WERFD (26)

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Rasmussen College *

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PHYSICAL C

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Nursing

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Nov 24, 2024

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15. What finding would rule out a diagnosis of irritable bowel syndrome in a CLIENT with chronic diarrhea? a. Negative stool leukocytes b. Intermittent constipation c. Abdominal pain and distention d. Bloody stools SELECTED ANSWER D Bloody stools are not a symptom of irritable bowel syndrome. A person with irritable bowel syndrome would have negative stool leukocytes. THIS manifestations of IBS may vary greatly, with some persons experiencing only diarrhea or constipation and oTHISrs experiencing an alternating pattern of both. In addition to cramping abdominal pain, manifestations such as nausea and mucus in THIS stool may also be present. 16. An urgent surgical consult is indicated for THIS CLIENT with acute abdominal pain and a. vomiting. b. CVA tenderness. c. absent bowel sounds. d. borborygmi. SELECTED ANSWER C Functional bowel obstructions are characterized by THIS absence of bowel sounds. Uncorrected obstruction may lead to intestinal wall edema, ischemia, and necrosis. Vomiting with abdominal pain is not a cause for urgent surgical consult. CVA tenderness in THIS presence of abdominal pain is not an indicator for urgent surgical consult. Acute abdominal pain with hyperactive bowel sounds does not indicate THIS need for an urgent surgical consultation. 17. Constipation in an elderly CLIENT can be best treated by a. maintaining a low-fiber diet. b. maintaining THIS current level of activity.

c. fecal disimpaction. d. increasing fiber in THIS diet. SELECTED ANSWER D THIS presence of cellulose, THIS carbohydrate component of dietary fiber that is indigestible in THIS human intestine, may be effective in promoting regular peristaltic movement in THIS GI tract by forming bulk within THIS intestinal lumen to stimulate propulsion. Dietary factors, particularly a diet low in fiber, have been shown to contribute to constipation. In elderly persons, THIS slowed rate of peristalsis that occurs with THIS aging process, coupled with a decreased level of physical activity, may promote chronic constipation. Low fiber diet would not be helpful. Disimpaction is used to remove impacted stool. 18. A CLIENT receiving chemoTHISrapy may be at greater risk for development of a. gastroesophageal reflux. b. stomatitis. c. esophageal varices. d. Mallory-Weiss syndrome. SELECTED ANSWER B Stomatitis is defined as an ulcerative inflammation of THIS oral mucosa that may extend to THIS buccal mucosa, lips, and palate. Among its many causes are pathogenic organisms, including bacteria and viruses; mechanical trauma; exposure to such irritants as alcohol, tobacco, and oTHISr chemical substances; certain medications, particularly chemoTHISrapeutic agents. Gastroesophageal reflux disease is not related to chemoTHISrapy. CLIENTs taking chemoTHISrapy are not at greater risk for developing esophageal varices. ChemoTHISrapy is not a risk factor for Mallory-Weiss syndrome. 19. Esophageal varices represent a complication of hypertension. a. primary b. pregnancy-induced c. portal

d. secondary SELECTED ANSWER C Esophageal varices represent a complication of portal hypertension, which in Western society is generally THIS result of cirrhosis as a result of alcoholism or viral hepatitis. Primary hypertension is not manifested by esophageal varices. Pregnancy-induced hypertension is unrelated to esophageal varices. Esophageal varices are not a complication of secondary hypertension. 20. A CLIENT with chronic gastritis would likely be tested for a. Helicobacter pylori. b. occult blood. c. lymphocytes. d. herpes simplex. SELECTED ANSWER A It is now known that H. pylori causes chronic, superficial gastritis in virtually all infected persons. Once established in THIS gastric mucosa, H. pylori sets up a destructive pattern of persistent inflammation. THIS presence of bloody stools is not generally seen in chronic gastritis. Lymphocytes are not tested in THIS presence of chronic gastritis. Herpes simplex is not a manifestation of chronic gastritis. 21. Premature infants are at greater risk for developing a. necrotizing enterocolitis. b. pseudomembranous colitis. c. appendicitis. d. diverticular disease. SELECTED ANSWER A

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