Chapter 51: Concepts of Care for Patients
with Noninflammatory Intestinal Disorders
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A nurse teaches a client who is at risk for colorectal cancer. Which dietary
recommendation would the nurse teach the client?
a. “Eat low-fiber and low-residual foods.”
b. “White rice and bread are easier to digest.”
c. “Add vegetables such as broccoli and cauliflower to your diet.”
d. “Foods high in animal fat help to protect the intestinal mucosa.”
ANS: C
The client would be taught to modify his or her diet to decrease animal fat and refined
carbohydrates. The client should also increase high-fiber foods and Brassica
vegetables, including broccoli and cauliflower, which help to protect the intestinal
mucosa from colon cancer.
DIF: Applying TOP: Integrated Process: Teaching/Learning KEY:
Colorectal cancer, Risk factors MSC: Client Needs Category: Health
Promotion and Maintenance
2. A nurse cares for a client who has a new colostomy. Which action would the nurse
take?
a. Empty the pouch frequently to remove excess gas collection.
b. Change the ostomy pouch and barrier every morning.
c. Allow the pouch to completely fill with stool prior to emptying it.
, d. Use surgical tape to secure the pouch and prevent leakage.
ANS: A
The nurse would empty the new ostomy pouch frequently because of excess gas
collection, and empty the pouch when it is one-third to one-half full of stool. The
ostomy pouch does not need to be changed every morning. Ostomy barriers would be
used to secure and seal the ostomy appliance; surgical tape would not be used.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning and
Implementation KEY: Ostomy, Nursing care MSC: Client
Needs Category: Physiological Integrity: Basic Care and Comfort
3. A nurse cares for a client who has a family history of colorectal cancer. The client
states, “My father and my brother had colon cancer. What is the chance that I will get
cancer?” How would the nurse respond?
a. “If you eat a low-fat and low-fiber diet, your chances decrease significantly.”
b. “You are safe. This is an autosomal dominant disorder that skips generations.”
c. “Preemptive surgery and chemotherapy will remove cancer cells and prevent
cancer.”
d. “You should have a colonoscopy more frequently to identify abnormal polyps
early.”
ANS: D
The nurse would encourage the patient to have frequent colonoscopies to identify
abnormal polyps and cancerous cells early. The abnormal gene associated with colon
cancer is an autosomal dominant gene mutation that does not skip a generation and
places the client at high risk for cancer. Changing the client’s diet to more high-fiber
(not low-fiber) and preemptive chemotherapy may decrease the client’s risk of colon
cancer but will not prevent it.
, DIF: Applying TOP: Integrated Process: Teaching/Learning KEY:
Colorectal cancer, Risk factors MSC: Client Needs Category: Health
Promotion and Maintenance
4. A client is preparing to have a fecal occult blood test (FOBT). What health teaching
would the nurse include prior to the test?
a. “This test will determine whether you have colorectal cancer.”
b. “You need to avoid red meat and NSAIDs for 48 hours before the test.”
c. “You don’t need to have this test because you can have a virtual colonoscopy.”
d. “This test can determine your genetic risk for developing colorectal cancer.”
ANS: B
The FOBT is a screening test that is sometimes used to assess for microscopic lower
GI bleeding. To help prevent false positive results, the client needs to avoid red meat,
Vitamin C, and NSAIDs. The test is not diagnostic nor does it determine a client’s
genetic risk for colorectal cancer.
DIF: Understanding TOP: Integrated Process: Teaching/Learning
KEY: Colorectal cancer, Diagnostic tests MSC: Client
Needs Category: Physiological Integrity: Physiological Adaptation
5. The nurse is caring for a client who is planning to have a laparoscopic colon resection
for colorectal cancer tomorrow. Which statement by the client indicates a need for
further teaching?
a. “I should have less pain after this surgery compared to having a large
incision.”
b. “I will probably be in the hospital for 3 to 4 days after surgery.”
c. “I will be able to walk around a little on the same day as the surgery.”
d. “I will be able to return to work in a week or two depending on how I do.”
ANS: B
with Noninflammatory Intestinal Disorders
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A nurse teaches a client who is at risk for colorectal cancer. Which dietary
recommendation would the nurse teach the client?
a. “Eat low-fiber and low-residual foods.”
b. “White rice and bread are easier to digest.”
c. “Add vegetables such as broccoli and cauliflower to your diet.”
d. “Foods high in animal fat help to protect the intestinal mucosa.”
ANS: C
The client would be taught to modify his or her diet to decrease animal fat and refined
carbohydrates. The client should also increase high-fiber foods and Brassica
vegetables, including broccoli and cauliflower, which help to protect the intestinal
mucosa from colon cancer.
DIF: Applying TOP: Integrated Process: Teaching/Learning KEY:
Colorectal cancer, Risk factors MSC: Client Needs Category: Health
Promotion and Maintenance
2. A nurse cares for a client who has a new colostomy. Which action would the nurse
take?
a. Empty the pouch frequently to remove excess gas collection.
b. Change the ostomy pouch and barrier every morning.
c. Allow the pouch to completely fill with stool prior to emptying it.
, d. Use surgical tape to secure the pouch and prevent leakage.
ANS: A
The nurse would empty the new ostomy pouch frequently because of excess gas
collection, and empty the pouch when it is one-third to one-half full of stool. The
ostomy pouch does not need to be changed every morning. Ostomy barriers would be
used to secure and seal the ostomy appliance; surgical tape would not be used.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning and
Implementation KEY: Ostomy, Nursing care MSC: Client
Needs Category: Physiological Integrity: Basic Care and Comfort
3. A nurse cares for a client who has a family history of colorectal cancer. The client
states, “My father and my brother had colon cancer. What is the chance that I will get
cancer?” How would the nurse respond?
a. “If you eat a low-fat and low-fiber diet, your chances decrease significantly.”
b. “You are safe. This is an autosomal dominant disorder that skips generations.”
c. “Preemptive surgery and chemotherapy will remove cancer cells and prevent
cancer.”
d. “You should have a colonoscopy more frequently to identify abnormal polyps
early.”
ANS: D
The nurse would encourage the patient to have frequent colonoscopies to identify
abnormal polyps and cancerous cells early. The abnormal gene associated with colon
cancer is an autosomal dominant gene mutation that does not skip a generation and
places the client at high risk for cancer. Changing the client’s diet to more high-fiber
(not low-fiber) and preemptive chemotherapy may decrease the client’s risk of colon
cancer but will not prevent it.
, DIF: Applying TOP: Integrated Process: Teaching/Learning KEY:
Colorectal cancer, Risk factors MSC: Client Needs Category: Health
Promotion and Maintenance
4. A client is preparing to have a fecal occult blood test (FOBT). What health teaching
would the nurse include prior to the test?
a. “This test will determine whether you have colorectal cancer.”
b. “You need to avoid red meat and NSAIDs for 48 hours before the test.”
c. “You don’t need to have this test because you can have a virtual colonoscopy.”
d. “This test can determine your genetic risk for developing colorectal cancer.”
ANS: B
The FOBT is a screening test that is sometimes used to assess for microscopic lower
GI bleeding. To help prevent false positive results, the client needs to avoid red meat,
Vitamin C, and NSAIDs. The test is not diagnostic nor does it determine a client’s
genetic risk for colorectal cancer.
DIF: Understanding TOP: Integrated Process: Teaching/Learning
KEY: Colorectal cancer, Diagnostic tests MSC: Client
Needs Category: Physiological Integrity: Physiological Adaptation
5. The nurse is caring for a client who is planning to have a laparoscopic colon resection
for colorectal cancer tomorrow. Which statement by the client indicates a need for
further teaching?
a. “I should have less pain after this surgery compared to having a large
incision.”
b. “I will probably be in the hospital for 3 to 4 days after surgery.”
c. “I will be able to walk around a little on the same day as the surgery.”
d. “I will be able to return to work in a week or two depending on how I do.”
ANS: B
