Deck 49: Fecal Elimination

Question 1

The nurse determines that a client's fecal elimination is pale in color.This finding supports which client behavior obtained during the health history?

A)The client rarely eats animal protein,and ingests milk and cheese at several meals each day.
B)The client rarely eats fruits or vegetables.
C)The client uses laxatives routinely.
D)The client drinks 8 to 10 8-ounce glasses of water each day.

Answer 1

The client rarely eats animal protein,and ingests milk and cheese at several meals each day.

Question 2

A client asks the nurse why expelled flatus is foul-smelling.What should the nurse respond?

A)The actions of microorganisms within the gastrointestinal tract are responsible for the odor.
B)The client's emotions are causing the gas formation.
C)The sensory nerves in the rectum are being stimulated.
D)The client has swallowed too much air while eating.

Answer 2

The actions of microorganisms within the gastrointestinal tract are responsible for the odor.

Question 3

The nurse is instructing a client on ostomy care.What should be included in this teaching?

A)Change the drainage pouch daily.
B)Clothing of a special style 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.

Answer 3

Secure the faceplate to the drainage pouch so no skin around the stoma is exposed.

Question 4

After eating dinner,a client asks for help to get to the bathroom because of an extreme urge to defecate.The nurse realizes that the client has experienced which physiological function of the colon?

A)Flatus
B)Mass peristalsis
C)Haustral churning
D)Peristalsis

Question 5

A client has a history of an inconsistent fecal elimination pattern.What should the nurse instruct this client to improve this health problem?

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 desired.

Question 6

A client is prescribed to receive a cleansing enema.What should the nurse instruct the client prior to administering this 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 fast breaths through the nose.

Question 7

The nurse is taking care of a client who states that he ignores the urge to defecate when he is at work.Which response should the nurse make to explain why this practice should be changed?

A)"If you continue to ignore the urge to defecate,the urge is ultimately lost."
B)"It is best to suppress the urge rather than suffer embarrassment at work."
C)"This is a common practice,and it will strengthen the reflex later."
D)"You will get the urge later;don't worry."

Question 8

A client asks the RN why it is more difficult to use a bedpan for defecating than sitting on the toilet.Which would be the nurse's best response?

A)The sitting position decreases the contractions of the muscles of the pelvic floor.
B)The sitting position increases the downward pressure on the rectum,making it easier to pass stool.
C)The sitting position increases the pressure within the abdomen.
D)The sitting position inhibits the urge to urinate,allowing one to defecate.

Question 9

The nurse is preparing to assess a client's fecal elimination status.Which activity will the nurse complete during this assessment?

A)Obtain a nursing history.
B)Interpret results of diagnostic tests.
C)Perform a physical examination.
D)Set goals with the client.

Question 10

The nurse is identifying goals for a client experiencing diarrhea.What goal should the nurse select for this client?

A)Client will defecate regularly.
B)Client will increase the amount of sugar in the diet.
C)Client will limit fluid intake.
D)Client will regain normal stool consistency.

Question 11

Which assessment technique will the nurse use first when examining a client with a fecal elimination problem?

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

Question 12

A client is prescribed a saline enema.Because this solution is hypertonic,the nurse would expect the enema to cause which action?

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

Question 13

A client has a bowel movement of hard,dry,but formed stool.The nurse associates these characteristics with

A)bowel incontinence.
B)constipation.
C)diarrhea.
D)fecal impaction.

Question 14

The nurse is caring for a client who is experiencing constipation.Which client behavior indicates that teaching was effective?

A)The client continues to ask for his pain medication.
B)The client decreases his fluid consumption.
C)The client refuses to eat the bran flakes on his tray.
D)The client walks around the unit several times a day.

Question 15

The nurse is caring for a client who experiences frequent bouts of diarrhea.What should the nurse instruct the client to do?

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

Question 16

The nurse suspects that a client is experiencing compromised gastrointestinal function.What assessment data did the nurse use to make this clinical decision?

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

Question 17

The home care nurse is reviewing a list of clients prior to making visits.For which client should the nurse plan interventions to decrease the risk of 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 toddler who is now walking

Question 18

The nurse is caring for the stoma of a client who has a colostomy.Which action is the most appropriate?

A)Apply pressure over the stoma.
B)Clean the stoma and pat dry.
C)Dilate the stoma.
D)Scrub the stoma.

Question 19

The nurse determines that an adult client's feces are normal.What did the nurse assess to come to this conclusion?

A)Black in color
B)Cylindrical in shape
C)Pungent in odor
D)Yellow in color

Question 20

What nursing diagnosis should the nurse select as appropriate to address bowel evacuation for a client who is on bed rest?

A)Bowel Incontinence
B)Constipation
C)Diarrhea
D)Disturbed Body Image

Question 21

A client has received an oil retention enema.The nurse should instruct the client that the enema will take effect within

A)1 to 3 hours.
B)10 to 20 minutes.
C)5 to 10 minutes.
D)10 to 15 minutes.

Question 22

During morning care,a UAP notes that thick green drainage is seeping around the appliance of a client's new ostomy.What should the UAP have been instructed to do?

A)Clean around the drainage.
B)Remove the ostomy appliance and cover the stoma with toilet tissue.
C)Perform complete ostomy care.
D)Report the drainage to the nurse.

Question 23

The nurse is discussing different types of ostomy appliances with a client with a new ostomy.During this discussion,the nurse should keep in mind that an ostomy appliance should
Standard Text: Select all that apply.

A)be changed daily.
B)protect the skin.
C)collect stool.
D)control odor.
E)be open,so the client can empty it sporadically throughout the day.

Question 24

A client with an upper gastrointestinal disorder is experiencing seeping of liquid stool,anorexia,abdominal distention,nausea,and vomiting.The nurse suspects the client is experiencing

A)constipation.
B)diarrhea.
C)trapped flatus.
D)fecal impaction.

Question 25

A client has received a return-flow enema.What should the nurse document about this procedure?
Standard Text: Select all that apply.

A)Number of times the solution was changed.
B)Type of solution.
C)Length of time the solution was retained.
D)The amount,color,and consistency of the return.
E)Client relief of flatus and abdominal distention.

Question 26

The nurse has completed care with a client who has a new ostomy.What should the nurse document about the care provided?
Standard Text: Select all that apply.

A)Any change in stoma size
B)Condition of the skin around the stoma
C)Amount and type of drainage
D)Client's response to the procedure
E)Degree of bowel sounds after care provided

Question 27

An older client tells the nurse that in order to have a daily bowel movement,the client uses laxatives most days of the week.What should the nurse tell this client?
Standard Text: Select all that apply.

A)Normal patterns of elimination are different for everyone.
B)Increase fiber intake to 20-35 grams a day.
C)Engage in enjoyable exercise.
D)Ignore the urge to have a bowel movement.
E)Drink six to eight glasses of fluid daily.

Question 28

A client experiencing hard,dry feces is scheduled for an enema.The nurse recognizes that what type of solution would be best for the client?
Standard Text: Select all that apply.

A)Hypertonic
B)Hypotonic
C)Soapsuds
D)Oil retention
E)Isotonic

Question 29

A hospitalized client tells the nurse of the inability to have a bowel movement because "too many people are around." What should the nurse do to promote normal fecal elimination for this client?

A)Provide a laxative.
B)Assist the client to the bathroom to ensure privacy.
C)Restrict fluids.
D)Assist the client with ambulation.

Question 30

The nurse is delegating activities regarding fecal elimination to unlicensed assistive personnel (UAP).Which activity can UAP safely perform to meet a client's fecal elimination needs?

A)Provide a fracture pan to a client on bed rest.
B)Provide a client who has a fecal impaction and prolapsed rectum with a cleansing enema.
C)Change a client's ostomy device.
D)Irrigate a client's ostomy.

Question 31

A client recovering from abdominal surgery is demonstrating abdominal distention from trapped flatus.What can the nurse do to help this client?

A)Assist the client to move in bed.
B)Restrict fluids.
C)Obtain an order for a rectal tube.
D)Provide a diet rich in foods that create flatulence.

Question 32

A client has occasional bouts of constipation,and asks the nurse what can be done to prevent these episodes in the future.What should the nurse instruct the client to do?
Standard Text: Select all that apply.

A)Establish a regular exercise regimen.
B)Include high-fiber foods,such as vegetables,fruits,and whole grains,in the diet.
C)Maintain fluid intake of 2000 to 3000 mL a day.
D)Do not ignore the urge to defecate.
E)Use over-the-counter medications to treat constipation.

Question 33

During an assessment,the nurse notes that a client's stool is black.Which medication should the nurse consider as causing this client's change in stool color?
Standard Text: Select all that apply.

A)Iron
B)Aspirin
C)Antacids
D)Antibiotics
E)Pepto-Bismol

Question 34

The nurse is caring for a client with a fecal incontinence pouch.What should the nurse do when caring for this client?
Standard Text: Select all that apply.

A)Assess perianal skin.
B)Irrigate the pouch every shift.
C)Maintain the drainage system.
D)Change the bag every 72 hours.
E)Explain the purpose of the system to the client.

Question 35

While administering an enema,the client complains of abdominal cramping.What should the nurse do?

A)Raise the height of the solution container.
B)Clamp the flow for 30 seconds,and restart at a slower rate.
C)Discontinue the enema infusion.
D)Assist the client to a supine position.