Deck 44: Bowel Elimination

Question 1

A nurse is assisting a patient in making dietary choices that promote healthy bowel elimination.Which menu option should the nurse recommend?

A)Grape and walnut chicken salad sandwich on whole wheat bread.
B)Broccoli and cheese soup with potato bread.
C)Dinner salad topped with hard-boiled eggs,cheese,and fat-free dressing.
D)Turkey and mashed potatoes with brown gravy.

Answer 1

Grape and walnut chicken salad sandwich on whole wheat bread.

Question 2

The nurse should question which order?

A)A normal saline enema to be repeated every 4 hours until stool is produced.
B)A hypertonic solution enema with a patient with fluid volume excess.
C)A Kayexalate enema for a patient with hypokalemia.
D)An oil retention enema for a patient using mineral oil laxatives.

Answer 2

A Kayexalate enema for a patient with hypokalemia.

Question 3

The nurse knows that most nutrients are absorbed in which portion of the digestive tract?

A)Stomach.
B)Duodenum.
C)Ileum.
D)Cecum.

Answer 3

Duodenum.

Question 4

Which patient is most at risk for increased peristalsis?

A)A 5-year-old child who ignores the urge to defecate owing to embarrassment.
B)A 21-year-old patient with three final examinations on the same day.
C)A 40-year-old woman with major depressive disorder.
D)An 80-year-old man in an assisted-living environment.

Question 5

The nurse is preparing to perform a fecal occult blood test.The nurse plans to properly perform the examination by doing which of the following?

A)Applying liberal amounts of stool to the guaiac paper.
B)Not allowing patients to collect their own specimens
C)Reporting any abnormal findings to the care provider.
D)Applying sterile disposable gloves.

Question 6

Which physiological change can cause a paralytic ileus?

A)Chronic cathartic abuse.
B)Surgery with anaesthesia for Crohn's disease.
C)Suppression of hydrochloric acid from medication.
D)Fecal impaction.

Question 7

The nurse is devising a plan of care for a patient with the nursing diagnosis of Constipation related to opioid use.Which of the following outcomes would the nurse evaluate as successful for the patient to establish normal defecation?

A)The patient reports eliminating a soft,formed stool.
B)The patient has quit taking opioid pain medication.
C)The patient's lower left quadrant is tender to the touch.
D)The nurse hears bowel sounds in all four quadrants.

Question 8

A nurse is preparing a patient for magnetic resonance imaging (MRI).Which nursing action is most important?

A)Ensuring that the patient does not eat or drink 2 hours before the examination.
B)Removing all of the patient's metallic jewellery.
C)Administering a colon-cleansing product 12 hours before the examination.
D)Obtaining an order for a pain medication before the test is performed.

Question 9

A patient informs the nurse that she was using laxatives three times daily to lose weight.After stopping use of the laxative,the patient had difficulty with constipation and wonders if she needs to take laxatives again.With which statement does the nurse educate the patient?

A)"Long-term laxative use causes the bowel to become less responsive to stimuli,and constipation may occur."
B)"Laxatives can cause trauma to the intestinal lining and scarring may result,leading to decreased peristalsis."
C)"Natural laxatives such as mineral oil are safer than chemical laxatives for relieving constipation."
D)"Laxatives cause the body to become malnourished,so when the patient begins eating again,the body absorbs all of the food,and no waste products are produced."

Question 10

Fecal impactions occur in which portion of the colon?

A)Ascending.
B)Descending.
C)Transverse.
D)Rectum.

Question 11

Which nursing intervention is most effective in promoting normal defecation for a patient who has muscle weakness in the legs that prevents ambulation?

A)Elevating the head of the bed 45 degrees 60 minutes after breakfast.
B)Using a mobility device to place the patient on a bedside commode.
C)Giving the patient a pillow to brace against the abdomen while bearing down.
D)Administering a soapsuds enema every 2 hours.

Question 12

The nurse would anticipate which diagnostic examination for a patient with black,tarry stools?

A)Ultrasonography.
B)Barium enema study.
C)Upper endoscopy.
D)Flexible sigmoidoscopy.

Question 13

A patient with a hip fracture is having difficulty defecating into a bed pan while lying in bed.Which action by the nurse would assist the patient in having a successful bowel movement?

A)Administering laxatives to the patient.
B)Raising the head of the bed.
C)Preparing to administer a barium enema.
D)Withholding narcotic pain medication.

Question 14

Which of the following is not a function of the large intestine?

A)Absorbing nutrients.
B)Absorbing water.
C)Secreting bicarbonate.
D)Eliminating waste.

Question 15

The nurse knows that a bowel elimination schedule would be most beneficial in the plan of care for which patient?

A)A 40-year-old patient with an ileostomy.
B)A 25-year-old patient with Crohn's disease.
C)A 30-year-old patient with C.difficile infection.
D)A 70-year-old patient with stool incontinence.

Question 16

A patient expresses concerns over having black stool.The fecal occult test is negative.Which response by the nurse is most appropriate?

A)"This is probably a false-negative result;we should rerun the test."
B)"Do you take iron supplements?"
C)"You should schedule a colonoscopy as soon as possible."
D)"Sometimes severe stress can alter stool colour."

Question 17

The nurse has attempted to administer a tap water enema to a patient with fecal impaction,with no success.What is the next priority nursing action?

A)Preparing the patient for a second tap water enema.
B)Donning gloves for digital removal of the stool.
C)Positioning the patient on the left side.
D)Inserting a rectal tube.

Question 18

The nurse would expect the least formed stool to be present in which portion of the digestive tract?

A)Ascending.
B)Descending.
C)Transverse.
D)Sigmoid.

Question 19

The nurse is caring for a patient who is confined to the bed.The nurse asks the patient if he needs to have a bowel movement 30 minutes after eating a meal for what reason?

A)The digested food needs to make room for recently ingested food.
B)Ingestion of food triggers the digestive system to begin peristalsis.
C)The smell of bowel elimination in the room would deter the patient from eating.
D)More ancillary staff members are available after meal times.

Question 20

The nurse is emptying an ileostomy pouch for a patient.Which assessment finding would the nurse report immediately?

A)Liquid consistency of stool.
B)Presence of blood in the stool.
C)Noxious odour from the stool.
D)Continuous output from the stoma.

Question 21

The nurse administers a cathartic to a patient.The nurse determines that the cathartic has had a therapeutic effect when what happens?

A)The patient has a decreased level of anxiety.
B)The patient experiences pain relief.
C)The patient has a bowel movement.
D)The patient passes flatulence.

Question 22

The nurse should place the patient in which position when preparing to administer an enema?

A)Left Sims's position.
B)Fowler's.
C)Supine.
D)Semi-Fowler's.

Question 23

A nurse is caring for a patient who has had diarrhea for the past week.Which additional assessment finding would the nurse expect?

A)Increased energy levels.
B)Distended abdomen.
C)Decreased serum bicarbonate level.
D)Increased blood pressure.

Question 24

A nurse is caring for an older patient with fecal incontinence caused by cathartic use.The nurse is most concerned about which complication that carries the greatest risk for severe injury?

A)Rectal skin breakdown.
B)Contamination of existing wounds.
C)Falls from attempts to reach the bathroom.
D)Cross-contamination into the upper GI tract.

Question 25

The nurse is caring for a patient with Clostridium difficile infection.Which of the following nursing actions is most efficacious in preventing the spread of bacteria?

A)Monthly in-service education about contact precautions.
B)Placing all contaminated items in biohazard bags.
C)Mandatory cultures for all patients.
D)Proper hand hygiene techniques.

Question 26

The nurse is caring for a patient who had a colostomy placed yesterday.The nurse should report which assessment finding immediately?

A)Stoma is protruding from the abdomen.
B)Stoma is moist.
C)Stool is discharging from the stoma.
D)Stoma is purple.

Question 27

A patient had an ileostomy surgically placed 2 days ago.Which diet would the nurse recommend to the patient to ease the transition to use of the new ostomy?

A)Eggs over easy,whole wheat toast,and orange juice with pulp.
B)Chicken fried rice with stir fried vegetables and iced tea.
C)Turkey meatloaf with white rice and apple juice.
D)Fish sticks with macaroni and cheese and soda.

Question 28

A patient receives a diagnosis of bowel obstruction.The nurse chooses which type of tube for gastric decompression?

A)Salem sump.
B)Dobhoff.
C)Sengstaken-Blakemore.
D)Small bore.

Question 29

The nurse knows that the ideal time to change an ostomy pouch is when?

A)Before the patient eats a meal,when the patient is comfortable.
B)When the patient feels that he or she needs to have a bowel movement.
C)When ordered in the patient's chart.
D)After the patient has ambulated the length of the hallway.

Question 30

A nurse is educating a patient on how to irrigate an ostomy bag.Which statement by the patient indicates the need for further instruction?

A)"I can use a Fleet enema to save money because it contains the same irrigation solution."
B)"Sitting on the toilet lets the irrigation sleeve eliminate into the bowl."
C)"I should never attempt to reach into my stoma to remove fecal material."
D)"Using warm tap water will reduce cramping and discomfort during the procedure."

Question 31

A guaiac test has been ordered.The nurse knows that this is a test for which of the following?

A)Bright red blood.
B)Dark black blood.
C)Blood that contains mucus.
D)Blood that cannot be seen.

Question 32

The nurse is assessing a patient 2 hours after a colonoscopy.For this procedure,what focused assessment will the nurse include?

A)Bowel sounds.
B)Presence of flatulence.
C)Bowel movements.
D)Nausea.

Question 33

An older person's perineal skin appears to be dry and thin with mild excoriation.When providing hygiene after a bowel movement,what should the nurse do?

A)Thoroughly scrub the skin with a washcloth and hypoallergenic soap.
B)Apply a skin protective lotion after perineal care.
C)Tape an occlusive moisture barrier pad to the patient's skin.
D)Massage the skin with deep kneading pressure.

Question 34

A patient has constipation and hypernatremia.The nurse prepares to administer which type of enema?

A)Oil retention.
B)Carminative.
C)Saline.
D)Tap water.

Question 35

After a patient returns from a barium swallow study,what is the nurse's priority?

A)Encourage the patient to increase fluid intake to flush out the barium.
B)Monitor stools closely for bright red blood or mucus,which indicates trauma from the procedure.
C)Inform the patient that the bowel movements are radioactive and that the patient should be sure to flush the toilet three times.
D)Thicken all the patient's drinks to prevent aspiration.

Question 36

A nurse is providing discharge teaching for a patient who is going home with a guaiac test.Which statement by the patient indicates the need for further education?

A)"If I get a positive result,I have gastrointestinal bleeding."
B)"I should not eat red meat before my examination."
C)"I should schedule to perform the examination when I am not menstruating."
D)"I will need to perform this test three times if I have a positive result."

Question 37

The patient is seen in the gastroenterology clinic after having experienced changes in his bowel elimination.A colonoscopy is ordered,and the patient has questions about the examination.What information should the nurse give the patient before the colonoscopy?

A)No special preparation is required.
B)Light sedation is normally used.
C)No metallic objects are allowed.
D)Swallowing of an opaque liquid is required.