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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.
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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.
The nurse is reviewing the laboratory test results of a client with Crohn disease. Which of the following would the nurse most likely find?
- A. Decreased white blood cell count
- B. Increased albumin levels
- C. Stool cultures negative for microorganisms or parasite
- D. Decreased erythrocyte sedimentation rate
Correct Answer: C
Rationale: Stool cultures fail to reveal an etiologic microorganism or parasite, but occult blood and white blood cells (WBCs) often are found in the stool. Results of blood studies indicate anemia from chronic blood loss and nutritional deficiencies. The WBC count and erythrocyte sedimentation rate may be elevated, confirming an inflammatory disorder. Serum protein and albumin levels may be low because of malnutrition.
The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder?
- A. The bowel twists and turns itself and obstructs the intestinal lumen.
- B. One part of the intestine telescopes into another portion of the intestine.
- C. The bowel protrudes through a weakened area in the abdominal wall.
- D. A loop of intestine adheres to an area that is healing slowly after surgery.
Correct Answer: B
Rationale: In intussusception of the bowel, one part of the intestine telescopes into another portion of the intestine. When the bowel twists and turns itself and obstructs the intestinal lumen, this is known as a volvulus. A hernia is when the bowel protrudes through a weakened area in the abdominal wall. An adhesion is a loop of intestine that adheres to an area that is healing slowly after surgery.
A client is recently diagnosed with Crohn disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response?
- A. Ciprofloxacin
- B. Methotrexate
- C. Azathioprine
- D. Sulfasalazine
Correct Answer: D
Rationale: Considered first-line treatment for inflammatory bowel disease, 5-ASA drugs contain salicylate, which is bonded to a carrying agent that allows the drug to be absorbed in the intestine. These drugs work by decreasing the inflammatory response. Methotrexate or azathioprine are used when failure to maintain remission necessitates the use of an immune-modulating agent. Ciprofloxacin is used as an effective adjunct to treat the disease.
The instructor is teaching a group of students about Crohn disease and antidiarrheal agents. The instructor determines that the teaching was effective when the students identify which of the following as an example of an opiate-based antidiarrheal agent?
- A. Diphenoxylate with atropine
- B. Bismuth subsalicylate
- C. Kaolin and pectin
- D. Bisacodyl
Correct Answer: A
Rationale: Diphenoxylate with atropine is an example of an opiate-based antidiarrheal agent. Bismuth subsalicylate and kaolin and pectin are examples of absorbent antidiarrheal agents. Bisacodyl is a chemical stimulant laxative.