Deck 34: Bowel Elimination

Question 1

Which type of enema usually is ordered for an infant?

A) Tap water
B) Hypertonic
C) Oil retention
D) Physiological normal saline

Answer 1

Physiological normal saline

Question 2

The nurse evaluates that further teaching is required if,during digital removal of feces,the new staff nurse:

A) Provides perianal skin care
B) Continues the procedure if bleeding starts
C) Follows the procedure by offering the patient the bedpan
D) Discontinues the procedure in the presence of bradycardia

Answer 2

Continues the procedure if bleeding starts

Question 3

The patient has been found to have a severe fecal impaction.What must the nurse do to address this problem?

A) Administer laxatives
B) Provide a high-fiber diet
C) Perform a digital removal
D) Administer an enema

Answer 3

Perform a digital removal

Question 4

The nurse has been directed to provide an enema for an elderly female patient who has very poor rectal sphincter control.Which position is the most appropriate position for this patient?

A) Sims' position
B) Dorsal recumbent position on the bedpan
C) Sitting on the toilet
D) Right lateral position

Question 5

What should the nurse do when assisting the patient to use a metal bedpan?

A) Lower the patient's head
B) Remove abduction pillows
C) Push the pan under the patient's hips
D) Place the bedpan under warm water before use

Question 6

The nurse is preparing to administer an enema to an adult patient who has normal sphincter control.For administration of the enema,the patient is placed in which position?

A) Right side-lying position
B) Dorsal recumbent position
C) Sims' position
D) Prone position

Question 7

The patient is a 74-year-old man who has been in the hospital for 4 days following an orthopedic surgical procedure.He is concerned because he has not moved his bowels every day as he did before surgery,but every other day.What action should the nurse take?

A) Tell the patient to put himself on over-the-counter laxatives
B) Tell the patient that daily bowel movements are not always necessary
C) Tell the patient that with increasing age, his bowel movements should increase in frequency
D) Tell the patient that she will call to get a laxative to get him back on track

Question 8

The patient is being prepped for surgery and has an order for "enemas until clear." The nurse realizes that she will be giving a maximum of how many enemas?

A) One
B) Two
C) Three
D) Four

Question 9

During the enema instillation,the patient experiences cramping.What action should the nurse take?

A) Discontinue the procedure
B) Increase the height of the solution
C) Slow the rate of the infusion
D) Have the patient roll into a supine position

Question 10

An appropriate technique for the nurse to implement during NG tube insertion is to:

A) Rotate the tube if resistance is felt
B) Advance the tube in between swallows
C) Start with the patient's head flexed
D) Check the tube placement by instilling air and auscultating over the stomach

Question 11

The patient having a nasogastric (NG)tube inserted is disoriented.What action should the nurse take?

A) Halt the procedure
B) Request assistance with insertion
C) Administer a hypnotic medication
D) Continue the procedure as with any other patient

Question 12

How far should the nurse insert the tube or nozzle of a prepared enema into an adult patient?

A) 1 to 1½ inches
B) 2 to 3 inches
C) 3 to 4 inches
D) 4 to 5 inches

Question 13

Stool softeners often are prescribed for which of the following patients? (Select all that apply.)

A) Patients who have had gynecological surgery
B) Patients with a history of cardiovascular disease
C) Patients with glaucoma
D) Patients who have had rectal surgery
E) None of above

Question 14

Which action should the nurse take when irrigating the patient's Salem sump tube?

A) Instill 10 mL of normal saline
B) Aspirate contents quickly
C) Instill 10 mL of air into the blue pigtail
D) Instill 10 mL of saline into the blue pigtail

Question 15

Which of the following patient conditions requires the nurse to exercise additional caution during the digital removal of feces?

A) Heart disease
B) Abdominal pain
C) Urinary infection
D) Diabetes mellitus

Question 16

An appropriate measure for the nurse to implement for the patient with a nasogastric (NG)tube in place is to:

A) Tape the tube up and around the ear on the side of insertion
B) Secure the tubing to the bed by the patient's head
C) Mark the tube where it exits the nose
D) Change the tubing daily

Question 17

The nurse is caring for a patient who has been on bed rest for several weeks.The nurse notes that the patient is continually seeping liquid stool rectally.What action should the nurse take?

A) Hold the patient's antibiotics
B) Put the patient on a bran diet
C) Perform a digital rectal examination
D) Increase the dosage of the patient's antibiotics

Question 18

Which of the following is an appropriate procedure for the nurse to implement while administering an enema?

A) Keeping the solution at room temperature
B) Positioning the patient on the right side
C) Raising the enema bag to 12 inches above the patient
D) Instructing the patient to release the enema solution as soon as possible

Question 19

What is an appropriate technique for measuring the length of the tube for NG insertion?

A) Measure from the nose to the ear to the patient's navel
B) Measure from the nose to the middle of the sternum
C) Measure and mark a point 30 inches from the end
D) Mark 50-cm point on the tube, measure in the traditional way, and insert halfway between the two spots

Question 20

The nurse is preparing to administer an enema to a patient.Of the following choices,choose the enema that is most likely to lead to circulatory overload.

A) Hypertonic solution enema
B) Soapsuds enema
C) Tap water enema
D) Harris Flush enema

Question 21

_____________ is the absolute inability to pass stool.

Question 22

The __________ system is an intrarectal catheter that has a retention cuff,intraluminal balloon,three pilot balloons,anchor straps,and a port for sampling stool.The purpose of this system is to divert feces away from wounds and provide access for administering rectal medications and irrigations.

Question 23

Infrequent bowel movements (less than every three days),difficulty in evacuating feces,inability to defecate,and hard feces are signs of ________________.

Question 24

The inability to pass a hard collection of stool is known as ______________.

Question 25

An ___________________ is a pliable tube inserted through the patient's nasopharynx into the stomach.The tube has a hollow lumen that allows the removal of gastric secretions and the introduction of solutions into the stomach.

Question 26

What should the nurse do to verify nasogastric (NG)tube placement? (Select all that apply.)

A) Ask the patient to speak
B) Inspect posterior pharynx
C) Aspirate back on the syringe
D) Measure the pH of the aspirate
E) None of above

Question 27

_________________ is the patient's inability to control the passage of feces and gas.

Question 28

Interventions for the control of constipation include which of the following? (Select all that apply.)

A) Lifestyle changes
B) Elimination of laxative use
C) Decreased dietary fiber
D) Increased fluids

Question 29

The patient has increased his fluid and dietary fiber intake,and has started a supervised exercise program.However,he is still having problems with constipation.Which of the following would be an effective intervention? (Select all that apply.)

A) Metamucil
B) Milk of Magnesia
C) Dulcolax
D) Mineral oil

Question 30

Enemas that are used with pharmacological therapeutic agents such as polystyrene sulfonate (Kayexalate)or antibiotics such as neomycin are known as ___________.

Question 31

The patient is receiving a soapsuds enema but is having a difficult time retaining the fluid.What action should the nurse take? (Select all that apply.)

A) Give the enema slowly
B) Place the patient in the dorsal recumbent position on a bedpan
C) Give the enema with the patient on the toilet
D) Give the enema in the right lateral position

Question 32

An enema designed to promote complete evacuation of feces from the colon by stimulating peristalsis is known as a _____________.

Question 33

The Levin tube and the Salem sump tube are the tubes used most commonly for stomach decompression.Which of the following statements about these tubes is true? (Select all that apply.)

A) Levin tubes have a blue port that functions as an air vent
B) Insertion of these tubes is done as a sterile procedure
C) The blue air vent should not be used for irrigation
D) The Salem sump tube has a blue port that functions as an air vent

Question 34

A bedpan that is designed for patients with body or leg casts or patients restricted from raising their hips (e.g.,following total joint replacement)is known as a _____________.

Question 35

An ___________ is the instillation of a solution into the rectum and sigmoid colon to promote defecation by stimulating peristalsis.