NURS 5461 ADULT GERONTOLOGY REAL FINAL EXAM TEST BANK 1 / NURS 5461 ADULT
GERONTOLOGY FINAL PREP /NURS 5461 ADULT GERONTOLOGY FINAL PRACTICE EXAM WITH
COMPLETE VERIFIED QUESTIONS AND CORRECT ANSWERS WITH DETAILED RATIONALES GRADED A
+
Sally had an ileostomy performed for inflammatory bowel disease. What type of
fecal output can Sally expect?
A. Hard, formed stool
B. Semisoft stool
C. Semisoft to very soft stool
D. A continuous, soft-to-watery effluent –
Correct Answer :Answer: D
Fecal output from an ileostomy is a malodorous, continuous, soft-to-watery
effluent material that contains intestinal enzymes that are very irritating to
the skin around the stoma. Stomas farther along
the large colon will have more formed stools, and a sigmoid colostomy will
result in stools that are almost normal in consistency.
,To differentiate among the different diagnoses of inflammatory bowel diseases,
you look at the client's histological, culture, and radiological features. Mary has
transmural inflammation, granulomas,
focal involvement of the colon with some skipped areas, and sparing of the
rectal mucosa. What do you suspect?
A. Crohn's disease
B. Ulcerative colitis
C. Infectious colitis
D. Ischemic colitis –
Correct Answer :Answer: A
Crohn's disease would show transmural inflammation, granulomas, focal
involvement of the colon with some skipped areas, and sparing of the rectal
mucosa. Ulcerative colitis would show acute inflammatory infi ltrates,
depleted goblet cells, negative cultures, and involvement of the rectum.
Infectious colitis, because of the toxic products released, may induce
periportal inflammation,
mild hepatomegaly, and low-grade liver enzyme abnormalities, but usually
without trophozoites in the liver. Ischemic colitis seen on colonoscopy
reveals segmental infl ammatory changes most often
in the rectosigmoid and the splenic fl exure, where there is more collateral
circulation.
,Marian, age 52, is obese. She complains of a rapid onset of severe right upper
quadrant abdominal cramping pain, nausea, and vomiting. Your differential
diagnosis might be
A. appendicitis.
B. irritable bowel syndrome.
C. cholecystitis.
D. Crohn's disease. –
Correct Answer :Answer: C
A rapid onset of severe right upper quadrant (RUQ) abdominal cramping
pain with nausea and vomiting is a classic presentation of acute
cholecystitis; 90% to 95% of clients with acute cholecystitis also have
gallstones. Other symptoms include low-grade fever, epigastric tenderness,
guarding, and pain on inspiration during palpation of the RUQ (Murphy's
sign). Pain associated with appendicitis would typically be near the navel
progressing to the right lower quadrant. In irritable bowel syndrome (IBS)
and Crohn's disease, the pain and cramping are more diffuse in the
abdomen and are not usually accompanied by nausea and vomiting. The
pain with IBS originates over some area of the colon, with the lower left
quadrant (LLQ) being most often affected. The seven F s of cholecystitis
are fair, fat, forty, female, fertile, fat intolerant, and flatulent.
In the ABCs of irritable bowel syndrome, the B stands for
, A. bloody stool.
B. bad odor to stool.
C. bloating or visible distention.
D. bowel attack. –
Correct Answer :Answer: C
In the ABCs of irritable bowel syndrome, the A is for abdominal pain or
discomfort—typically in the lower abdomen but could be anywhere; the B
is for bloating or visible distention; the C is for constipation—hard,
difficult to evacuate, or infrequent stools; the D is for diarrhea—loose,
watery, or frequent stools; and the E is for extra bowel symptoms, such as
fatigue, headache, backache, muscle pain, urinary frequency, and sleep
disturbance.
A. All areas from the mouth to the anus
B. The colon
C. The sigmoid colon
D. The small intestine –
GERONTOLOGY FINAL PREP /NURS 5461 ADULT GERONTOLOGY FINAL PRACTICE EXAM WITH
COMPLETE VERIFIED QUESTIONS AND CORRECT ANSWERS WITH DETAILED RATIONALES GRADED A
+
Sally had an ileostomy performed for inflammatory bowel disease. What type of
fecal output can Sally expect?
A. Hard, formed stool
B. Semisoft stool
C. Semisoft to very soft stool
D. A continuous, soft-to-watery effluent –
Correct Answer :Answer: D
Fecal output from an ileostomy is a malodorous, continuous, soft-to-watery
effluent material that contains intestinal enzymes that are very irritating to
the skin around the stoma. Stomas farther along
the large colon will have more formed stools, and a sigmoid colostomy will
result in stools that are almost normal in consistency.
,To differentiate among the different diagnoses of inflammatory bowel diseases,
you look at the client's histological, culture, and radiological features. Mary has
transmural inflammation, granulomas,
focal involvement of the colon with some skipped areas, and sparing of the
rectal mucosa. What do you suspect?
A. Crohn's disease
B. Ulcerative colitis
C. Infectious colitis
D. Ischemic colitis –
Correct Answer :Answer: A
Crohn's disease would show transmural inflammation, granulomas, focal
involvement of the colon with some skipped areas, and sparing of the rectal
mucosa. Ulcerative colitis would show acute inflammatory infi ltrates,
depleted goblet cells, negative cultures, and involvement of the rectum.
Infectious colitis, because of the toxic products released, may induce
periportal inflammation,
mild hepatomegaly, and low-grade liver enzyme abnormalities, but usually
without trophozoites in the liver. Ischemic colitis seen on colonoscopy
reveals segmental infl ammatory changes most often
in the rectosigmoid and the splenic fl exure, where there is more collateral
circulation.
,Marian, age 52, is obese. She complains of a rapid onset of severe right upper
quadrant abdominal cramping pain, nausea, and vomiting. Your differential
diagnosis might be
A. appendicitis.
B. irritable bowel syndrome.
C. cholecystitis.
D. Crohn's disease. –
Correct Answer :Answer: C
A rapid onset of severe right upper quadrant (RUQ) abdominal cramping
pain with nausea and vomiting is a classic presentation of acute
cholecystitis; 90% to 95% of clients with acute cholecystitis also have
gallstones. Other symptoms include low-grade fever, epigastric tenderness,
guarding, and pain on inspiration during palpation of the RUQ (Murphy's
sign). Pain associated with appendicitis would typically be near the navel
progressing to the right lower quadrant. In irritable bowel syndrome (IBS)
and Crohn's disease, the pain and cramping are more diffuse in the
abdomen and are not usually accompanied by nausea and vomiting. The
pain with IBS originates over some area of the colon, with the lower left
quadrant (LLQ) being most often affected. The seven F s of cholecystitis
are fair, fat, forty, female, fertile, fat intolerant, and flatulent.
In the ABCs of irritable bowel syndrome, the B stands for
, A. bloody stool.
B. bad odor to stool.
C. bloating or visible distention.
D. bowel attack. –
Correct Answer :Answer: C
In the ABCs of irritable bowel syndrome, the A is for abdominal pain or
discomfort—typically in the lower abdomen but could be anywhere; the B
is for bloating or visible distention; the C is for constipation—hard,
difficult to evacuate, or infrequent stools; the D is for diarrhea—loose,
watery, or frequent stools; and the E is for extra bowel symptoms, such as
fatigue, headache, backache, muscle pain, urinary frequency, and sleep
disturbance.
A. All areas from the mouth to the anus
B. The colon
C. The sigmoid colon
D. The small intestine –
