Please answer the questions below Care of Patients With Disorders of the Lower Gastrointestinal System CHAPTER 29Go tomedsurg) for the following FREE learning resources:. Animations, audio, and videoAnswers and rationales for questions and activitiesGlossary with pronunciations in English and Spanish• Interactive Review Questions and more!Review Questions for the NCLEX Examination1. You encourage a patient with IBS to keep a fooddiary. What is the best nursing response to the patientregarding the importance of keeping the diary?1. "The diary will monitor caloric intake."2. "The diary will help identify foods that causebloating.3. "The diary will determine food preferences."4. "The diary will reinforce the need for better foodchoices."NCLEX Client Need: Health Promotion and Maintenance2. A 68-year-old patient complains of mild left lowerabdominal pain that is accompanied by frequentdiarrhea, slight fever, and rectal bleeding. Whichtreatment measure should you anticipate?1. Administration of a bulk-forming stool softener2. Increasing fluid intake3. Encouraging solid foods4. Increasing physical activityNCLEX Client Need: Physiological Integrity: Basic Care andComfort3. A patient who was admitted with a bowel obstructionis complaining of severe pain. Their abdominal girthhas increased by 4 inches in the past hour and theblood pressure is now 80/50 mm Hg. List your actionsin priority order.1. Assess breathing.2. Notify the health care provider.3. Position to support blood pressure.4. Ensure IV patency.NCLEX Client Need: Physiological Integrity: Reduction of RiskPotential4. During a home visit, you provide verbal instructions toa patient with a possible blockage of an ostomy. Whatwould be an appropriate instruction to give?1. Massage the stoma.2. Try different body positions.3. Take a cold bath.4. Begin a high-fiber diet.NCLEX Client Need: Physiological Integrity: PhysiologicalAdaptation5. You are caring for a patient who is postoperative afteran ileostomy. Which order should you question?1. Strict intake and output recording for 8 hours2. Clear liquid diet3. IV fluids 125 ml/h4. Occlusive dressing over stomaNCLEX Client Need: Physiological Integrity: PhysiologicalAdaptation7116. In caring for a patient with an ostomy, whichstatement is true regarding medication administration?1. Time-release capsules can be given to patients withan ileostomy.2. Enteric-coated tablets are adequately absorbed bypatients with ileostomy.3. Glycerin suppositories are readily evacuated in thedistal colostomy stoma.4. An antiemetic suppository can be effectivelyabsorbed when inserted in the distal colostomystoma.NCLEX Client Need: Physiological Integrity: PharmacologicalTherapies7. A patient has a new colostomy. Which behavior is anearly sign of acceptance of the change in body image?1. The patient allows you to empty the colostomy bag.2. The patient refuses to look at the ostomy site.3. The patient holds and examines a new appliancebag.4. The patient continues to ask for a bedpan to have abowel movement.NCLEX Client Need: Psychosocial Integrity8. A patient develops a paralytic ileus as a complicationof peritonitis. Which patient comment suggests areturn of peristalsis?1. "I feel thirsty; may I have some water?"2. "I would like to try to walk to the toilet."3. "When will I be allowed to have solid food?"4. "I am sorry to pass gas while you are here."NCLEX Client Need: Physiological Integrity: Reduction of RiskPotential9. What would be included in the recommended diet forpatients with IBD? (Select all that apply.)1. Low fat2. High fiber3. High protein4. Low calorie5. Lactose avoidanceNCLEX Client Need: Physiological Integrity: Reduction of RiskPotential10. You admit a 23-year-old patient with possibleappendicitis. You anticipate which sign(s) and/orsymptom(s)? (Select all that apply.)1. Increased red blood cell count2. Abdominal tenderness3. Anorexia and vomiting4. Mild fever5. Dark black stoolsNCLEX Client Need: Physiological Integrity: PhysiologicalAdaptation .Care of Patients with Disorders of the Gallbladder, Liver, and Pancreas CHAPTER 30Signs and symptoms of pancreatic cancer are weightloss, anorexia, vomiting, and signs of pancreaticdysfunction. Not smoking reduces the risk of pancreaticcancer by 50%.. Treatment of pancreatic cancer includes painmanagement and chemotherapy and radiation, whichmay improve food absorption, relieve pain, and alleviateduct obstruction.Additional Learning ResourcesSG Go to your Study Guide for additional learning activitiesto help you master this chapter content.Go to your Evolve website (http://evolve.elsevier.com/deWit/medsurg) for the following FREE learning resources:. Animations, audio, and video.Answers and rationales for questions and activities• Glossary with pronunciations in English and SpanishInteractive Review Questions and more!·Review Questions for the NCLEX® Examination1. Before being discharged to home, a patient who hada laparoscopic cholecystectomy is given instructionsregarding pain control. Which patient statementsindicate successful teaching? (Select all that apply.)1. "I will stay mobile and change positions frequently."2. "Opioids are the best medication for relieving pain."3. "I will continue my swimming routine for exercise,and this will help my pain."4. "Passing gas will relieve my pain."5. "Pain will become less as the gas in my abdomenis absorbed."6. "I will take NSAIDs for pain control."NCLEX Client Need: Health Promotion and Maintenance2. If the patient has a history of chronic cholecystitis,which comment is cause for the greatest concern?1. "I have back pain at the level of the shoulderblade."2. "I had nausea after eating a hamburger and fries."3. "I have generalized abdominal pain and fever."4. "I have discomfort in the right upper part of myabdomen."NCLEX Client Need: Physiological Integrity: PhysiologicalAdaptation3. You are caring for a 57-year-old patient with ascitesresulting from liver disease. You anticipate that thehealth care provider will use which therapeutic regimento reduce portal hypertension?1. Vascular shunting of the portal venous systems2. Repeated abdominal paracentesis3. Diet restrictions and nutrient supplementation4. Fluid replacement therapyNCLEX Client Need: Physiological Integrity: Reduction of RiskPotential7374. A patient with high levels of serum ammonia asks,"Why do I have to continue taking lactulose?" What isthe best response?1. "It destroys ammonia-producing bacteria in theintestines."2. "It reduces intestinal absorption of ammonia."3. "It corrects vitamin B, deficiency."4. "It is used in preparation for a diagnostic test."NCLEX Client Need: Physiological Integrity: PharmacologicalTherapies5. You are caring for a patient who underwent a recentliver transplantation. You reinforce the teaching relatedto self-care. Which teaching topics are most importantto address before discharge? (Select all that apply.)1. Reporting any kind of pain associated with feverand changes in stool color2. Location and meeting time of local support groups3. Use of strict hand hygiene in changing dressings4. The lifelong need to take antirejection medicationsNCLEX Client Need: Physiological Integrity: Reduction of RiskPotential6. You are caring for a patient who underwent radicalpancreaticoduodenectomy. Which postoperativecomplication would be the most likely to occur andcause the greatest concern?1. Hypoglycemia2. Adhesions3. Hemorrhage4. AnorexiaNCLEX Client Need: Physiological Integrity: Reduction of RiskPotential7. Which instructions should be given to a patientregarding preventing the spread of hepatitis A? (Selectall that apply.)1. Bleach solutions must be used to clean thebathroom.2. Somebody else should be doing the cooking rightnow.3. No vaccination is available for hepatitis A.4. Good hand hygiene reduces the likelihood ofpassing the virus.NCLEX Client Need: Safe and Effective Care Environment: Safetyand Infection Control8. A patient has cirrhosis of the liver and ascites. Youshould question which order?1. Bed rest with bathroom privileges2. Discontinue furosemide (Lasix) 80 mg3. Give 2-g sodium diet4. Fluid restriction 1500 mL/24 hNCLEX Client Need: Physiological Integrity: PharmacologicalTherapies9. A patient with acute pancreatitis has a bluishdiscoloration around the umbilicus. What actionsshould you take? (Place in priority order.)1. Place head flat and feet elevated.2. Notify health care provider.3. Assess vital signs.4. Verify patency of IV line.NCLEX Client Need: Physiological Integrity: PhysiologicalAdaptation

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Care of Patients With Disorders of the Lower Gastrointestinal System CHAPTER 29 Go to your Evolve website (http://evolve.elsevier.com/deWit/ medsurg) for the following FREE learning resources: Animations, audio, and video . • Answers and rationales for questions and activities Glossary with pronunciations in English and Spanish • Interactive Review Questions and more! Review Questions for the NCLEX Examination 1. You encourage a patient with IBS to keep a food diary. What is the best nursing response to the patient regarding the importance of keeping the diary? 1. "The diary will monitor caloric intake." 2. "The diary will help identify foods that cause bloating." 3. "The diary will determine food preferences." 4. "The diary will reinforce the need for better food choices." NCLEX Client Need: Health Promotion and Maintenance 2. A 68-year-old patient complains of mild left lower abdominal pain that is accompanied by frequent diarrhea, slight fever, and rectal bleeding. Which treatment measure should you anticipate? 1. Administration of a bulk-forming stool softener 2. Increasing fluid intake 3. Encouraging solid foods 4. Increasing physical activity NCLEX Client Need: Physiological Integrity: Basic Care and Comfort 3. A patient who was admitted with a bowel obstruction is complaining of severe pain. Their abdominal girth has increased by 4 inches in the past hour and the blood pressure is now 80/50 mm Hg. List your actions in priority order. 1. Assess breathing. 2. Notify the health care provider. 3. Position to support blood pressure. 4. Ensure IV patency. NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 4. During a home visit, you provide verbal instructions to a patient with a possible blockage of an ostomy. What would be an appropriate instruction to give? 1. Massage the stoma. 2. Try different body positions. 3. Take a cold bath. 4. Begin a high-fiber diet. NCLEX Client Need: Physiological Integrity: Physiological Adaptation 5. You are caring for a patient who is postoperative after an ileostomy. Which order should you question? 1. Strict intake and output recording for 8 hours 2. Clear liquid diet 3. IV fluids 125 mL/h 4. Occlusive dressing over stoma NCLEX Client Need: Physiological Integrity: Physiological Adaptation 6. In caring for a patient with an ostomy, which statement is true regarding medication administration? 1. Time-release capsules can be given to patients with an ileostomy. 2. Enteric-coated tablets are adequately absorbed by patients with ileostomy. 3. Glycerin suppositories are readily evacuated in the distal colostomy stoma. 4. An antiemetic suppository can be effectively absorbed when inserted in the distal colostomy stoma. 711 NCLEX Client Need: Physiological Integrity: Pharmacological Therapies 7. A patient has a new colostomy. Which behavior is an early sign of acceptance of the change in body image? 1. The patient allows you to empty the colostomy bag. 2. The patient refuses to look at the ostomy site. 3. The patient holds and examines a new appliance bag. 4. The patient continues to ask for a bedpan to have a bowel movement. NCLEX Client Need: Psychosocial Integrity 8. A patient develops a paralytic ileus as a complication of peritonitis. Which patient comment suggests a return of peristalsis? 1. "I feel thirsty; may I have some water?" 2. "I would like to try to walk to the toilet." 3. "When will I be allowed to have solid food?" 4. "I am sorry to pass gas while you are here." NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 9. What would be included in the recommended diet for patients with IBD? (Select all that apply.) 1. Low fat 2. High fiber 3. High protein 4. Low calorie 5. Lactose avoidance NCLEX Client Need: Physiological Integrity: Reduction of Risk Potential 10. You admit a 23-year-old patient with possible appendicitis. You anticipate which sign(s) and/or symptom(s)? (Select all that apply.) 1. Increased red blood cell count 2. Abdominal tenderness 3. Anorexia and vomiting 4. Mild fever 5. Dark black stools NCLEX Client Need: Physiological Integrity: Physiological Adaptation