Chapter 29: Care of Patients with
Disorders of the Lower
Gastrointestinal System DeWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
MULTIPLE CHOICE
1.Which type of hernia can lead to necrosis?
a.Strangulate d hernia
b.Indirect hernia
c.Direct hernia
d.Irreducible hernia
ANS: A
The incarcerated hernia may become strangulated, which cuts off the blood supply and can lead to necrosis of the trapped bowel loop. Hernias are classified as reducible,
which means the protruding organ can be returned to its proper place by pressing on the organ, and irreducible, which means that the protruding part of the organ is tightly
wedged outside the cavity and cannot be pushed back through the opening. Another name for an irreducible hernia is incarcerated hernia. An indirect hernia protrudes through the inguinal ring. A direct hernia protrudes through the posterior inguinal wall.
PTS:1DIF: Cognitive Level: Knowledge REF: 676
OBJ:1 (theory) TOP: Incarcerated Hernia: Complications
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2.The nurse is caring for patient with a history of a chronic incarcerated hernia. The patient suddenly complains of abdominal pain and vomits dark material with a fecal odor. The nurse recognizes these signs as indications of which complication?
a.Complete intestinal obstruction
b.Rupture
c.Gastroenteritis
d.Duodenal ulcer
ANS: A
The symptoms of intestinal obstruction vary according to the location of the obstruction. Fecal odor or material in the emesis suggests a complete intestinal obstruction. In this case, the incarcerated hernia has blocked the flow of bowel content. If there is a defect in the muscular wall of the abdomen, the intestine may break through the defect; his protrusion is called a hernia or a rupture. Gastroenteritis is inflammation of the stomach and intestines. A duodenal ulcer occurs in the small intestine (the duodenum).
PTS:1DIF: Cognitive Level: Comprehension REF:671
OBJ:1 (theory) TOP: Incarcerated Hernia: Obstructions
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
3.The nurse explains that a hernioplasty is a surgery that involves which process?
a.Reducing the hernia by manual pressure.
b.Sewing synthetic mesh over the abdominal wall defect to reduce the hernia.
c.Applying an individualized truss for the reduction of the hernia.
d.Reducing the hernia and suturing the defect in the abdominal wall.
ANS: B
Hernioplasty is a surgical intervention in which the hernia is reduced and a synthetic mesh is sewn over the defect in the wall to prevent reoccurrence.
PTS:1DIF: Cognitive Level: Comprehension REF:676
OBJ:1 (theory) TOP: Hernia Repair: Hernioplasty
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
4.The nurse is caring for a patient whose home medications include bismuth subsalicylate (Pepto Bismol). The nurse should educate the patient about which side effect of this medication?
a.Pink urine
b.Sunburn-lik rash
c.Stained teeth
d.Black stools
ANS: D
This medication often turns the stool black. It does not cause a rash, or stain the urine or teeth.
PTS:1DIF: Cognitive Level: Comprehension REF: 667, Table 29-1
OBJ:2 (theory) TOP: Bismuth Subsalicylate: Side Effects
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
5.Which age-related change predisposes older adult patients to diverticula?
a.Loss of bowel tone reduces motility.
b.Chronic constipation increases intra-abdominal pressure and allows herniation.
c.The diet may be deficient in bulk.
d.Multipharmacy has altered bowel mucosa.
Disorders of the Lower
Gastrointestinal System DeWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
MULTIPLE CHOICE
1.Which type of hernia can lead to necrosis?
a.Strangulate d hernia
b.Indirect hernia
c.Direct hernia
d.Irreducible hernia
ANS: A
The incarcerated hernia may become strangulated, which cuts off the blood supply and can lead to necrosis of the trapped bowel loop. Hernias are classified as reducible,
which means the protruding organ can be returned to its proper place by pressing on the organ, and irreducible, which means that the protruding part of the organ is tightly
wedged outside the cavity and cannot be pushed back through the opening. Another name for an irreducible hernia is incarcerated hernia. An indirect hernia protrudes through the inguinal ring. A direct hernia protrudes through the posterior inguinal wall.
PTS:1DIF: Cognitive Level: Knowledge REF: 676
OBJ:1 (theory) TOP: Incarcerated Hernia: Complications
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2.The nurse is caring for patient with a history of a chronic incarcerated hernia. The patient suddenly complains of abdominal pain and vomits dark material with a fecal odor. The nurse recognizes these signs as indications of which complication?
a.Complete intestinal obstruction
b.Rupture
c.Gastroenteritis
d.Duodenal ulcer
ANS: A
The symptoms of intestinal obstruction vary according to the location of the obstruction. Fecal odor or material in the emesis suggests a complete intestinal obstruction. In this case, the incarcerated hernia has blocked the flow of bowel content. If there is a defect in the muscular wall of the abdomen, the intestine may break through the defect; his protrusion is called a hernia or a rupture. Gastroenteritis is inflammation of the stomach and intestines. A duodenal ulcer occurs in the small intestine (the duodenum).
PTS:1DIF: Cognitive Level: Comprehension REF:671
OBJ:1 (theory) TOP: Incarcerated Hernia: Obstructions
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
3.The nurse explains that a hernioplasty is a surgery that involves which process?
a.Reducing the hernia by manual pressure.
b.Sewing synthetic mesh over the abdominal wall defect to reduce the hernia.
c.Applying an individualized truss for the reduction of the hernia.
d.Reducing the hernia and suturing the defect in the abdominal wall.
ANS: B
Hernioplasty is a surgical intervention in which the hernia is reduced and a synthetic mesh is sewn over the defect in the wall to prevent reoccurrence.
PTS:1DIF: Cognitive Level: Comprehension REF:676
OBJ:1 (theory) TOP: Hernia Repair: Hernioplasty
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
4.The nurse is caring for a patient whose home medications include bismuth subsalicylate (Pepto Bismol). The nurse should educate the patient about which side effect of this medication?
a.Pink urine
b.Sunburn-lik rash
c.Stained teeth
d.Black stools
ANS: D
This medication often turns the stool black. It does not cause a rash, or stain the urine or teeth.
PTS:1DIF: Cognitive Level: Comprehension REF: 667, Table 29-1
OBJ:2 (theory) TOP: Bismuth Subsalicylate: Side Effects
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
5.Which age-related change predisposes older adult patients to diverticula?
a.Loss of bowel tone reduces motility.
b.Chronic constipation increases intra-abdominal pressure and allows herniation.
c.The diet may be deficient in bulk.
d.Multipharmacy has altered bowel mucosa.
