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.
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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.
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.
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.
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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