain associated with appendicitis
is acute, not chronic.
PTS: 1 REF: p. 1299
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
11. A nurse is talking with a client who is scheduled to have a hemicolectomy with the creation of a
colostomy. The client admits to being anxious, and has many questions concerning the surgery, the care
of a stoma, and necessary lifestyle changes. What nursing action is most appropriate?
A. Reassure the client that the procedure is relatively low risk and that clients are usually successful in
adjusting to an ostomy.
B. Provide the client with educational materials that match the client's learning style.
C. Encourage the client to write down these concerns and questions to bring forward to the surgeon.
D. Maintain an open dialogue with the client and facilitate a referral to the wound-ostomy-continence
(WOC) nurse. - correct answerD
Rationale: A wound-ostomy-continence (WOC) nurse is a registered nurse who has received advanced
education in an accredited program to care for clients with stomas. The enterostomal nurse therapist
can assist with the selection of an appropriate stoma site, teach about stoma care, and provide
emotional support. The surgeon is less likely to address the client's psychosocial and learning needs.
Reassurance does not address the client's questions, and education may or may not alleviate anxiety.
PTS: 1 REF: p. 1321
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
, TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
12. The nurse is caring for a client who is undergoing diagnostic testing for suspected malabsorption.
When taking this client's health history and performing the physical assessment, the nurse should
recognize what finding as most consistent with this diagnosis?
A. Recurrent constipation coupled with weight loss
B. Foul-smelling diarrhea that contains fat
C. Fever accompanied by a rigid, tender abdomen
D. Bloody bowel movements accompanied by fecal incontinence - correct answerB
Rationale: The hallmarks of malabsorption syndrome from any cause are diarrhea or frequent, loose,
bulky, foul-smelling stools that have increased fat content and are often grayish (steatorrhea).
Constipation and bloody bowel movements are not suggestive of malabsorption syndromes. Fever and a
tender, rigid abdomen are associated with peritonitis.
PTS: 1 REF: p. 1291
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
13. A nurse caring for a client with a newly created ileostomy assesses the client and notes that the
client has not had ostomy output for the past 12 hours. The client also reports worsening nausea. What
is the nurse's priority action?
A. Facilitate a referral to the wound-ostomy-continence (WOC) nurse.
B. Report signs and symptoms of obstruction to the health care provider.
C. Encourage the client to mobilize in order to enhance motility.
Medical-surgical Nursing- Chapter 41
Multiple Choice
Chapter 41: Management of Patients with Intestinal and Rectal Disorders
1. A nurse is working with a client who has chronic constipation. What should be included in client
teaching to promote normal bowel function?
A. Use glycerin suppositories on a regular basis.
B. Limit physical activity in order to promote bowel peristalsis.
C. Consume high-residue, high-fiber foods.
D. Resist the urge to defecate until the urge becomes intense. - correct answerC
Rationale: Goals for the client include restoring or maintaining a regular pattern of elimination by
responding to the urge to defecate, ensuring adequate intake of fluids and high-fiber foods, learning
about methods to avoid constipation, relieving anxiety about bowel elimination patterns, and avoiding
complications. Ongoing use of pharmacologic aids should not be promoted, due to the risk of
dependence. Increased mobility helps to maintain a regular pattern of elimination. The urge to defecate
should be heeded.
PTS: 1 REF: p. 1289 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
10. A 16-year-old presents at the emergency department reporting right lower quadrant pain and is
subsequently diagnosed with appendicitis. When planning this client's nursing care, the nurse should
prioritize what nursing diagnosis?
A. Imbalanced nutrition: Less than body requirements related to decreased oral intake
B. Risk for infection related to possible rupture of appendix
,C. Constipation related to decreased bowel motility and decreased fluid intake
D. Chronic pain related to appendicitis - correct answerB
Rationale: The client with a diagnosis of appendicitis has an acute risk of infection related to the
possibility of rupture. This immediate physiologic risk is a priority over nutrition and constipation,
though each of these concerns should be addressed by the nurse. The pain associated with appendicitis
is acute, not chronic.
PTS: 1 REF: p. 1299
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
11. A nurse is talking with a client who is scheduled to have a hemicolectomy with the creation of a
colostomy. The client admits to being anxious, and has many questions concerning the surgery, the care
of a stoma, and necessary lifestyle changes. What nursing action is most appropriate?
A. Reassure the client that the procedure is relatively low risk and that clients are usually successful in
adjusting to an ostomy.
B. Provide the client with educational materials that match the client's learning style.
C. Encourage the client to write down these concerns and questions to bring forward to the surgeon.
D. Maintain an open dialogue with the client and facilitate a referral to the wound-ostomy-continence
(WOC) nurse. - correct answerD
Rationale: A wound-ostomy-continence (WOC) nurse is a registered nurse who has received advanced
education in an accredited program to care for clients with stomas. The enterostomal nurse therapist
can assist with the selection of an appropriate stoma site, teach about stoma care, and provide
emotional support. The surgeon is less likely to address the client's psychosocial and learning needs.
Reassurance does not address the client's questions, and education may or may not alleviate anxiety.
PTS: 1 REF: p. 1321
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
, TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
12. The nurse is caring for a client who is undergoing diagnostic testing for suspected malabsorption.
When taking this client's health history and performing the physical assessment, the nurse should
recognize what finding as most consistent with this diagnosis?
A. Recurrent constipation coupled with weight loss
B. Foul-smelling diarrhea that contains fat
C. Fever accompanied by a rigid, tender abdomen
D. Bloody bowel movements accompanied by fecal incontinence - correct answerB
Rationale: The hallmarks of malabsorption syndrome from any cause are diarrhea or frequent, loose,
bulky, foul-smelling stools that have increased fat content and are often grayish (steatorrhea).
Constipation and bloody bowel movements are not suggestive of malabsorption syndromes. Fever and a
tender, rigid abdomen are associated with peritonitis.
PTS: 1 REF: p. 1291
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 41: Management of Clients with Intestinal and Rectal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
Multiple Choice
13. A nurse caring for a client with a newly created ileostomy assesses the client and notes that the
client has not had ostomy output for the past 12 hours. The client also reports worsening nausea. What
is the nurse's priority action?
A. Facilitate a referral to the wound-ostomy-continence (WOC) nurse.
B. Report signs and symptoms of obstruction to the health care provider.
C. Encourage the client to mobilize in order to enhance motility.
