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MEDICAL-SURGICAL NURSING QUIZ 9 WITH ANSWERS AND RATIONALE

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Which of the following tests should be administered to a client suspected of having diverticulosis?

Correct! Wrong!

A barium enema will cause diverticula to fill with barium and be easily seen on x-ray. An abdominal US can tell more about structures, such as the gallbladder, liver, and spleen, than the intestine. A barium swallow and gastroscopy view upper GI structures.

Which of the following complications is thought to be the most common cause of appendicitis?

Correct! Wrong!

A fecalith is a fecal calculus, or stone, that occludes the lumen of the appendix and is the most common cause of appendicitis. Bowel wall swelling, kinking of the appendix, and external occlusion, not internal occlusion, of the bowel by adhesions can also be causes of appendicitis.

Which of the following mechanisms can facilitate the development of diverticulosis into diverticulitis?

Correct! Wrong!

Undigested food can block the diverticulum, decreasing blood supply to the area and predisposing the area to invasion of bacteria. Chronic laxative use is a common problem in elderly clients, but it doesn’t cause diverticulitis. Chronic constipation can cause an obstruction—not diverticulitis. Herniation of the intestinal mucosa causes an intestinal perforation.

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Which of the following terms best describes the pain associated with appendicitis?

Correct! Wrong!

The pain begins in the epigastrium or periumbilical region, then shifts to the right lower quadrant and becomes steady. The pain may be moderate to severe.

Which of the following definitions best describes diverticulosis?

Correct! Wrong!

Diverticulosis involves a noninflamed outpouching of the intestine. Diverticulitis involves an inflamed outpouching. The partial impairment of forward flow of the intestine is an obstruction; abnormal protrusion of an organ is a hernia.

Which of the following types of diets is implicated in the development of diverticulosis?

Correct! Wrong!

Low-fiber diets have been implicated in the development of diverticula because these diets decrease the bulk in the stool and predispose the person to the development of constipation. A high-fiber diet is recommended to help prevent diverticulosis. A high-protein or low-carbohydrate diet has no effect on the development of diverticulosis.

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Which of the following nursing interventions should be implemented to manage a client with appendicitis?

Correct! Wrong!

The focus of care is to assess for peritonitis, or inflammation of the peritoneal cavity. Peritonitis is most commonly caused by appendix rupture and invasion of bacteria, which could be lethal. The client with appendicitis will have pain that should be controlled with analgesia. The nurse should discourage oral intake in preparation for surgery. Discharge teaching is important; however, in the acute phase, management should focus on minimizing preoperative complications and recognizing when such may be occurring.

Which of the following symptoms indicated diverticulosis?

Correct! Wrong!

Diverticulosis is an asymptomatic condition. The other choices are signs and symptoms of diverticulitis.

Which of the following substances is most likely to cause gastritis?

Correct! Wrong!

NSAIDS are a common cause of gastritis because they inhibit prostaglandin synthesis. Milk, once thought to help gastritis, has little effect on the stomach mucosa. Bicarbonate of soda, or baking soda, may be used to neutralize stomach acid, but it should be used cautiously because it may lead to metabolic acidosis. ASA with enteric coating shouldn’t contribute significantly to gastritis because the coating limits the aspirin’s effect on the gastric mucosa.

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Which of the following definitions best describes gastritis?

Correct! Wrong!

Gastritis is an inflammation of the gastric mucosa that may be acute (often resulting from exposure to local irritants) or chronic (associated with autoimmune infections or atrophic disorders of the stomach). Erosion of the mucosa results in ulceration. Inflammation of a diverticulum is called diverticulitis; reflux of stomach acid is known as gastroesophageal disease.

MEDICAL-SURGICAL NURSING QUIZ 9 WITH ANSWERS AND RATIONALE
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