Nokea
A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder?
- A. Abdominal distention
- B. Frank blood in the stool
- C. A change in bowel habits
- D. Abdominal pain
Correct Answer: C
Rationale: Although abdominal distention and blood in the stool (frank or occult) may be present, the chief characteristic of cancer of the colon is a change in bowel habits, such as alternating constipation and diarrhea. Abdominal pain is a late sign.
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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.
A client informs the nurse of having abdominal pain that is relieved when having a bowel movement. The health care provider diagnosed the client with irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder?
- A. Weight loss due to malabsorption
- B. Blood and mucus in the stool
- C. Chronic constipation with sporadic bouts of diarrhea.
- D. Client is awakened from sleep due to abdominal pain.
Correct Answer: C
Rationale: Most clients with irritable bowel syndrome (IBS) describe having chronic constipation with sporadic bouts of diarrhea. Some report the opposite pattern, although less commonly. Most clients experience various degrees of abdominal pain that defecation may relieve. Weight usually remains stable, indicating that when diarrhea occurs, malabsorption of nutrients does not accompany it. Stools may have mucus, but blood is not usually found because the bowel is not locally inflamed. The sleep is not disturbed from abdominal pain.
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.
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 with a hernia decides to manage the herniation with a truss. The nurse would emphasize which of the following?
- A. Using laxatives to ensure regular bowel movement
- B. Wearing warm, woolen clothes to avoid dryness
- C. Applying a sunscreen to prevent exposure to direct sunlight
- D. Using cornstarch to absorb moisture in the area
Correct Answer: D
Rationale: When a client is managing herniation with a truss, the nurse informs the client to keep the skin clean and dry or to use cornstarch to absorb moisture. This minimizes the risk for infection. Use of warm, woolen clothes will not help reduce moisture, it may increase the moisture and increase the risk of infections. If the client's bowel movements are regular, laxatives would not be necessary. However, the client would need teaching to prevent constipation. Applying sunscreen is a general recommendation for any client to reduce the risk of exposure to ultraviolet radiation from the sun.