the nurse is irrigating a clients colostomy when she complains of abdominal cramping after receiving about 100 ml of the irrigating solution what shou
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Nursing Elites

ATI RN

Gastrointestinal System Nursing Exam Questions

1. The nurse is irrigating a client's colostomy when she complains of abdominal cramping after receiving about 100 mL of the irrigating solution. What should the nurse's first response be in this situation?

Correct answer: A

Rationale: The abdominal cramping that can occur during colostomy irrigation results from stimulation of the colon by the irrigating solution. The nurse's first response should be to temporarily stop the flow of solution to allow the cramping to subside. Repositioning the client to the right side will not alleviate the cramping. Removing the tube will not decrease the cramping and will necessitate reinsertion of the tube when the irrigation is resumed. Massaging the abdomen gently may be soothing to some clients, but it is not the nurse's first priority action.

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

Correct answer: B

Rationale: A barium enema is a diagnostic test used to visualize the colon and can help diagnose diverticulosis.

3. Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse would determine that this medication has had a therapeutic effect if which of the following is noted?

Correct answer: B

Rationale: Lactulose is prescribed for the client with hepatic encephalopathy to reduce bacterial breakdown of protein in the bowel. The medication creates an acidic environment in the bowel and causes the ammonia to leave the bloodstream and enter the colon. Ammonia then becomes trapped in the bowel. Lactulose also has a laxative effect that allows for the elimination of the ammonia.

4. Which of the following laboratory results would be expected in a client with peritonitis?

Correct answer: D

Rationale: A white blood cell count above 15,000 is indicative of an infection, such as peritonitis.

5. The client with a colostomy has an order for irrigation of the colostomy. The nurse used which solution for irrigation?

Correct answer: B

Rationale: Tap water at body temperature is generally used for colostomy irrigation unless the local water supply is not safe for drinking, in which case bottled water can be used.

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