ATI LPN
Test Bank for Medical Surgical Nursing: Concepts for Interprofessional Collaborative Care 10th Edition
Chapter 57 : Care of Patients with Inflammatory Intestinal Disorders Questions
Question 1 of 5
After teaching a client with perineal excoriation caused by diarrhea from acute gastroenteritis, a nurse assesses the client's understanding. Which statement by the client indicates a need for additional teaching?
Correct Answer: B
Rationale:
Toilet paper can irritate sensitive perineal skin, so warm water rinses or a soft cotton washcloth should be used instead. Aloe vera is not effective for protecting skin from the excoriating effects of liquid stools. The other options describe appropriate care to prevent further irritation.
Question 2 of 5
After teaching a client who is prescribed adalimumab (Humira) for severe ulcerative colitis, the nurse assesses the client's understanding. Which statement by the client indicates a need for additional teaching?
Correct Answer: B
Rationale: Adalimumab (Humira) is administered via subcutaneous injection, not orally with meals. Avoiding crowds and sick individuals, recognizing nausea and vomiting as side effects, and practicing good hand hygiene are correct actions, as adalimumab causes immune suppression.
Question 3 of 5
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?
Correct Answer: C
Rationale: Asacol is an enteric-coated pill that should not be crushed, chewed, or broken, as this would disrupt its delayed-release mechanism. It is not available as a suspension or elixir. A mesalamine enema (Rowasa) is an alternative formulation that can be prescribed if the client cannot swallow the oral form.
Question 4 of 5
A nurse assesses a client who has ulcerative colitis and severe diarrhea. Which assessment should the nurse complete first?
Correct Answer: C
Rationale: Severe diarrhea can lead to hypovolemia and electrolyte imbalances, such as low potassium or magnesium, which may cause dysrhythmias. Assessing heart rate and rhythm is the priority to detect potential cardiac complications. Oral mucosa inspection, dietary intake review, and abdominal percussion are important but lower priority.
Question 5 of 5
A nurse assesses a client with Crohn's disease and colonic strictures. Which clinical manifestation should alert the nurse to urgently contact the health care provider?
Correct Answer: A
Rationale: Colonic strictures predispose the client to intestinal obstruction. A distended abdomen may indicate an obstruction, requiring urgent notification of the provider. Low-grade fever, loose and bloody stools, and abdominal cramps are common symptoms of Crohn's disease and do not require immediate intervention.