Chapter 47 Practice Questions - Bowel Elimination

Question 1

The nurse is teaching a health class about the gastrointestinal tract. The nurse will explain that which portion of the digestive tract absorbs most of the nutrients?

a. Ileum
b. Cecum
c. Stomach
d. Duodenum

Answer 1

d. Duodenum

Question 2

The nurse is caring for patients with ostomies. In which ostomy location will the nurse expect very liquid stool to be present?

a. Sigmoid
b. Transverse
c. Ascending
d. Descending

Answer 2

c. Ascending

Question 3

A nurse is teaching a patient about the large intestine in elimination. In which order will the nurse list the structures, starting with the first portion?

a. Cecum, ascending, transverse, descending, sigmoid, and rectum
b. Ascending, transverse, descending, sigmoid, rectum, and cecum
c. Cecum, sigmoid, ascending, transverse, descending, and rectum
d. Ascending, transverse, descending, rectum, sigmoid, and cecum

Answer 3

a. Cecum, ascending, transverse, descending, sigmoid, and rectum

Question 4

The nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel (AP)?

a. Performing the first postoperative pouch change
b. Maintaining a nasogastric tube
c. Administering an enema
d. Digitally removing stool

Answer 4

c. Administering an enema

Question 5

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

a. Broccoli and cheese soup with potato bread
b. Turkey and mashed potatoes with brown gravy
c. Grape and walnut chicken salad sandwich on whole wheat bread
d. Dinner salad topped with hard-boiled eggs, cheese, and fat-free dressing

Answer 5

c. Grape and walnut chicken salad sandwich on whole wheat bread

Question 6

A patient is using laxatives 3 times daily to lose weight. After stopping laxative use, the patient has difficulty with constipation and wonders if laxatives should be taken again. Which information will the nurse share with 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. Long-term use of emollient laxatives is effective for treatment of chronic constipation and may be useful in certain situations.
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.

Answer 6

a. Long-term laxative use causes the bowel to become less responsive to stimuli, and constipation may occur.

Question 7

A patient recovering from a hip fracture is having difficulty defecating into a bedpan while lying in bed. Which action by the nurse will assist the patient in having a successful bowel movement?

a. Preparing to administer a barium enema
b. Withholding narcotic pain medication
c. Administering laxatives to the patient
d. Raising the head of the bed

Answer 7

d. Raising the head of the bed

Question 8

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 female with three final examinations on the same day
c. A 40-year-old female with major depressive disorder
d. An 80-year-old male in an assisted-living environment

Answer 8

b. A 21-year-old female with three final examinations on the same day

Question 9

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; we should rerun the test.”
b. “You should schedule a colonoscopy as soon as possible.”
c. “Are you under a lot of stress?”
d. “Do you take iron supplements?”

Answer 9

d. “Do you take iron supplements?”

Question 10

Which patient will the nurse assess most closely for an ileus?

a. A patient with a fecal impaction
b. A patient with chronic cathartic abuse
c. A patient with surgery for bowel disease and anesthesia
d. A patient with suppression of hydrochloric acid from medication

Answer 10

c. A patient with surgery for bowel disease and anesthesia

Question 11

A patient is experiencing a fecal impaction. Which portion of the colon will the nurse assess?

a. Descending
b. Transverse
c. Ascending
d. Rectum

Answer 11

d. Rectum

Question 12

The nurse is managing bowel training for a patient. To which patient is the nurse most likely providing care?

a. A 25-year-old patient with diarrhea
b. A 30-year-old patient with Clostridium difficile
c. A 40-year-old patient with an ileostomy
d. A 70-year-old patient with stool incontinence

Answer 12

d. A 70-year-old patient with stool incontinence

Question 13

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

a. Administer a soapsuds enema every 2 hours.
b. Use a mobility device to place the patient on a bedside commode.
c. Give the patient a pillow to brace against the abdomen while bearing down.
d. Elevate the head of the bed 20 degrees 60 minutes after breakfast while on bedpan.

Answer 13

b. Use a mobility device to place the patient on a bedside commode.

Question 14

The nurse is devising a plan of care for a patient with the nursing diagnosis of Constipation related to opioid use. Which outcome will 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.

Answer 14

a. The patient reports eliminating a soft, formed stool.

Question 15

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

a. Liquid consistency of stool
b. Presence of blood in the stool
c. Malodorous stool
d. Continuous output from the stoma

Answer 15

b. Presence of blood in the stool

Question 16

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

a. Ultrasound
b. Barium enema
c. Endoscopy
d. Anorectal manometry

Answer 16

c. Endoscopy

Question 17

The nurse has attempted to administer a tap water enema for a patient with fecal impaction with no success. The fecal mass is too large for the patient to pass voluntarily. Which is the next priority nursing action?

a. Preparing the patient for a second tap water enema
b. Obtaining an order for digital removal of stool
c. Positioning the patient on the left side
d. Inserting a rectal tube

Answer 17

b. Obtaining an order for digital removal of stool

Question 18

A nurse is checking orders. Which order should the nurse question?

a. A normal saline enema to be repeated every 4 hours until stool is produced
b. A hypertonic solution enema for a patient with fluid volume excess
c. A Kayexalate enema for a patient with severe hypokalemia
d. An oil retention enema for a patient with constipation

Answer 18

c. A Kayexalate enema for a patient with severe hypokalemia

Question 19

The nurse performing a fecal occult blood test should take what action?

a. Test the quality control section before testing the stool specimens.
b. Apply liberal amounts of stool to the guaiac paper.
c. Report a positive finding to the provider.
d. Don sterile disposable gloves.

Answer 19

c. Report a positive finding to the provider.

Question 20

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

a. Ensuring that the patient does not eat or drink 2 hours before the examination
b. Administering a colon cleansing product 6 hours before the examination
c. Obtaining an order for a pain medication before the test is performed
d. Removing all of the patient’s metallic jewelry

Answer 20

d. Removing all of the patient’s metallic jewelry

Question 21

A patient with a fecal impaction has an order to remove stool digitally. In which order will the nurse perform the steps, starting with the first one?

1. Obtain baseline vital signs.
2. Apply clean gloves and lubricate.
3. Insert index finger into the rectum.
4. Identify patient using two identifiers.
5. Place patient on left side in Sims’ position.
6. Massage around the feces and work down to remove.

a. 4, 1, 5, 2, 3, 6
b. 1, 4, 2, 5, 3, 6
c. 4, 1, 2, 5, 3, 6
d. 1, 4, 5, 2, 3, 6

Answer 21

a. 4, 1, 5, 2, 3, 6

Question 22

Before being administered a cleansing enema an 80-year-old patient says “I don’t think I will be able to hold the enema.” Which is the next priority nursing action?

a. Rolling the patient into right-lying Sims’ position
b. Positioning the patient in the dorsal recumbent position on a bedpan
c. Inserting a rectal plug to contain the enema solution after administering
d. Assisting the patient to the bedside commode and administering the enema

Answer 22

b. Positioning the patient in the dorsal recumbent position on a bedpan

Question 23

A nurse is providing care to a group of patients. Which patient will the nurse see first?

a. A child about to receive a normal saline enema
b. A teenager about to receive loperamide for diarrhea
c. A dehydrated older patient about to receive a hypertonic enema
d. A middle-aged patient with myocardial infarction about to receive docusate sodium

Answer 23

c. A dehydrated older patient about to receive a hypertonic enema

Question 24

A patient is diagnosed with a bowel obstruction. Which type of tube is the best for the nurse to obtain for gastric decompression?

a. Salem sump
b. Small bore
c. Levin
d. 8 Fr

Answer 24

a. Salem sump

Question 25

A patient had an ileostomy surgically placed 2 days ago. Which diet will the nurse recommend to the patient to ease the transition of the new ostomy? a. Eggs over easy, whole wheat toast, and orange juice with pulp b. Chicken fried rice with fresh pineapple and iced tea c. Turkey sandwich on whole wheat bread and iced tea d. Fish sticks with sweet corn and soda

Answer 25

c. Turkey sandwich on whole wheat bread and iced tea

Question 26

A nurse is pouching an ostomy on a patient with an ileostomy. Which action by the nurse is most appropriate? a. Changing the skin barrier portion of the ostomy pouch daily b. Emptying the pouch at least once every 7 days. c. Thoroughly cleansing the skin around the stoma with soap and water to remove excess stool and adhesive d. Measuring the correct size for the barrier device while leaving a 1/2-inch space around the stoma

Answer 26

b. Emptying the pouch at least once every 7 days.

Question 27

The nurse will irrigate a patient’s nasogastric (NG) tube. Which action should the nurse take? a. Instill solution into pigtail slowly. b. Check placement after instillation of solution. c. Immediately aspirate after instilling fluid. d. Prepare 60 mL of tap water into Asepto syringe.

Answer 27

c. Immediately aspirate after instilling fluid.

Question 28

The nurse administers a cathartic to a patient. Which finding helps the nurse determine that the cathartic has a therapeutic effect? a. Reports decreased diarrhea. b. Experiences pain relief. c. Has a bowel movement. d. Passes flatulence.

Answer 28

c. Has a bowel movement.

Question 29

An older adult’s perineal skin is dry and thin with mild excoriation. When providing hygiene care after episodes of diarrhea, what should the nurse do? a. Thoroughly scrub the skin with a washcloth and hypoallergenic soap. b. Tape an occlusive moisture barrier pad to the patient’s skin. c. Apply a skin protective ointment after perineal care. d. Massage the skin with light kneading pressure.

Answer 29

c. Apply a skin protective ointment after perineal care.

Question 30

Which action will the nurse take to reduce the risk of excoriation to the mucosal lining of the patient’s nose from a nasogastric tube? a. Instill Xylocaine into the nares once a shift. b. Tape tube securely with light pressure on nare. c. Lubricate the nares with water-soluble lubricant. d. Apply a small ice bag to the nose for 5 minutes every 4 hours.

Answer 30

c. Lubricate the nares with water-soluble lubricant.

Question 31

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 blue color that means the test is negative.” b. “I should not get any urine on the stool I am testing.” c. “If I eat red meat before my test, it could give me false results.” d. “I should check with my doctor to stop taking aspirin before the test.”

Answer 31

a. “If I get a blue color that means the test is negative.”

Question 32

A nurse is preparing to lavage a patient in the emergency department for an overdose. Which tube should the nurse obtain? a. Ewald b. Dobhoff c. Miller-Abbott d. Sengstaken-Blakemore

Answer 32

a. Ewald

Question 33

The nurse is caring for a patient diagnosed with C. difficile. Which nursing actions will have the greatest impact in preventing the spread of the bacteria? a. Appropriate disposal of contaminated items in biohazard bags b. Monthly inservices about contact precautions c. Mandatory cultures on all patients d. Proper hand hygiene techniques

Answer 33

d. Proper hand hygiene techniques

Question 34

A nurse is performing an assessment on a patient who has not had a bowel movement in 3 days. The nurse will expect which other assessment finding? a. Hypoactive bowel sounds b. Increased fluid intake c. Soft tender abdomen d. Jaundice in sclera

Answer 34

a. Hypoactive bowel sounds

Question 35

A nurse is caring for a patient who has had diarrhea for the past week. Which additional assessment finding will the nurse expect? a. Distended abdomen b. Increased skin dryness c. Increased energy levels d. Elevated blood pressure

Answer 35

b. Increased skin dryness

Question 36

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 flush with the skin. c. Stoma is purple. d. Stoma is moist.

Answer 36

c. Stoma is purple.

Question 37

A patient is receiving a neomycin solution enema. Which primary goal is the nurse trying to achieve? a. Prevent gaseous distention. b. Prevent constipation. c. Prevent colon infection. d. Prevent lower bowel inflammation.

Answer 37

c. Prevent colon infection.

Question 38

A guaiac test is ordered for a patient. Which type of blood is the nurse checking for in this patient’s stool? a. Bright red blood b. Dark black blood c. Microscopic d. Mucoid

Answer 38

c. Microscopic

Question 39

A patient is receiving opioids for pain. Which bowel assessment is a priority? a. C. difficile b. Constipation c. Hemorrhoids d. Diarrhea

Answer 39

b. Constipation

Question 40

Which nutritional instruction is a priority for the nurse to advise a patient about with an ileostomy? a. Keep fiber low. b. Eat large meals. c. Increase fluid intake. d. Chew food thoroughly.

Answer 40

c. Increase fluid intake.

Question 41

A nurse is preparing a bowel training program for a patient. Which actions will the nurse take? (Select all that apply.) a. Record times when the patient is incontinent. b. Help the patient to the toilet at the designated time. c. Lean backward on the hips while sitting on the toilet. d. Maintain normal exercise within the patient’s physical ability. e. Apply pressure with hands over the abdomen, and strain while pushing. f. Choose a time based on the patient’s pattern to initiate defecation-control measures

Answer 41

a. Record times when the patient is incontinent. b. Help the patient to the toilet at the designated time. d. Maintain normal exercise within the patient’s physical ability. f. Choose a time based on the patient’s pattern to initiate defecation-control measures

Question 42

A nurse is teaching a health class about colorectal cancer. Which information should the nurse include in the teaching session? (Select all that apply.) a. A risk factor is smoking. b. A risk factor is high intake of animal fats or red meat. c. A warning sign is rectal bleeding. d. A warning sign is a sense of incomplete evacuation. e. Screening with a colonoscopy is every 5 years, starting at age 50. f. Screening with flexible sigmoidoscopy is every 10 years, starting at age 50.

Answer 42

a. A risk factor is smoking. b. A risk factor is high intake of animal fats or red meat. c. A warning sign is rectal bleeding. d. A warning sign is a sense of incomplete evacuation.