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Chapter 41 Management of Patients With Intestinal and Rectal Disorders
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Chapter 41 Management of Patients With Intestinal and Rectal Disorders
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Chapter 41 Management of Patients With Intestinal andRectal Disorders
1. A nurse is caring for a patient who just has been diagnosed with a peptic ulcer. When
teaching the patient about his new diagnosis, how should the nurse best describe a
peptic ulcer?
A) Inflammation of the lining of the stomach
B) Erosion of the lining of the stomach or intestine
C) Bleeding from the mucosa in the stomach
D) Viral invasion of the stomach wall
Ans: B
Feedback:
A peptic ulcer is erosion of the lining of the stomach or intestine. Peptic ulcers are
often
accompanied by bleeding and inflammation, but these are not the definitive
characteristics.
2. A patient comes to the clinic complaining of pain in the epigastric region. What
assessment question during the health interview would most help the nurse
determine if the patient has a peptic ulcer?
A) ìDoes your pain resolve when you have something to eat?î
B) ìDo over-the-counter pain medications help your pain?î
C) ìDoes your pain get worse if you get up and do some exercise?î
D) ìDo you find that your pain is worse when you need to have a bowel
movement?î
Ans: A
Feedback:
Pain relief after eating is associated with duodenal ulcers. The pain of peptic ulcers is
, generally unrelated to activity or bowel function and may or may not respond to
analgesics.
3. A patient with a diagnosis of peptic ulcer disease has just been prescribed
omeprazole (Prilosec). How should the nurse best describe this medication's
therapeutic action? A) ìThis medication will reduce the amount of acid secreted in
your stomach.î
B) ìThis medication will make the lining of your stomach more resistant to
damage.î
C) ìThis medication will specifically address the pain that accompanies
peptic ulcer disease.î
D) ìThis medication will help your stomach lining to repair itself.î
Ans: A
Feedback:
Proton pump inhibitors like Prilosec inhibit the synthesis of stomach acid. PPIs do not
increase the durability of the stomach lining, relieve pain, or stimulate tissue repair.
, 4. A nurse is admitting a patient diagnosed with late-stage gastric cancer. The patient's
family is distraught and angry that she was not diagnosed earlier in the course of her
disease. What factor contributes to the fact that gastric cancer is often detected at a
later stage?
A) Gastric cancer does not cause signs or symptoms until metastasis has occurred.
B) Adherence to screening recommendations for gastric cancer is exceptionally
low.
C) Early symptoms of gastric cancer are usually attributed to constipation.
D) The early symptoms of gastric cancer are usually not alarming or highly unusual.
Ans: D
Feedback:
Symptoms of early gastric cancer, such as pain relieved by antacids, resemble those
of benign ulcers and are seldom definitive. Symptoms are rarely a cause for alarm or
for detailed diagnostic testing. Symptoms precede metastasis, however, and do not
include constipation.
5. A nurse is preparing to discharge a patient after recovery from gastric surgery. What
is an appropriate discharge outcome for this patient?
A) The patient's bowel movements maintain a loose consistency. B) The patient
is able to tolerate three large meals a day.
C) The patient maintains or gains weight.
D) The patient consumes a diet high in calcium.
Ans: C
Feedback:
Expected outcomes for the patient following gastric surgery include ensuring that the
patient is maintaining or gaining weight (patient should be weighed daily),
experiencing no excessive diarrhea, and tolerating six small meals a day. Patients may
require vitamin B12 supplementation by the intramuscular route and do not require
a diet excessively rich in calcium.
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