Deck 30: Promoting Bowel Elimination

Question 1

A patient scheduled for bowel surgery has an order to receive enemas until clear. The nurse is aware that no more than three enemas should be given because:

A) repeated enemas may cause more flatus.
B) the patient may develop an irritated rectum.
C) repeated enemas may cause electrolyte imbalance.
D) the patient may develop severe diarrhea.

Answer 1

repeated enemas may cause electrolyte imbalance.

Question 2

A patient calls the nurse at the health clinic and reports that since his trip to Mexico, he has been experiencing diarrhea. The nurse suggests he try the antidiarrheal drug:

A) docusate sodium (Colace).
B) loperamide (Imodium).
C) polycarbophil (FiberCon).
D) senna (Senokot).

Answer 2

loperamide (Imodium).

Question 3

A patient has just completed a series of upper gastrointestinal tract radiographs that involved the use of barium as a contrast agent. Which measure will this patient need to help excrete the barium?

A) Diuretics and fluid restriction to 1.5 L
B) Diuretics and fluid intake increased to 3.5 L
C) Laxatives and fluid restriction to 1.5 L
D) Laxatives and fluid intake increased to 3.5 L

Answer 3

Laxatives and fluid intake increased to 3.5 L

Question 4

A patient who is badly constipated has just received an oil retention enema. The nurse encourages this patient to try to hold the enema for at least how long before trying to have a bowel movement?

A) 10 minutes
B) 15 minutes
C) 20 minutes
D) 40 minutes

Question 5

The nurse should plan interventions to combat constipation in a patient:

A) being treated for diabetes mellitus.
B) who has a routine order for Metamucil.
C) who just completed barium studies of the bowel.
D) with orders to ambulate with assistance.

Question 6

The nurse has documented that a patient has had two episodes of steatorrhea, which means that the character of the stool is:

A) hard and clay colored.
B) frothy and foul smelling.
C) very liquid and streaked with blood.
D) soft and filled with mucus.

Question 7

A patient with a new colostomy should have the hole in the faceplate cut to allow _____ inch around the stoma.

A) 1 1/4
B) 1
C) 1/2
D) 1/4

Question 8

A nurse has performed abdominal assessments on four patients. After reviewing the findings, the nurse is least concerned about problems with bowel elimination for the patient with:

A) abdomen nondistended, firm, with hypoactive bowel sounds in all four quadrants.
B) abdomen nondistended, soft, with active bowel sounds in all four quadrants.
C) abdomen distended, firm, with hypoactive bowel sounds in all four quadrants.
D) abdomen distended, soft, with hyperactive bowel sounds in all four quadrants.

Question 9

An ambulatory clinic patient telephones to report diarrhea and to ask for advice on medication to manage it. The best response by the nurse is, "Do not use antidiarrheal medication for longer than:

A) 24 hours without calling back for an appointment."
B) 48 hours without calling back for an appointment."
C) 72 hours without calling back for an appointment."
D) 96 hours without calling back for an appointment."

Question 10

An older adult patient who routinely takes the bulk forming laxative psyllium (Metamucil) is counseled by the home health nurse that in order to prevent constipation and possible fecal impaction, this patient should be sure to take:

A) extra vitamin C.
B) a fat-soluble vitamin.
C) the medication with a large amount of fluid.
D) an over the counter antacid.

Question 11

A nurse is digitally removing a fecal impaction from a patient. The nurse should stop the procedure immediately and take corrective action if the patient's:

A) blood pressure increases from 110/84 to 118/88 mm Hg.
B) pulse rate decreases from 78 to 52 beats/min.
C) respiratory rate increases from 16 to 24 breaths/min.
D) temperature increases from 98.8° F to 99.0° F.

Question 12

A patient who has started antibiotic therapy is having diarrhea as a side effect of the medication. The nurse should encourage the patient to eat:

A) yogurt.
B) raisins.
C) gelatin fruit flavored dessert (eg, Jell O).
D) poultry.

Question 13

There is an order to administer a cleansing enema to an adult patient before bowel surgery. The nurse will fill the enema bag with how many milliliters of fluid for this procedure?

A) 500 to 1000 mL
B) 300 to 500 mL
C) 200 to 300 mL
D) 50 to 150 mL

Question 14

The nurse caring for a patient with lactose intolerance would anticipate the need to offer interventions for:

A) diarrhea.
B) steatorrhea.
C) constipation.
D) hemorrhoid discomfort.

Question 15

The nurse has assessed that a patient's stool has changed from brown to dark black and sticky. The nurse suspects:

A) blockage of the bile duct.
B) blockage of the pancreatic duct.
C) recent excessive intake of milk products.
D) presence of occult blood.

Question 16

A nurse is assisting a patient with a new continent ileostomy to catheterize the internal reservoir to drain the ileostomy. When the catheter meets resistance from the internal valve, the nurse should:

A) have the patient take a deep breath and apply gentle pressure over the area.
B) withdraw the catheter and start again with a new one.
C) ask the patient to bear down and hold her breath.
D) coat the opening with petroleum jelly or a water soluble lubricant.

Question 17

A nurse is monitoring bowel elimination of a patient who has a history of constipation. The nurse implements measures to assist with bowel elimination if the patient has not had a bowel movement within how many days?

A) 5
B) 3
C) 2
D) 1

Question 18

A nurse is reinforcing education with a patient who will begin a bowel training program. An intervention this program does not include is:

A) regularly scheduled time for toileting.
B) fluid intake of at least 1500 mL daily.
C) use of a suppository.
D) use of an enema.

Question 19

An older adult resident in a long-term care facility has experienced constant diarrhea for 3 days and is now exhibiting signs and symptoms of dehydration. The nurse initiates an intervention to offer small amounts of ________ frequently.

A) a cola beverage
B) ginger ale
C) Gatorade
D) Kool-Aid

Question 20

A nurse is preparing a cleansing enema for an adult patient who is constipated and has not responded to laxative use. Before giving the enema, the nurse should:

A) cool the solution to 70° F.
B) warm the solution in the microwave.
C) keep the solution at room temperature.
D) warm the solution to 105° F.

Question 21

A nurse is caring for a patient who had bowel surgery 3 days ago and is now beginning to have a well-functioning ostomy. The ostomy drainage bag should be emptied whenever it is:

A) one fourth full.
B) one half full.
C) three fourths full.
D) full.

Question 22

A patient with a colostomy asks about foods that can be eaten that will reduce odor in the ostomy drainage bag. The most informative response by the nurse is to say that ostomy odor can be decreased with the intake of:

A) buttermilk.
B) eggs.
C) cucumbers.
D) beans.

Question 23

The nurse instructs a patient with a new colostomy against eating food that may cause an obstruction. These foods include: (Select all that apply.)

A) spicy foods.
B) whole kernel corn.
C) cucumbers.
D) tomatoes.
E) shrimp.

Question 24

The nurse reminds the patient that digestion of food is a complex process with much of the food breaking down in intestines. The small intestine functions to:

A) reabsorb sodium and chlorides.
B) propel waste material toward the anus.
C) absorb food substances from the bloodstream.
D) return water from the waste material to the bloodstream.

Question 25

The gastrocolic reflex initiates ________.

Question 26

The nurse instructs the patient who has had an ileostomy to modify the diet to include: (Select all that apply.)

A) increase the protein intake.
B) choose foods that are high in calories.
C) select foods that have a milk base.
D) eat raw vegetables and fruits.
E) include whole grain products in diet daily.

Question 27

The nurse assesses a pale, light gray stool and recognizes that the cause of this abnormal color is due to an obstruction in the _________ duct.

Question 28

The patient with the new colostomy is concerned about how to control diarrhea of the effluent. The nurse suggests that diarrhea can be controlled by the intake of:

A) cheese.
B) apple juice.
C) raw vegetables.
D) beams.

Question 29

The nurse caring for a patient who had a colostomy 2 days ago assesses slight bleeding around the stoma when the area is cleansed, colostomy bag filled with gas, pale stoma, and a reddened area under the adhesive of the appliance. The assessment that should be reported immediately is the assessment pertaining to the:

A) skin irritation.
B) bleeding around the stoma.
C) amount of gas in the bag.
D) pale stoma.

Question 30

The nurse is caring for an anxious patient who is scheduled for surgery for colostomy placement. While the nurse is talking to the patient, the patient states, "I am so scared." The nurse's most supportive response would be:

A) "Surgeries like yours are very safe."
B) "What about your colostomy scares you?"
C) "Why are you scared?"
D) "Sounds like someone has been telling you horror stories."

Question 31

The patient asks the nurse how an ileostomy differs from a colostomy. The most informative response by the nurse would be that:

A) an ileostomy is performed to remove stool from the colon, whereas a colostomy is the removal of lower portions of bowel, diverting intestinal contents.
B) an ileostomy has effluent that is more formed, whereas a colostomy has effluent that is liquid.
C) a colostomy is an opening into the colon, whereas an ileostomy is an opening at the ileum.
D) an ileostomy requires irrigating, whereas a colostomy requires catheterizing.

Question 32

The nurse points out that age-related changes in the intestinal tract are relatively insignificant. The changes include: (Select all that apply.)

A) atrophy of the villi in the small intestine.
B) increased incidence of hemorrhoids.
C) decreased absorption of fats and vitamin B₁₂.
D) creation of excessive flatus.
E) decreased motility in the large intestine.

Question 33

The nurse reminds a group of older adults that a colonoscopy is recommended every _______ year(s) after the age of 50.