Help Patients Defy Diverticular Disease
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* Read the article on pages 82–87.
* Take the test, recording your answers in the test answers section (Section B) of the CE enrollment form. Each question has only one correct answer.
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* A passing score for this test is 13 correct answers.
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Registration Deadline: June 30, 2014
The authors and planners have disclosed that they have no financial relationships related to this article.
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CE TEST QUESTIONS
General Purpose Statement
To provide registered professional nurses with an understanding of diverticular disease.
After reading this article and taking this test, you should be able to:
1. Explain the incidence, pathophysiology, signs and symptoms, and diagnosis of diverticular disease.
2. Outline the treatment of patients with diverticular disease and potential complications of the disease.
1. The areas most commonly affected by diverticula are the
a. descending and sigmoid colon.
b. ascending and transverse colon.
c. sigmoid colon and rectum.
d. transverse and descending colon.
2. Which statement is true regarding diverticulosis?
a. The incidence in men and women is 2:1.
b. Diverticulitis will develop in 10%–25% of persons with diverticulosis.
c. Roughly 65% of patients hospitalized for diverticulitis will require surgery.
d. Eighty percent of the population will have diverticulosis by age 80.
3. The pathophysiology and structural changes of diverticular disease include
a. long, narrow pouches in the transverse colon.
b. inward bulging of the colon.
c. elevated intraluminal pressure in the colon.
d. typically, 2–3 centimeter bulges.
4. Risk factors for diverticulosis include all of the following except
a. low fat intake.
b. overuse of laxatives.
c. consistent use of nonsteroidal anti-inflammatory medications.
5. Where do patients with uncomplicated diverticulitis typically complain of abdominal pain?
a. right lower quadrant
b. left upper quadrant
d. left lower quadrant
6. Symptoms of uncomplicated diverticulitis may include
a. low white blood cell count.
b. burning sensation in the pelvis.
c. urinary urgency with frequency.
d. epigastric tenderness.
7. Dysuria, pneumaturia, and fecaluria are symptoms of what diverticulitis complication?
a. bowel obstruction
b. a vesicosigmoid fistula
d. bowel abscess
8. Which of the following is a typical finding in patients with diverticulitis?
a. erythrocyte sedimentation rate > 30 mm/hr
b. amylase 60–80 U/L
c. potassium > 5.5 mEq/L
d. leukocytes < 10,000/mL
9. Marrs (2006) notes differential diagnoses for patients with diverticulitis symptoms include all of the following except
b. ulcerative colitis.
c. hemorrhagic ovarian cyst.
d. ectopic pregnancy.
10. After the initial bout of diverticulitis, the colon should not be biopsied for
a. 1–2 weeks.
b. 2–4 weeks.
c. 4–8 weeks.
d. 10–12 weeks.
11. Most patients with uncomplicated diverticulitis and mild symptoms are treated with
a. hospitalization and intravenous hydration.
b. antibiotics and a clear liquid diet.
c. bowel rest and nothing by mouth status.
d. colonoscopy and antibiotics.
12. Which statement is true regarding the treatment of diverticular disease?
a. A high fiber diet can reverse the effects of diverticular disease.
b. Ice packs are helpful in relieving abdominal discomfort.
c. The goal is to work up to a low-fat, higher fiber diet over 2–4 weeks.
d. Fiber adds bulk to stool, promoting defecation and increasing colonic pressure.
13. What is the recommended daily amount of fiber intake?
a. 5–10 grams
b. 10–15 grams
c. 15–25 grams
d. 25–35 grams
14. Which of the following is a pharmacologic intervention for diverticular disease?
a. anticholinergic agents to relieve colon spasms
b. antibiotics to cover gram-positive rods
c. morphine for pain management
d. antibiotics to cover aerobic organisms
15. Organ transplant recipients who have diverticular disease
a. have the same symptoms of the disease as persons in the general population.
b. suffer fewer postoperative complications.
c. require less surgical intervention.
d. are prone to more perforations.
16. Jesus' teaching example demonstrates that we must first
a. explain the positive aspects of the condition to patients.
b. understand the patient's understanding of their illness.
c. elaborate on effective treatment methods.
d. examine the effects of the disease on the patient's family.
17. Lifestyle recommendations provided in the article for persons with diverticulosis include
a. avoiding medication and food that can cause heartburn.
b. drinking 10–12 glasses of water per day.
c. avoiding excessive alcohol consumption.
d. exercising on a regular basis.
18. Which of the following foods contains the most fiber?
a. 1 cup of brown rice (cooked)
b. 1/2 cup of garbanzo beans
c. 1/2 cup of wheat bran
d. 1 cup of turnips