Nokea
A client has developed an anorectal abscess. Which client is likely at risk for the development of this type of abscess?
- A. A client with Crohn disease
- B. A client with hemorrhoids
- C. A client with colon cancer
- D. A client with diverticulosis
Correct Answer: A
Rationale: An anorectal abscess is common in clients with Crohn disease. The other disorders do not predispose the client to risk for anorectal abscess.
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Which test will best determine whether a client has an abnormality of the muscles surrounding the anal sphincter?
- A. Kidneys, ureters, bladder (KUB)
- B. Colonic transit studies
- C. Defecography
- D. Abdominal radiography
Correct Answer: C
Rationale: In defecography, a thick barium paste is inserted into the rectum. Radiographs are taken as the client expels the barium to determine whether there are any anatomic abnormalities or problems with the muscles surrounding the anal sphincter. A KUB will not determine this. Colonic transit studies are used to determine how long it takes for food to travel through the intestines. Abdominal radiography will show the structure but does not determine the muscle ability surrounding the anal sphincter.
A client realizes that regular use of laxatives has led to bowel pattern improvement. However, the nurse cautions this client against the prolonged use of laxatives for which reason?
- A. The client may develop inflammatory bowel disease.
- B. The client may develop arthritis or arthralgia.
- C. The client's natural bowel function may become sluggish.
- D. The client's appetite may be depleted.
Correct Answer: C
Rationale: It is essential for the nurse to caution the client against the prolonged use of laxatives because it decreases muscle tone in the large intestine. Prolonged use of laxatives may cause the client's natural bowel function to become sluggish. Laxatives do not increase the risk of developing inflammatory bowel disease, arthritis, or arthralgia, nor do they cause a loss in appetite.
The instructor is teaching a group of students about intestinal obstruction. The instructor determines that the teaching was effective when the students identify which of the following as a cause of a functional obstruction?
- A. Volvolus
- B. Intussusception
- C. Tumor
- D. Abdominal surgery
Correct Answer: D
Rationale: In functional obstruction, the intestine can become adynamic from an absence of normal nerve stimulation to intestinal muscle fibers. For example, abdominal surgery can lead to paralytic ileus. Mechanical obstructions result from a narrowing of the bowel lumen with or without a space-occupying mass. A mass may include a tumor, adhesions (fibrous bands that constrict tissue), incarcerated or strangulated hernias, volvulus (kinking of a portion of intestine), intussusception (telescoping of one part of the intestine into an adjacent part), or impacted feces or barium.
The nurse is talking with a group of clients who are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care providers?
- A. Change in bowel habits
- B. Excess gas
- C. Daily bowel movements
- D. Abdominal cramping when having a bowel movement
Correct Answer: A
Rationale: The chief characteristic of cancer of the colon is a change in bowel habits, such as alternating constipation and diarrhea. Excess gas, daily bowel movements, and abdominal cramping when having a bowel movement are not indicators of colon cancer.
A client reports taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about taking a stimulant laxative?
- A. They can be habit forming and will require increasing doses to be effective.
- B. If the client is drinking 8 glasses of water per day, it is all right to continue taking them.
- C. The laxative is safe to take with other medication the client is taking.
- D. The client should take a fiber supplement along with the stimulant laxative.
Correct Answer: A
Rationale: The nurse should discourage self-treatment with daily or frequent enemas or laxatives. Chronic use of such products causes natural bowel function to be sluggish. In addition, laxatives containing stimulants can be habit forming, requiring continued use in increasing doses. Although the nurse should encourage the client to have adequate fluid intake, laxative use should not be encouraged. The laxative may interact with other medications the client is taking and may cause a decrease in absorption. A fiber supplement may be taken alone but should not be taken with a stimulant laxative.