Deck 41: Fecal Elimination

Question 1

The nurse is called to Mr.Martinez's room to assess his first bowel movement after surgery.While he has indicated feelings of urgency over the last few days,he has not had a bowel movement in 6 days.Upon investigation,the nurse finds a very small amount of liquid stool.What would the nurse conclude?

A)Mr.Martinez is constipated.
B)Mr.Martinez has fecal impaction.
C)Mr.Martinez has diarrhea.
D)Mr.Martinez has fecal incontinence.

Answer 1

Mr.Martinez has fecal impaction.

Question 2

Mrs.Beatty has been hospitalized to determine the cause of her right-sided epigastric pain.Which of the following assessment data would indicate compromised gastrointestinal function?

A)Bowel sounds active in all four quadrants
B)Clay colour stool
C)Increased appetite
D)Semisolid and moist stool

Answer 2

Clay colour stool

Question 3

The nurse is taking care of Mr.Alexander,who states that he ignores the urge to defecate when he is at work.What information can the nurse provide him about this practice?

A)If you continue to ignore the urge to defecate,the urge is ultimately lost.
B)It is best to suppress the urge than suffer embarrassment at work.
C)This is a common practice,and it will help strengthen the reflex.
D)The internal anal sphincter responds by stopping feces from progressing into the rectum.

Answer 3

If you continue to ignore the urge to defecate,the urge is ultimately lost.

Question 4

Forty-five year-old Ms.Allison has had multiple sclerosis for 20 years and has been confined to a wheelchair in an extended care unit for 5 years.Which of the following nursing diagnoses would be most appropriate for her?

A)Bowel incontinence
B)Constipation
C)Diarrhea
D)Grieving

Question 5

Mrs.Smith asks the nurse why it is more difficult to use a bedpan for defecating than sitting on the toilet.Which of the following is the best response?

A)Sitting on the toilet decreases the contractions of the muscles of the pelvic floor.
B)Sitting on the toilet increases the downward pressure on the rectum.
C)Sitting on the toilet increases the pressure within the abdomen.
D)Sitting on the toilet contracts the internal oblique muscles.

Question 6

Which of the following suggestions by the nurse would assist Mr.Adamson to maintain a normal fecal elimination pattern?

A)Drink two to four glasses of water daily
B)Include more spicy foods and sugar in the diet
C)Include more whole grains in the diet
D)Use enemas as necessary

Question 7

Mrs.Jackson asks the nurse what she can do about her frequent bouts of diarrhea.Which of the following is the best response by the nurse?

A)Change her daily routine
B)Decrease fluid consumption
C)Increase fibre in the diet
D)Note the precipitating event

Question 8

Mrs.Beauvert comes to the clinic with her 1-month-old infant.She tells the nurse that she is going to have to stop breast-feeding her daughter because her baby's stools are yellow.What is the nurse's best response?

A)"You are correct.Let's discuss this problem with your doctor."
B)"You really don't need to worry.It is normal for the baby's stools to be that colour."
C)"Do you feel that because your baby's stools are yellow that you are not providing adequate nutrition for her?"
D)"Yellow stools are normal in infants.Is there any other reason you feel you should quit breast-feeding?"

Question 9

The nurse has taught Mr.Johnson about measures to relieve his constipation.Which of the following outcome criteria is most appropriate for Mr.Johnson?

A)He will remain free of flatulence.
B)He will remain free of perianal irritation.
C)He will use bisacodyl daily to manage his constipation.
D)He will eat a diet that includes fibre and 8 to 10 glasses of fluid daily.

Question 10

Which of the following findings is indicative of fecal impaction?

A)Loss of desire to defecate
B)Constipation with liquid fecal seepage
C)Absence of stool upon digital rectal exam
D)Alternating patterns of normal stool and diarrhea

Question 11

What physiological changes occur that predispose the elderly to constipation?

A)Decreased control of the anal sphincter muscles
B)Diminished innervation of the internal sphincter
C)Inability to absorb fluid from the chyme in the colon
D)Loss of tone in the smooth muscle of the colon

Question 12

The nurse is collecting a stool specimen from a bedpan.Which of the following actions are indicated?

A)Wear sterile gloves and use a sterile specimen cup
B)Take the specimen to the laboratory at the end of the shift
C)Avoid contaminating the outside of the container with feces
D)Wear gloves,use a paper towel to remove and transfer the feces to the specimen cup

Question 13

Which of the following assessment skills would the RN perform first when examining Beatrice for fecal elimination problems?

A)Auscultation
B)Inspection
C)Palpation
D)Percussion

Question 14

Mr.Adamson is booked for a colonoscopy and requires a cleansing enema.What information does the nurse provide Mr.Adamson before administering the enema?

A)Hold the solution for a short time
B)Lie in the left lateral position
C)Lie in the right lateral position
D)Take quick breaths in through the nose

Question 15

Thirty-year-old Mrs.Shelley was diagnosed with cancer of the colon requiring a bowel resection and formation of a colostomy.Which of the following instructions will assist her in taking care of her colostomy?

A)Change the drainage pouch daily
B)Loose clothing will be needed now that a pouch is worn
C)Stick a pin into the drainage pouch to relieve any gas buildup
D)Secure the faceplate to the drainage pouch so no skin around the stoma is exposed

Question 16

Which of the following characteristics assessed by the nurse is considered normal for an adult's feces?

A)Black in colour
B)Cylindrical in shape
C)Pungent in odour
D)Yellow in colour

Question 17

Students in an anatomy and physiology class learn that there are three distinct types of movement in the large intestine.What do they learn is the reason for Haustral churning?

A)It aids in the absorption of water from the intestinal contents.
B)It is responsible for the promotion of peristalsis.
C)It regulates the flow of chyme into the large intestine.
D)It prevents the back flow of intestinal contents into the ileum.

Question 18

Which of the following clients is at greatest risk for developing constipation?

A)An adult who is on bed rest
B)An infant who is breast-fed
C)A school-age child at recess
D)A 2-year-old toddler

Question 19

Twenty-five year-old Mr.James has diarrhea.Which of the following goals would be appropriate for him?

A)He will have bowel movements regularly.
B)He will increase the amount of sugar in the diet.
C)He will limit fluid intake.
D)He will regain normal stool consistency.

Question 20

Mrs.Ramone has a problem with constipation and requires a cleansing enema.What action is expected of a hypertonic solution enema like sodium phosphate?

A)It exerts osmotic pressure and draws fluid from the interstitial space into the colon.
B)It exerts a lower osmotic pressure than the surrounding interstitial fluid.
C)It exerts the same osmotic pressure as the interstitial fluid surrounding the colon.
D)It stimulates peristalsis by increasing the volume in the colon and irritating the colon.

Question 21

Mrs.Ellinor is being administered an enema this morning.The nurse encounters resistance at the internal sphincter when inserting the enema tube into Mrs.Ellinor's rectum.What should the nurse do next?

A)Have Mrs.Ellinor take a deep breath and run a small amount of fluid through the tube
B)Raise the height of the container holding the solution to increase pressure
C)Withdraw the tube right away and report the resistance to the charge nurse
D)Withdraw the tube and re-insert it

Question 22

Mrs.McIsaac calls the clinic at 4 pm to report that her 6-month-old daughter has had four loose stools in 3 hours.The infant is irritable and has a slight fever.What should the nurse advise Mrs.McIsaac to do?

A)Make an appointment for her to be seen in the clinic the following day
B)The infant should be seen by a physician
C)Have Mrs.McIsaac give her infant a yogurt drink with probiotics
D)Restrict the infant's intake to clear fluids

Question 23

Mrs.McIsaac calls the health clinic for advice on how to care for her husband and 11-year-old son,who both have diarrhea.The nurse advises her to have her son and husband increase their fluid intake and limit their intake of whole wheat and whole grain breads and cereals.What is the most important reason for limiting the whole wheat and whole grain products?

A)These products will draw more water into the colon.
B)During bouts of diarrhea,dietary intake should be limited to fluids.
C)These products are not high enough in sodium and potassium to replace losses.
D)These products do not have a high enough probiotic content.

Question 24

Mr.Jorgen has chronic constipation.What would be the first step in initiating a bowel training program for Mr.Jorgen?

A)Administer a suppository
B)Increase the client's fluid intake
C)Increase the fibre in Mr.Jorgen's diet
D)Assess Mr.Jorgen's usual bowel habits

Question 25

Thirty-year-old Mrs.Shelley was diagnosed with cancer of the colon requiring a bowel resection and formation of a colostomy.Which of the following is a correct part of the procedure for changing Mrs.Shelley's ostomy appliance?

A)Don sterile gloves before removing the ostomy pouch
B)Peel the bag off quickly to decrease the amount of pain
C)Schedule the ostomy change for 30 to 45 minutes before meal time
D)Empty the pouch into a bedpan before removing the ostomy appliance

Question 26

The nurse has been teaching Mr.Georgson measures to prevent constipation.Which of the following changes implemented by Mr.Georgson would demonstrate the need for additional teaching?

A)He is using noncodeine-based analgesic for his arthritic pain.
B)He has increased intake of fruits and vegetables in his diet.
C)He swims 5 days a week for 1 hour.
D)He has increased his fluid intake to 1000 mL daily.

Question 27

Thirty-year-old Mrs.Shelley was diagnosed with cancer of the colon requiring a bowel resection and formation of a colostomy.When assessing Mrs.Shelley's stoma,the nurse notes that it is dark blue in colour.What should be the nurse's priority action?

A)Notify the physician immediately
B)Apply an antibiotic powder to the stoma surface
C)Use only hypoallergenic adhesive on the ostomy appliance
D)Remove the old Karaya wafer and apply a new one to the stoma area

Question 28

Ms.Percy is a student nurse who has just completed giving a tap water enema to her client.The client had a small bowel movement and states she stills feels full.What reason would the nurse give to Ms.Percy for why she wouldn't repeat the enema?

A)The action of this hypotonic solution may cause circulatory overload.
B)The action of this hypertonic solution may cause sodium retention.
C)It may cause irritation and damage to the intestinal mucosa.
D)Multiple enemas with isotonic solution may cause dehydration.