Deck 19: Nonaseptic Techniques

Question 1

After bedpan use,hygiene of the female patient's perineum is important.Proper cleansing of this region requires using gloves and several folded tissues to wipe the region

A)from the anus to the mons pubis.
B)transversely between gluteal folds.
C)from the mons pubis to the anus.
D)in circular motions.

Answer 1

C
The patient may require assistance in cleaning the perineum.For female patients,be sure to wipe from the mons pubis toward the rectal area to avoid contaminating the genital area.

Question 2

When performing a cleansing enema on an adult patient,

A)lukewarm water just above body temperature is used.
B)the patient is placed in the Sims position for enema tip insertion.
C)after the bowel is filled with liquid,generally more than 500 mL,the patient should rest quietly to allow the liquids to work.
D)all of the above are appropriate.

Answer 2

D
Cleansing enemas require that the water temperature is slightly above body temperature.The water used should be warmed to approximately 103° F (39° C).The patient is placed in the Sims position,and the administered enema fluid is allowed to flow in slowly.The patient should rest quietly on the table for at least 10 minutes before going to the toilet to expel the enema.This allows the fluids to work on the bowel walls and contents.

Question 3

Giving cleansing enemas "until clear" involves

A)giving two or three enemas until the bowel contents are free of fecal material.
B)administering enemas until the patient's state of hydration is at risk.
C)giving the patient cleansing enemas until his or her sinuses have drained.
D)asking the patient to hold the enema contents until the fluoroscopy schedule is open for the examination.

Answer 3

A
Preparation for some studies requires that a second or even a third enema be administered so that the bowel is thoroughly cleansed.This process is called "giving enemas until clear" and means that the enema fluid is expelled with no fecal matter present.

Question 4

For a single-contrast barium enema,

A)approximately 500 mL of barium is used for an adult.
B)air or carbon dioxide is used as a contrast agent.
C)spot images of the cecum,hepatic flexure,splenic flexure,and sigmoid are taken.
D)a postevacuation image is unnecessary.

Question 5

When performing a barium enema examination,

A)show the patient the entire volume of enema solution to prepare him or her for the study.
B)suspend the enema bag above the table at a height no greater than 30 inches.
C)continue emptying the barium solution as the patient cramps to encourage peristalsis.
D)encourage the patient to use short breaths or gasps and to tighten abdominal movements,similar to a bowel movement.

Question 6

Which of the following is a TRUE statement regarding cleansing enemas?

A)Oil retention enemas are used to "harden" stool material for more complete evacuation.
B)A hypertonic or Fleet enema is used for patients unable to handle large fluid enema volumes.
C)Hypotonic enemas can be performed repeatedly until the stool is clear.
D)An enema consisting of salt with approximately 500 mL of water is harmful to infants and should never be performed.

Question 7

All of the following are true of cleansing enemas EXCEPT

A)they are intended for the administration of enteric medications.
B)they promote the defecation reflex and discharge.
C)they are complete when bowel contents are clear and free of fecal matter.
D)there are several types of enemas,each with its own strengths and weaknesses.

Question 8

The most common type of nasogastric tube used for stomach decompression is the

A)Swan-Ganz catheter.
B)central venous pressure line.
C)peripherally inserted central catheter (PICC).
D)single-lumen Levin tube.

Question 9

Nasogastric (NG)tubes are inserted with the patient in the _____ position.

A)Sims'
B)high Fowler
C)Trendelenburg
D)recumbent,prone

Question 10

When transporting a patient with a NG tube to medical imaging,

A)confirm the suction pressure before disconnecting the tube.
B)make sure the NG tube is secured to the patient's nose.
C)confirm the allowable time for suction interruption.
D)do all of the above.

Question 11

The use of a water-soluble contrast agent such as Gastrografin for a colon examination is warranted for patients with

A)polyps.
B)a possible bowel perforation.
C)diverticulosis.
D)pancreatitis.

Question 12

As you begin to perform a hip examination on an elderly female patient who has undergone hip surgery,the patient states that she "needs to go to the bathroom." Which of the following should be done?
1)Use a standard bedpan.
2)Provide for the patient's privacy and locate a fracture bedpan.
3)Be sure to wear gloves and wash your hands.
4)If the bedpan is metallic,run it under warm water for patient comfort and throw it away after each use.
5)You and an assistant should assist the patient with movement onto the bedpan.
6)Return the patient to the nursing floor for cleanup and patient hygiene.

A)1,3,4,5,and 6 only
B)2,3,and 5 only
C)1,5,and 6 only
D)2,3,5,and 6 only

Question 13

To confirm the placement of an NG tube in its proper position,a physician may use

A)a syringe to remove gastric contents as proof.
B)fluoroscopy or radiography for visualization.
C)feedback from the patient by asking if he or she can feel it in the stomach.
D)both a and b.

Question 14

When working with a nonambulatory male patient who needs to void,

A)ask the patient how much assistance he feels he needs and allow him to use a urinal.
B)after the patient has voided,record the volume of urine in the patient's chart if documentation is required.
C)dispose of the urine in the toilet and rinse the urinal with cold water.
D)remove your disposable gloves,wash your hands,and place the soiled urinal in a receptacle for resterilization.
E) do all of the above.

Question 15

A common misunderstanding of patients regarding barium enemas is that

A)the actual barium enema examination is "just another cleansing enema."
B)the barium enema is all that is needed as a cleansing enema.
C)they will be asked to drink a chalky "milkshake" for the examination.
D)they will be expected to defecate during the examination for filming.

Question 16

To facilitate removal of a nasogastric tube,the patient is

A)sedated heavily.
B)encouraged to take a deep breath.
C)in the Trendelenburg position.
D)all of the above.

Question 17

NG tubes are inserted through the patient's _____ with the end of the tube placed in the _____.

A)mouth;duodenum
B)nasopharynx;stomach
C)mouth;ileum
D)oropharynx;stomach

Question 18

In many instances,cleansing enemas are self-administered by the patient before the examination.Instructions for a self-administered enema include
1)eating fruits and vegetables within 24 hours of the examination.
2)limiting water intake to prevent hydration.
3)using purgation mixtures.
4)eating a low-residue diet.
5)a clear liquid diet,including carbonated beverages,clear gelatin,clear broth,or coffee and tea with sugar.
6)administering a cleansing clear water enema.

A)1,2,4,5,and 6 only
B)3,4,5,and 6 only
C)2,3,5,and 6 only
D)1,3,4,and 6 only

Question 19

As you arrive into a patient's room for transport to radiology,you notice that the patient has an NG tube in place with a syringe upright and pinned to the gown.You should know that this patient

A)has a double-lumen NG tube in place.
B)has a Levine line that is single lumen.
C)must have the line clamped before transport.
D)Both a and c are correct.

Question 20

The administration of glucagon shortly before a double-contrast barium enema is intended to

A)increase liver function and the release of glycogen.
B)cause the gallbladder to empty.
C)relieve bowel spasm.
D)increase peristalsis to improve bowel motility.

Question 21

In preparation for a barium examination of a colostomy patient,it is important to

A)tell the patient to not take his or her bismuth anti-odor tablets before the examination.
B)understand the sensitivity of these patients to their condition and lifestyle change.
C)irrigate the stoma the night before and morning of the examination.
D)do all of the above.

Question 22

Postprocedural care for patients who have had a colon examination should include

A)instructions for maintaining hydration.
B)an increase in fluid intake and dietary fiber for a few days after the examination.
C)an awareness of the change in stool color to an ashen gray color and the importance of eliminating the barium during defecation.
D)all of the above.

Question 23

To allow tissue healing from a partial colon resection,

A)the patient is kept bedridden for the entire recovery period.
B)an external stoma is created to allow for defecation.
C)the patient will be kept on a liquid diet for the entire recovery period.
D)the patient's colon will be clamped off distal to the resection site.

Question 24

When a barium examination of an ostomy patient is performed,

A)the patient is imaged in the prone position.
B)it is important to prevent leakage of the barium around the stoma site.
C)glucagon is never given to such patients.
D)a larger volume of barium is used than in a conventional barium enema.

Question 25

The radiographic evaluation of the small and large bowel that has been connected to the skin surface as a substitute for the urinary bladder with an ostomy is typically called a(n)

A)stomogram.
B)fecagram.
C)loopogram.
D)ostomagram.