GI MED SURGE EXAM | QUESTIONS AND CORRECT
ANSWERS WITH EXPLANATIONS (GRADED A+) |
LATEST EXAM | JUST RELEASED | VERIFIED
ANSWERS
Which patient statement indicates that the nurses teaching about
sulfasalazine (Azulfidine) for ulcerative colitis has been effective?
a. The medication will be tapered if I need surgery.
b. I will need to use a sunscreen when I am outdoors.
c. I will need to avoid contact with people who are sick.
d. The medication will prevent infections that cause the diarrhea. ---------
CORRECT ANSWER-----------------ANS: B
Sulfasalazine may cause photosensitivity in some patients. It is not
used to treat infections. Sulfasalazine does not reduce immune
function. Unlike corticosteroids, tapering of sulfasalazine is not
needed.
A 22-year-old female patient with an exacerbation of ulcerative colitis is
having 15 to 20 stools daily and has excoriated perianal skin. Which patient
behavior indicates that teaching regarding maintenance of skin integrity has
been effective?
a.
The patient uses incontinence briefs to contain loose stools.
b.
The patient asks for antidiarrheal medication after each stool.
c.
The patient uses witch hazel compresses to decrease irritation.
d.
The patient cleans the perianal area with soap after each stool. ---------
CORRECT ANSWER-----------------c. The patient uses witch hazel
compresses to decrease irritation.
Which diet choice by the patient with an acute exacerbation of inflammatory
bowel disease (IBD) indicates a need for more teaching?
,a. Scrambled eggs
b. White toast and jam
c. Oatmeal with cream
d. Pancakes with syrup ---------CORRECT ANSWER-----------------ANS: C
During acute exacerbations of IBD, the patient should avoid high-fiber
foods such as whole grains. High-fat foods also may cause diarrhea
in some patients. The other choices are low residue and would be
appropriate for this patient.
After a total proctocolectomy and permanent ileostomy, the patient tells the
nurse, I cannot manage all these changes. I dont want to look at the stoma.
What is the best action by the nurse?
a. Reassure the patient that ileostomy care will become easier.
b. Ask the patient about the concerns with stoma management.
c. Develop a detailed written list of ostomy care tasks for the patient.
d. Postpone any teaching until the patient adjusts to the ileostomy. ---------
CORRECT ANSWER-----------------ANS: B
Encouraging the patient to share concerns assists in helping the
patient adjust to the body changes. Acknowledgment of the patient's
feelings and concerns is important rather than offering false
reassurance. Because the patient indicates that the feelings about the
ostomy are the reason for the difficulty with the many changes,
development of a detailed ostomy care plan will not improve the
patient's ability to manage the ostomy. Although detailed ostomy
teaching may be postponed, the nurse should offer teaching about
some aspects of living with an ostomy.
A 51-year-old male patient has a new diagnosis of Crohns disease after
having frequent diarrhea and a weight loss of 10 pounds (4.5 kg) over 2
months. The nurse will plan to teach about
a. medication use.
b. fluid restriction.
c. enteral nutrition.
d. activity restrictions. ---------CORRECT ANSWER-----------------ANS: A
Medications are used to induce and maintain remission in patients
with inflammatory bowel disease (IBD). Decreased activity level is
,indicated only if the patient has severe fatigue and weakness. Fluids
are needed to prevent dehydration. There is no advantage to enteral
feedings.
A 24-year-old woman with Crohns disease develops a fever and symptoms
of a urinary tract infection (UTI) with tan, fecal-smelling urine. What
information will the nurse add to a general teaching plan about UTIs in
order to individualize the teaching for this patient?
a. Bacteria in the perianal area can enter the urethra.
b. Fistulas can form between the bowel and bladder.
c. Drink adequate fluids to maintain normal hydration.
d. Empty the bladder before and after sexual intercourse. ---------
CORRECT ANSWER-----------------ANS: B
Fistulas between the bowel and bladder occur in Crohn's disease and
can lead to UTI. Teaching for UTI prevention in general includes good
hygiene, adequate fluid intake, and voiding before and after
intercourse.
A 73-year-old patient with diverticulosis has a large bowel obstruction. The
nurse will monitor for
a. referred back pain.
b. metabolic alkalosis.
c. projectile vomiting.
d. abdominal distention. ---------CORRECT ANSWER-----------------ANS: D
Abdominal distention is seen in lower intestinal obstruction. Referred
back pain is not a common clinical manifestation of intestinal
obstruction. Metabolic alkalosis is common in high intestinal
obstruction because of the loss of HCl acid from vomiting. Projectile
vomiting is associated with higher intestinal obstruction.
The nurse preparing for the annual physical exam of a 50-year-old man will
plan to teach the patient about
a. endoscopy.
b. colonoscopy.
, c. computerized tomography screening.
d. carcinoembryonic antigen (CEA) testin ---------CORRECT ANSWER-------
----------ANS: B
At age 50, individuals with an average risk for colorectal cancer (CRC)
should begin screening for CRC. Colonoscopy is the gold standard
for CRC screening. The other diagnostic tests are not recommended
as part of a routine annual physical exam at age 50
A 26-year-old patient with a family history of stomach cancer asks the
nurse about ways to decrease the risk for developing stomach cancer. The
nurse will teach the patient to avoid
a. emotionally stressful situations.
b. smoked foods such as ham and bacon.
c. foods that cause distention or bloating.
d. chronic use of H2 blocking medications. ---------CORRECT ANSWER-----
------------ANS: B
Smoked foods such as bacon, ham, and smoked sausage increase
the risk for stomach cancer. Stressful situations, abdominal
distention, and use of H2 blockers are not associated with an
increased incidence of stomach cancer.
The nurse is assessing a patient who had a total gastrectomy 8 hours ago.
What information is most important to report to the health care provider?
a.
Absent bowel sounds
b.
Complaints of incisional pain
c.
Temperature 102.1° F (38.9° C)
d.
Scant nasogastric (NG) tube drainage ---------CORRECT ANSWER-----------
------ANS: C
An elevation in temperature may indicate leakage at the anastomosis,
which may require return to surgery or keeping the patient NPO. The
other findings are expected in the immediate postoperative period for
patients who have this surgery.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller nevilletadayo. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $25.99. You're not tied to anything after your purchase.
