Deck 19: Bowel Elimination and Gastric Intubation

Question 1

A patient requires digital removal of a fecal impaction.Which action should the nurse perform before beginning this procedure?

A) Administer large-volume tap water enemas until clear.
B) Assist the patient into the dorsal recumbent position.
C) Check for an order from the healthcare provider.
D) Delegate the procedure to nursing assistive personnel (NAP).

Answer 1

Check for an order from the healthcare provider.

Question 2

A patient in skeletal traction for a fractured pelvis needs to use the bedpan.Which intervention should the nurse use to prevent complications?

A) Logroll the patient and maintain skeletal traction.
B) Place a bedpan under the patient while the hips are lifted.
C) Remove weights on the traction and turn the patient.
D) Warm the bedpan before placing it under the patient.

Answer 2

Place a bedpan under the patient while the hips are lifted.

Question 3

During the insertion of the nasogastric (NG)tube into a patient's left nares,the nurse meets strong resistance.What should the nurse have done to minimize the chance that this problem would occur?

A) Use a small-diameter tube.
B) Apply lubricant to the NG tube.
C) Instruct the patient to bear down.
D) Assess the patency of both nostrils.

Answer 3

Assess the patency of both nostrils.

Question 4

The nurse records a patient's intake and output for an 8-hour period and notes nasogastric (NG)tube irrigation with 50 mL of normal saline solution every 4 hours and lactulose syrup,30 mL,instilled through the NG tube with 30 mL of normal saline solution.Which total should the nurse record as the patient's intake over 8 hours?

A) 30 mL
B) 160 mL
C) 110 mL
D) 210 mL

Question 5

A home care patient has a history of fecal impaction.Which intervention does the nurse instruct the home health aide to implement to prevent another fecal impaction?

A) Provide the patient with low-residue foods.
B) Notify the provider of patient abdominal pain.
C) Administer a cleansing enema every 3 days.
D) Encourage and assist the patient to take additional fluids daily.

Question 6

The patient's nasogastric (NG)tube drains approximately 400 mL/day of yellow-green drainage.When the patient begins to complain of nausea,which intervention should the nurse implement first?

A) Irrigate the tube with 50 mL of water.
B) Assess the patency of the NG tube.
C) Replace the NG tube with a much larger tube.
D) Elevate the patient's head and reassess.

Question 7

During preparation for removal of a nasogastric (NG)tube,the patient becomes anxious.Which action should the nurse take to reassure the patient before removing the NG tube?

A) Grasp the tube and remove it quickly.
B) Medicate the patient with an analgesic.
C) Tell the patient this procedure is painless.
D) Inform the patient that it only takes a few seconds.

Question 8

The nurse is caring for four patients.Which patient's assessment information supports the nurse's decision to remove the nasogastric (NG)tube after the order by the healthcare provider is completed?

A) Restless, confused, without bowel sounds
B) Difficulty swallowing from left-sided stroke
C) Not passing gas with lack of appetite
D) Abdomen slightly rounded with incisional pain

Question 9

The nurse performs digital removal of a fecal impaction for a patient with atrial fibrillation and heart failure.Which is the most serious unexpected outcome that the nurse assesses during the procedure?

A) Rectal bleeding
B) Perianal redness
C) Liquid stool leakage after removal of the impaction
D) Abdominal cramping

Question 10

The patient is alert and cooperative for insertion of a nasogastric (NG)tube.In which position should the nurse place the patient for the procedure?

A) Sitting upright but leaning back slightly
B) In left lateral Sims' position with the head elevated
C) Leaning forward on the overbed table
D) Any position that is comfortable

Question 11

The nurse implements the teaching plan for a patient with chronic constipation.Which of the following outcomes indicates patient teaching has been effective?

A) The patient passes a small liquid stool daily.
B) The patient has a firm stool every fourth day.
C) The patient reports less frequent abdominal cramping.
D) The patient describes methods to prevent constipation.

Question 12

The nurse is inserting a nasogastric (NG)tube and assessing the patient during the procedure.Which assessment finding indicates a potentially serious problem?

A) Restlessness
B) Inability to speak
C) Nasal pressure
D) Mouth breathing

Question 13

The nurse assesses a patient during digital removal of a fecal impaction.Which patient assessment finding does the nurse determine to be unexpected?

A) Complaints of abdominal cramping
B) Large amount of brown, liquid stool
C) Blood pressure 130/86 mm Hg, stable
D) Heart monitor showing sinus bradycardia

Question 14

A patient is weak,has diarrhea,and is refusing to use the bedpan but is on bed rest and unable to get out of bed.Which is the best nursing intervention to maintain patient dignity?

A) Keep the bedpan out of the patient's sight until it is needed.
B) Reassure the patient that most people use the bedpan willingly.
C) Instruct the patient that the only alternative for elimination is to use the bedpan.
D) Explain to the patient how the nurse ensures privacy and safety when the patient is using the bedpan.

Question 15

The nurse determines a patient requires a fecal impaction removal.Which assessment result justifies the nurse's finding?

A) The patient exhibits rebound tenderness.
B) The patient experiences hard stool that cannot be passed.
C) The patient has a history of fecal impaction.
D) The patient denies having a bowel movement today.

Question 16

The nurse inserts a nasogastric (NG)tube to the measured length.Which method is the best way to confirm placement of the NG tube without an x-ray film?

A) Measure the pH of the gastric aspirate.
B) Ask the patient if the tube is comfortable.
C) Instill air and listen over the stomach.
D) Advance the tube past the measured length.

Question 17

The nurse performs digital removal of feces for a patient.Which patient diagnosis cues the nurse to assess the patient more frequently than usual during the procedure?

A) Abdominal pain
B) Atrial fibrillation
C) Urinary infection
D) Diabetes mellitus

Question 18

The nurse prepares to irrigate a patient's nasogastric (NG)tube after a colon resection.Which intervention does the nurse implement to irrigate the NG tube?

A) Observe sterile technique for each irrigation.
B) Inject 50 mL of warm tap water into the tube.
C) Gently instill 30 mL of normal saline solution.
D) Watch nursing assistive personnel (NAP) irrigate the NG tube.

Question 19

The nurse is providing routine care for a patient with a nasogastric (NG)tube.Care by the nurse is correct if which technique is used?

A) Alternates NG tube placement between the nares daily
B) Provides patient oral care daily and lubricant to the lips
C) Keeps the head of the bed flat with the tube in place
D) Prevents pressure on the nasal tissue

Question 20

The nurse prepares to insert a nasogastric (NG)tube into a patient.Which explanation does the nurse give to the patient to explain the use of the NG tube?

A) An NG tube eases distention and nausea.
B) The small, thin tube lubricates the stomach.
C) It causes peristalsis to return more quickly.
D) It prevents vomiting from ever occurring.

Question 21

The nurse is preparing to insert a nasogastric (NG)tube.Which techniques should the nurse use to measure the length of an NG tube before gastric intubation?

A) Measure and mark a point 72 cm (30 inches) from the end.
B) Measure from the nose to the middle of the sternum.
C) Measure from the nose to the ear to the patient's navel.
D) Measure from the nose to the earlobe to the xiphoid process.

Question 22

1. A ________ ________ device is a useful intervention for patients with severe fecal incontinence,such as those with Clostridium difficile-associated diarrhea.

Question 23

A patient's nasogastric tube needs to be irrigated.Which action does the nurse implement first to prevent complications?

A) Introduces 30 mL of sterile fluid
B) Verifies the placement of the tube
C) Aspirates gastric contents
D) Positions the patient on the left side

Question 24

During insertion of a nasogastric (NG)tube,the patient begins to cough and gag.Which intervention should the nurse implement for the patient's benefit?

A) Withdraw the tube slightly and ask the patient to swallow.
B) Stop the procedure, anchor the tube, and request an x-ray film.
C) Tell the patient that the gagging will pass, and advance the tube.
D) Remove the tube and allow the patient to regain composure.

Question 25

A right-handed nurse needs to remove the patient's nasogastric (NG)tube.Which intervention maintains patient safety during removal of the NG tube?

A) Leaving the suction on the low setting
B) Clamping and then pulling out the tube
C) Standing on the patient's left side
D) Asking the patient to inhale deeply

Question 26

2. When considering the application of a fecal containment device,it is important to assess the patient for ______ allergies.