NSG 322 Exam 3 Study Guide with Questions and Correct Answers
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Course
NSG 322
Institution
NSG 322
Which action will thenurse include in the plan of care for a 42- yr. old pt. who is being admitted with clostridum difficile?
a. educate the pt. about proper food storage b. order a diet with no diary products for the patient c. place the pt. in a private room on contact precautions d. teach the p...
NSG 322 Exam 3 Study Guide with
Questions and Correct Answers
Which action will thenurse include in the plan of care for a 42- yr. old pt. who is being
admitted with clostridum difficile?
a. educate the pt. about proper food storage
b. order a diet with no diary products for the patient
c. place the pt. in a private room on contact precautions
d. teach the pt. about why antibiotics will not be used ✅c. place the patient in a private
room on contact isolation
because C. difficile is highly contagious, the patient should be placed in a private toom
and contact precaustions should be used. There is no need to restrict dairy prodycts for
this type of diarrhea. Metronidazole (flagyl) is refquently used to treat C diff.. improper
food handling and storage do not cause C. diff.
A 71-year-old male patient tells the nurse that growing old causes constipation so he
has been using a suppository for constipation every morning. Which action should the
nurse take first?
a. Encourage the patient to increase oral fluid intake.
b.Assess the patient about risk factors for constipation.
C.Suggest that the patient increase intake of high-fiber foods.
d.Teach the patient that a daily bowel movement is unnecessary. ✅b.Assess the
patient about risk factors for constipation.
The nurses initial action should be further assessment of the patient for risk factors for
constipation and for his usual bowel pattern. The other actions may be appropriate but
will be based on the assessment.
A 64-year-old woman who has chronic constipation asks the nurse about the use of
psyllium (Metamucil). Which information will the nurse include in the response?
a.Absorption of fat-soluble vitamins may be reduced by fiber-containing laxatives.
b.Dietary sources of fiber should be eliminated to prevent excessive gas formation.
C.Use of this type of laxative to prevent constipation does not cause adverse effects.
d.Large amounts of fluid should be taken to prevent impaction or bowel obstruction.
✅d.
Large amounts of fluid should be taken to prevent impaction or bowel obstruction.
A high fluid intake is needed when patients are using bulk-forming laxatives to avoid
worsening constipation. Although bulk-forming laxatives are generally safe, the nurse
,should emphasize the possibility of constipation or obstipation if inadequate fluid intake
occurs. Although increased gas formation is likely to occur with increased dietary fiber,
the patient should gradually increase dietary fiber and eventually may not need the
psyllium. Fat-soluble vitamin absorption is blocked by stool softeners and lubricants, not
by bulk-forming laxatives.
A 26-year-old woman is being evaluated for vomiting and abdominal pain. Which
question from the nurse will be most useful in determining the cause of the patients
symptoms?
a.What type of foods do you eat?
b.Is it possible that you are pregnant?
C.Can you tell me more about the pain?
d.What is your usual elimination pattern? ✅C.Can you tell me more about the pain?
A complete description of the pain provides clues about the cause of the problem.
Although the nurse should ask whether the patient is pregnant to determine whether the
patient might have an ectopic pregnancy and before any radiology studies are done,
this information is not the most useful in determining the cause of the pain. The usual
diet and elimination patterns are less helpful in determining the reason for the patients
symptoms.
A patient complains of gas pains and abdominal distention two days after a small bowel
resection. Which nursing action is best to take?
a.Encourage the patient to ambulate.
b.Instill a mineral oil retention enema.
C.Administer the ordered IV morphine sulfate.
d.Offer the ordered promethazine (Phenergan) suppository. ✅a.Encourage the patient
to ambulate.
Ambulation will improve peristalsis and help the patient eliminate flatus and reduce gas
pain. A mineral oil retention enema is helpful for constipation with hard stool. A return-
flow enema might be used to relieve persistent gas pains. Morphine will further reduce
peristalsis. Promethazine (Phenergan) is used as an antiemetic rather than to decrease
gas pains or distention.
A 58-year-old man with blunt abdominal trauma from a motor vehicle crash undergoes
peritoneal lavage. If the lavage returns brown fecal drainage, which action will the nurse
plan to take next?
a.Auscultate the bowel sounds.
b.Prepare the patient for surgery.
C.Check the patients oral temperature.
d.Obtain information about the accident. ✅b.Prepare the patient for surgery.
,Return of brown drainage and fecal material suggests perforation of the bowel and the
need for immediate surgery. Auscultation of bowel sounds, checking the temperature,
and obtaining information about the accident are appropriate actions, but the priority is
to prepare to send the patient for emergency surgery.
A 27-year-old female patient is admitted to the hospital for evaluation of right lower
quadrant abdominal pain with nausea and vomiting. Which action should the nurse
take?
a.Encourage the patient to sip clear liquids.
b.Assess the abdomen for rebound tenderness.
C.Assist the patient to cough and deep breathe.
d.Apply an ice pack to the right lower quadrant. ✅d.Apply an ice pack to the right lower
quadrant.
The patients clinical manifestations are consistent with appendicitis, and application of
an ice pack will decrease inflammation at the area. Checking for rebound tenderness
frequently is unnecessary and uncomfortable for the patient. The patient should be NPO
in case immediate surgery is needed. The patient wil need to know how to cough and
deep breathe postoperatively, but coughing will increase pain at this time.
Which nursing action will be included in the plan of care for a 27-year-old male patient
with bowel irregularity and a new diagnosis of irritable bowel syndrome (IBS)?
a.Encourage the patient to express concerns and ask questions about IBS.
b.Suggest that the patient increase the intake of milk and other dairy products.
C.Educate the patient about the use of alosetron (Lotronex) to reduce symptoms.
d.Teach the patient to avoid using nonsteroidal antiinflammatory drugs (NSAIDs).
✅a.Encourage the patient to express concerns and ask questions about IBS.
Because psychologic and emotional factors can affect the symptoms for IBS,
encouraging the patient to discuss emotions and ask questions is an important
intervention. Alosetron has serious side effects, and is used only for female patients
who have not responded to other therapies. Although yogurt may be beneficial, milk is
avoided because lactose intolerance can contribute to symptoms in some patients.
NSAIDs can be used by patients with IBS.
A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy
abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to
a.administer IV metoclopramide (Reglan).
b.discontinue the patients oral food intake.
C.administer cobalamin (vitamin B12) injections.
d.teach the patient about total colectomy surgery. ✅b.discontinue the patients oral
food intake.
, An initial therapy for an acute exacerbation of inflammatory bowel disease (IBD) is to
rest the bowel by making the patient NPO. Metoclopramide increases peristalsis and
will worsen symptoms. Cobalamin (vitamin B12) is absorbed in the ileum, which is not
affected by ulcerative colitis. Although total colectomy is needed for some patients,
there is no indication that this patient is a candidate.
Which nursing action will the nurse include in the plan of care for a 35-year-old male
patient admitted with an exacerbation of inflammatory bowel disease (IBD)?
a.Restrict oral fluid intake.
b.Monitor stools for blood.
C.Ambulate four times daily.
d.Increase dietary fiber intake. ✅b.Monitor stools for blood.
Because anemia or hemorrhage may occur with IBD, stools should be assessed for the
presence of blood. The other actions would not be appropriate for the patient with IBD.
Because dietary fiber may increase gastrointestinal (GI) motility and exacerbate the
diarrhea, severe fatigue is common with IBD exacerbations, and dehydration may
occur.
Which patient statement indicates that the nurses teaching about sulfasalazine
(Azulfidine) for ulcerative colitis has been effective?
a.The medication will be tapered if I need surgery.
b.I will need to use a sunscreen when I am outdoors.
C.I will need to avoid contact with people who are sick.
d.The medication will prevent infections that cause the diarrhea. ✅b.I will need to use
a sunscreen when I am outdoors.
Sulfasalazine may cause photosensitivity in some patients. It is not used to treat
infections. Sulfasalazine does not reduce immune function. Unlike corticosteroids,
tapering of sulfasalazine is not needed.
A 22-year-old female patient with an exacerbation of ulcerative colitis is having 15 to 20
stools daily and has excoriated perianal skin. Which patient behavior indicates that
teaching regarding maintenance of skin integrity has been effective?
a.The patient uses incontinence briefs to contain loose stools.
b.The patient asks for antidiarrheal medication after each stool.
C.The patient uses witch hazel compresses to decrease irritation.
d.The patient cleans the perianal area with soap after each stool. ✅C.The patient uses
witch hazel compresses to decrease irritation.
Witch hazel compresses are suggested to reduce anal irritation and discomfort.
Incontinence briefs may trap diarrhea and increase the incidence of skin breakdown.
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