Page 1542 - Saunders Comprehensive Review For NCLEX-RN

Health Problem: Adult Health: Gastrointestinal: Lower GI Disorders
Priority Concepts: Clinical Judgment; Elimination
Reference: Lewis et al. (2017), p. 960.

551. Answer: 4

Rationale: A frequent complication that occurs following ileostomy is fluid and
electrolyte imbalance. The client requires constant monitoring of intake and output
to prevent this from occurring. Losses require replacement by intravenous infusion
until the client can tolerate a diet orally. Intestinal obstruction is a less frequent
complication. Fat malabsorption and folate deficiency are complications that could
occur later in the postoperative period.
Test-Taking Strategy: Note the strategic word, most. Also note the subject, an
ileostomy. Remember that ileostomy drainage is liquid, placing the client at risk for
fluid and electrolyte imbalance.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Gastrointestinal
Health Problem: Adult Health: Gastrointestinal: Lower GI Disorders
Priority Concepts: Clinical Judgment; Elimination
Reference: Lewis et al. (2017), p. 962.

552. Answer: 1

Rationale: IBS is a functional gastrointestinal disorder that causes chronic or
recurrent diarrhea, constipation, and/or abdominal pain and bloating. Dietary fiber
and bulk help produce bulky, soft stools and establish regular bowel elimination
habits. Therefore, the client should consume a high-fiber diet. Eating regular meals,
drinking 8 to 10 cups of liquid a day, and chewing food slowly help promote normal
bowel function. Medication therapy depends on the main symptoms of IBS. Bulk-
forming laxatives or antidiarrheal agents or other agents may be prescribed.
Test-Taking Strategy: Note the strategic words, need for further teaching. These
words indicate a negative event query and the need to select the incorrect client
statement. Think about the pathophysiology associated with IBS to answer correctly.
Also, note the word limit in option 1. With IBS, dietary fiber and bulk is important to
assist in controlling symptoms.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Adult Health: Gastrointestinal
Health Problem: Adult Health: Gastrointestinal: Lower GI Disorders
Priority Concepts: Client Education; Inflammation
Reference: Lewis et al. (2017), pp. 946, 949.

553. Answer: 1

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