1. A nurse assesses a client who has appendicitis. Which clinical
manifestation should the nurse expect to find?
a. Severe, steady right lower quadrant pain
b. Abdominal pain associated with nausea and vomiting
c. Marked peristalsis and hyperactive bowel sounds
d. Abdominal pain that increases with knee flexion Correct
Answer ANS: A. Severe, steady right lower quadrant pain
Right lower quadrant pain, specifically at McBurneys point, is
characteristic of appendicitis. Usually if nausea and vomiting
begin first, the client has gastroenteritis. Marked peristalsis and
hyperactive bowel sounds are not indicative of appendicitis.
Abdominal pain due to appendicitis decreases with knee flexion.
1. A nurse cares for a client who is prescribed 5 mg/kg of
infliximab (Remicade) intravenously. The client weighs 110 lbs
and the pharmacy supplies infliximab 100 mg/10 mL solution.
How many milliliters should the nurse administer to this client?
(Record your answer using a whole number.) ____ mL Correct
Answer ANS: 25 mL
110 lb = 50 kg.
50 kg (5 mg/kg) = 250 mg. 250/100 x 10= 25 mL
1. After teaching a client with a parasitic gastrointestinal
infection, a nurse assesses the clients understanding. Which
statements made by the client indicate that the client correctly
understands the teaching? (Select all that apply.)
a. Ill have my housekeeper keep my toilet clean.
,b. I must take a shower or bathe every day.
c. I should have my well water tested.
d. I will ask my sexual partner to have a stool test.
e. I must only eat raw vegetables from my own garden. Correct
Answer ANS: B, C, D
Parasitic infections can be transmitted to other people. The client
himself or herself should keep the toilet area clean instead of
possibly exposing another person to the disease. Parasites are
transmitted via unclean water sources and sexual practices with
rectal contact. The client should test his or her well water and
ask sexual partners to have their stool examined for parasites.
Raw vegetables are not associated with parasitic gastrointestinal
infections. The client can eat vegetables from the store or a
home garden as long as the water source is clean.
10. A nurse cares for a client who is prescribed mesalamine
(Asacol) for ulcerative colitis. The client states, I am having
trouble swallowing this pill. Which action should the nurse take?
a. Contact the clinical pharmacist and request the medication in
suspension form.
b. Empty the contents of the capsule into applesauce or pudding
for administration.
c. Ask the health care provider to prescribe the medication as an
enema instead.
d. Crush the pill carefully and administer it in applesauce or
pudding. Correct Answer ANS: C. Ask the health care provider
to prescribe the medication as an enema instead
Asacol is the oral formula for mesalamine and is produced as an
enteric-coated pill that should not be crushed, chewed, or
broken. Asacol is not available as a suspension or elixir. If the
,client is unable to swallow the Asacol pill, a mesalamine enema
(Rowasa) may be administered instead, with a providers order.
10. The nurse is caring for a client who is prescribed
sulfasalazine. Which question would the nurse ask the client
before starting this drug?
a. "Are you taking Vitamin C or B?
b. "Do you have any allergy to sulfa drugs?"
c. "Can you swallow pills pretty easily?"
d. "Do you have insurance to cover this drug?" Correct Answer
ANS: B
Sulfasalazine is a sulfa drug given for clients who have
ulcerative colitis. However, it should not be given to those who
have an allergy to sulfa and sulfa drugs to prevent a
hypersensitivity reaction.
11. A nurse assesses a client who has ulcerative colitis and
severe diarrhea. Which assessment should the nurse complete
first?
a. Inspection of oral mucosa
b. Recent dietary intake
c. Heart rate and rhythm
d. Percussion of abdomen Correct Answer ANS: C. Heart rate
and rhythm
Although the client with severe diarrhea may experience skin
irritation and hypovolemia, the client is most at risk for cardiac
dysrhythmias secondary to potassium and magnesium loss from
severe diarrhea. The client should have her or his electrolyte
levels monitored, and electrolyte replacement may be necessary.
Oral mucosa inspection, recent dietary intake, and abdominal
, percussion are important parts of physical assessment but are
lower priority for this client than heart rate and rhythm.
11. A nurse assesses a client who has ulcerative colitis and
severe diarrhea. Which assessment would the nurse complete
first?
a. Inspection of oral mucosa
b. Recent dietary intake
c. Heart rate and rhythm
d. Percussion of abdomen Correct Answer ANS: C. Heart rate
and rhythm
Although the client with severe diarrhea may experience skin
irritation and hypovolemia, the client is most at risk for cardiac
dysrhythmias secondary to potassium and magnesium loss from
severe diarrhea. The client would have her or his electrolyte
levels monitored, and electrolyte replacement may be necessary.
Oral mucosa inspection, recent dietary intake, and abdominal
percussion are important parts of physical assessment but are
lower priority for this patient than heart rate and rhythm.
12. A nurse assesses a client with Crohns disease and colonic
strictures. Which clinical manifestation should alert the nurse to
urgently contact the health care provider?
a. Distended abdomen
b. Temperature of 100.0 F (37.8 C)
c. Loose and bloody stool
d. Lower abdominal cramps Correct Answer ANS: A.
Distended abdomen
The presence of strictures predisposes the client to intestinal
obstruction. Abdominal distention may indicate that the client
has developed an obstruction of the large bowel, and the clients
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