Nur 204 Exam 5 Latest Questions And Already Passed Answers.
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Course
NUR 204
Institution
NUR 204
The nurse is caring for a patient who periodically has small streaks of fresh red blood in the stool. The patient denies abdominal pain or loss of appetite. The nurse identifies what to be the most likely cause of this patient's bleeding?
a. Hemorrhoids
b. Bleeding gastric ulcer
c. Colon polyps
...
Nur 204 Exam 5 Latest Questions And
Already Passed Answers.
The nurse is caring for a patient who periodically has small streaks of fresh red blood in the stool. The
patient denies abdominal pain or loss of appetite. The nurse identifies what to be the most likely cause
of this patient's bleeding?
a. Hemorrhoids
b. Bleeding gastric ulcer
c. Colon polyps
d. Perforated colon - Answer hemorrhoids
The nurse is caring for a patient who has diarrhea and identifies which priority nursing diagnosis for this
patient?
a. Lack of knowledge related to prescribed diet modifications.
b. Impaired nutritional intake related to poor appetite.
c. Diarrhea related to excessive loss of fluid through stool.
d. Anxiety related to incontinence with loose stools and need for clothing change. - Answer diarrhea
related to excessive loss of fluid through stool
The nurse is caring for a patient who is prescribed diphenoxylate-atropine (Lomotil). Which assessment
finding by the nurse indicates a need to contact the prescriber and question the order?
a. The patient has skin breakdown from loose stools.
b. The patient is constipated with last BM 3 days ago.
c. The patient is on a low-fiber, gluten-free diet.
d. The patient has painful bleeding hemorrhoids. - Answer the patient is constipated with last BM 3
days ago
The nurse is caring for an immobile patient who has abdominal pain and frequent small, liquid stools.
The patient vomited his breakfast and is still nauseated. Which action by the nurse is the highest
priority?
a. Provide oral care after each episode of emesis
,.b. Apply a skin barrier to the patient's perineal area.
c. Check the patient for a fecal impaction.
d. Administer antiemetic medication with a sip of water. - Answer check patient for a fecal infection
The nurse is caring for a patient who is recovering from bowel surgery. Which assessment finding best
indicates that the bowel is starting to resume function and the patient will be able to resume oral intake
soon?
a. The patient has bowel sounds × 4 quadrants and is passing gas.
b. The patient has no nausea, and abdominal pain is minimal
.c. The patient feels hungry for chicken soup and hot tea.
d. The patient's nasogastric tube was discontinued the previous day. - Answer The patient has bowel
sounds × 4 quadrants and is passing gas.
The nurse is caring for a patient who has an ileostomy. Which nursing diagnosis has the highest priority
for the patient?
a. Impaired skin integrity r/t localized skin irritation from liquid stool.
b. Social isolation r/t potential leakage of stool from ostomy appliance.
c. Lack of knowledge r/t care and maintenance of ostomy appliance.
d. Disturbed body image r/t presence of stoma and altered elimination. - Answer impaired skin
integrity r/t localized skin irritation from liquid stool
The nurse is caring for a patient who is taking narcotic pain medication after surgery. Which breakfast
choices will help prevent constipation and promote return to regular bowel function?
a. Raisin bran with skim milk, fresh fruit, and wheat toast.
b. Pancakes with maple syrup, bacon, and coffee with cream.
c. Omelet with cheddar cheese, green pepper, and onions.
d. Bagel with cream cheese, and strawberry nonfat yogurt. - Answer Raisin bran with skim milk, fresh
fruit, and wheat toast.
The nurse is caring for a patient who has not had a bowel movement for 2 days. Which is the priority
nursing intervention for this patient?
a. Obtain an order to administer a soap suds cleansing enema.
,b. Teach the patient how to use the Valsalva maneuver.
c. Discontinue medications that can cause constipation.
d. Assess the patient's usual pattern of bowel movements. - Answer assess the patients usual pattern
of bowel movement
The nurse is caring for a patient who will be undergoing upper GI series testing the next day. Which
instruction will the nurse provide to the patient about the upcoming exam?
a. "The back of your throat will be sprayed with numbing medicine."
b. "You will need to have a clear liquid diet and take a laxative tonight."
c. "You will be given a milky liquid to drink shortly before the test starts."
d. "You should not take your dose of warfarin (Coumadin) tonight." - Answer "You will be given a milky
liquid to drink shortly before the test starts."
The nurse is caring for a patient who will undergo colonoscopy testing. Which intervention will the nurse
include in the patient's plan of care for the day before the test?
a. Provide the patient with zinc oxide skin barrier cream for the perineal area.
b. Obtain an order for a gentle laxative to be given once the test is completed.
c. Carefully assess the patient's ability to swallow liquids through a straw.
d. Check the patient for allergies to shellfish and iodine-based contrast dyes. - Answer provide the
patient with zinc oxide skin barrier cream for the perineal area
The nurse is caring for a patient who is to have testing for fecal occult blood. What step will the nurse
perform during this testing?
a. Keep the patient on a clear liquid diet for 72 hours.
b. Put the sample container on ice and send to the lab immediately after collection.
c. Inform the patient that several stool samples will be needed.
d. Use a sterile container when collecting the stool samples. - Answer Inform the patient that several
stool samples will be needed.
The nurse is caring for a patient who is to have a cleansing enema. Which assessment finding by the
nurse indicates a need to contact the prescriber and question the order?
a. The patient is recovering from a traumatic brain injury.
, b. The patient has not had a bowel movement for 3 days.
c. The patient is to have a lower GI series the following morning.
d. The patient had an upper GI series performed the previous day. - Answer the patient is recovering
from a traumatic brain injury
The nurse is caring for a postoperative patient who underwent bowel resection surgery that morning.
The nurse assesses the patient's abdomen and notes that there are hypoactive bowel sounds. The
patient is resting quietly without nausea or vomiting. What is the appropriate action of the nurse?
a. Keep the patient NPO and document the findings in the chart.
b. Administer a laxative suppository to stimulate peristalsis.
c. Insert a Salem sump nasogastric tube to low continuous suction.
d. Notify the surgeon and prepare the patient to return to surgery. - Answer keep the patient NPO and
document the findings in the chart
The nurse is caring for a patient who is constipated and has not had a bowel movement for 3 days. The
nurse performs a rectal examination and finds hard dry stool in the rectum. What is the best option to
help the patient have a bowel movement?
a. Glass of warmed prune juice
b. Loperamide (Imodium)
c. Oral fiber supplement
d. An oil retention enema - Answer an oil retention enema
The nurse is caring for a patient who has just completed 2 weeks of IV antibiotics for a severe infection.
The patient now has frequent loose watery stools and a low-grade temperature. What is the most likely
cause of the patient's new symptoms?
a. Clostridium difficile infection
b. Paralytic ileus
c. Fecal impaction
d. Salmonella food poisoning - Answer clostridium difficile infection
The nurse is caring for a patient who had a colonoscopy earlier that day. The patient states that he still
feels very bloated after the procedure. What is the best action of the nurse?
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