1. A nurse is collecting data from a client who has peptic ulcer disease. Which of the following finding is a manifestation of

gastrointestinal perforation?

A. Hyperactive bowelsounds

B. Severe upper abdominal pain

C. Report of epigastric fullness

D. Bradycardia

ANS: Severe upper abdominal pain.

Sudden, severe abdominal pain that radiatesto the shoulder is a manifestation of gastrointestinal perforation.

2. A nurse is reinforcing dietary teaching with a client who tellsthe nurse she would like to reduce her solid fat intake and increase oil

intake in her diet. Which of the following instructions should the nurse include in her teaching?

A. Replace tub margarine with stick margarine

B. Use safflower oil instead of butter when baking

C. Consume 2% or whole milk

D. Choose ground beef that is at least 80% lean meat

ANS: Use safflower oil instead of butter when baking

The client should replace butter with safflower oil when baking to decrease solid fats and increase oil intake.

3. A nurse is administering a tap water enema to a client. The client reports cramping as the nurse instills the irrigating solution.

Which of the following actions should the nurse take to relieve the client’s discomfort?

A. Lower the height of the solution container

B. Encourage the client to bear down

C. Allow the client to expelsome fluid before continuing

D. Stop the enema and document that the client did not tolerate the procedure

ANS: Lower the height of the solution container

If nausea or cramping occurs, the nurse should slow the flow of water, leaving the tube in place. The nurse should then raise the

solution container when the cramping has passed.

4. A nurse isreinforcing teaching with a client how has Cron’s Disease and is experiencing frequent cramping and diarrhea. Which of

the following statements should the nurse include in the teaching?

A. Increase your caloric intake by eating foods high in protein

B. Include fresh fruits and vegetables at each meal

C. Maintain your weight by eating high fat foods

D. Drink whole milk to ensure adequate calcium intake

ANS: Increase your caloric intake by eating foods high in protein

Clients who have Crohn's disease are at risk for malnutrition; therefore, they should eat a diet high in protein to help maintain their

weight and promote healing and recovery.

5. A nurse isreinforcing teaching with a client that reports having constipation. Which of the following should the nurse discuss as

causes of constipation? (Select all that apply)

A. Excessive laxative use

B. Ignoring the urge to defecate

C. Inadequate fluid intake

D. Increased fiber in the diet

E. Increased activity

ANS: Excessive laxative use. Chronic use of laxatives causes the large intestine to lose muscle tone and become less responsive to

stimulation by laxatives. Ignoring the urge to defecate. Anything that prevents the client from responding to the urge to

defecate and disrupts regular habits can cause possible alterations in bowel habits, such as constipation. Inadequate fluid