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The nurse is caring for a patient who is undergoing diagnostic testing for suspected malabsorption. When taking this patients health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis?
- A. Recurrent constipation coupled with weight loss
- B. Foul-smelling diarrhea that contains fat
- C. Fever accompanied by a rigid, tender abdomen
- D. Bloody bowel movements accompanied by fecal incontinence
Correct Answer: B
Rationale: The hallmarks of malabsorption syndrome from any cause are diarrhea or frequent, loose, bulky, foul-smelling stools that have increased fat content and are often grayish (steatorrhea). Constipation and bloody bowel movements are not suggestive of malabsorption syndromes. Fever and a tender, rigid abdomen are associated with peritonitis.
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A patient has been experiencing disconcerting GI symptoms that have been worsening in severity. Following medical assessment, the patient has been diagnosed with lactose intolerance. The nurse should recognize an increased need for what form of health promotion?
- A. Annual screening colonoscopies
- B. Adherence to recommended immunization schedules
- C. Regular blood pressure monitoring
- D. Frequent screening for osteoporosis
Correct Answer: D
Rationale: Persons with lactose intolerance often experience hypocalcemia and a consequent risk of osteoporosis related to malabsorption of calcium. Lactose intolerance does not create an increased need for screening for colorectal cancer, immunizations, or blood pressure monitoring.
A nurse is caring for a patient admitted with symptoms of an anorectal infection; cultures indicate that the patient has a viral infection. The nurse should anticipate the administration of what drug?
- A. Acyclovir (Zovirax)
- B. Doxycycline (Vibramycin)
- C. Penicillin (penicillin G)
- D. Metronidazole (Flagyl)
Correct Answer: A
Rationale: Acyclovir (Zovirax) is often given to patients with viral anorectal infections. Doxycycline (Vibramycin) and penicillin (penicillin G) are drugs of choice for bacterial infections. Metronidazole (Flagyl) is used for other infections with a bacterial etiology; it is ineffective against viruses.
A nurse is caring for a patient who has been admitted to the hospital with diverticulitis. Which of the following would be appropriate nursing diagnoses for this patient?
- A. Acute Pain Related to Increased Peristalsis and GI Inflammation
- B. Activity Intolerance Related to Generalized Weakness
- C. Bowel Incontinence Related to Increased Intestinal Peristalsis
- D. Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea
- E. Impaired Urinary Elimination Related to GI Pressure on the Bladder
Correct Answer: A,B,D
Rationale: Patients with diverticulitis are likely to experience pain and decreased activity levels, and are at risk of fluid volume deficit. The patient is unlikely to experience fecal incontinence and urinary function is not directly influenced.
A nurse caring for a patient with colorectal cancer is preparing the patient for upcoming surgery. The nurse administers cephalexin (Keflex) to the patient and explains what rationale?
- A. To treat any undiagnosed infections
- B. To reduce intestinal bacteria levels
- C. To reduce bowel motility
- D. To reduce abdominal distention postoperatively
Correct Answer: B
Rationale: Antibiotics such as kanamycin (Kantrex), neomycin (Mycifradin), and cephalexin (Keflex) are administered orally the day before surgery to reduce intestinal bacteria. Preoperative antibiotics are not given to treat undiagnosed infections, reduce motility, or prevent abdominal distention.
An older adult has a diagnosis of Alzheimers disease and has recently been experiencing fecal incontinence. However, the nurse has observed no recent change in the character of the patients stools. What is the nurses most appropriate intervention?
- A. Keep a food diary to determine the foods that exacerbate the patients symptoms.
- B. Provide the patient with a bland, low-residue diet.
- C. Toilet the patient on a frequent, scheduled basis.
- D. Liaise with the primary care provider to obtain an order for loperamide.
Correct Answer: C
Rationale: Because the patients fecal incontinence is most likely attributable to cognitive decline, frequent toileting is an appropriate intervention. Loperamide is unnecessary in the absence of diarrhea. Specific foods are not likely to be a cause of, or solution to, this patients health problem.