Deck 14: Bowel Management

Question 1

A client has long-standing chronic diarrhea. What assessment finding indicates the goal for a priority nursing diagnosis has been met?

A) Keeps an elimination log
B) Perianal skin is intact.
C) Denies embarrassment
D) Understands etiology

Answer 1

Perianal skin is intact.

Question 2

The nurse is preparing to insert an anal tube and notes the client has hemorrhoids. What action does the nurse take?

A) Documents "unable to perform."
B) Uses lidocaine gel for lubricant.
C) Notifies the healthcare provider.
D) Avoids the area around the hemorrhoid.

Answer 2

Notifies the healthcare provider.

Question 3

What action does the nurse take when applying a fecal management system to a client?

A) Inflates the balloon with 25 mL of water or saline
B) Places a finger in the finger pocket to guide the tube
C) Mark the tube where it exits the client's anus
D) Hang the drainage bag below the level of the bowel

Answer 3

Places a finger in the finger pocket to guide the tube

Question 4

The nurse is administering a tap water cleansing enema. What action by the nurse demonstrates the need to review the skill?

A) Uses tepid water (40° to 43° C [105° F to 110° F])
B) Inserts the tube 12 to 14 cm (4.7 to 5.5 inches)
C) Primes the tubing prior to inserting the tube
D) Starts the enema with the bag level with the client's hip

Question 5

The nurse is collecting a stool sample from a client. Which action will the nurse take?

A) Obtain at least 10 mL of liquid stool.
B) Take sample from two areas of the stool.
C) Rinses urine out of the stool collection device.
D) Collect at least 1.27 cm (1/2 inch) of stool.

Question 6

A nurse is working on a gastrointestinal inpatient unit. Which client does the nurse see first?

A) Fecal occult blood test positive
B) Has fecal management system
C) Is incontinent of stool just now
D) Colostomy stoma grayish brown

Question 7

A client is scheduled for a colostomy. When does the self-care management teaching begin?

A) Prior to being hospitalized
B) In the pre-op holding area
C) The day after the operation
D) The day of discharge

Question 8

The nursing student is caring for a client with a colostomy. Which action by the student indicates a need to review this skill?

A) Changes the pouch and adhesive between meals
B) Dries peristomal skin before placing new adhesive devise
C) Cuts the new adhesive device 6.5 cm (1/4 inch) bigger than stoma
D) Uses stoma paste to prevent leakage of effluent

Question 9

A client has a new ileostomy. What assessment finding by the nurse indicates the goal for the priority nursing diagnosis has been met?

A) Good skin turgor and moist mucus membranes
B) Is able to change own ostomy pouch
C) Has not needed ostomy irrigated in 3 days
D) Peristomal skin is dry and intact.

Question 10

An older client asks the nurse why constipation has become a problem, when his diet has not changed. What answer does the nurse provide?

A) "Your fiber needs have increased with age."
B) "Nerve innervation declines with advanced age."
C) "As you age, movement through the bowel slows."
D) "Decreased enzyme production dries the stool."

Question 11

A student nurse asks why diuretics can cause constipation. What response does the faculty provide?

A) "Diuretics actually can cause diarrhea."
B) "Loss of fluid dries the stool."
C) "Excreting potassium slows the bowels."
D) "It suppresses the appetite, so the bowels aren't stimulated."

Question 12

A client has a new colostomy and the nurse assesses the client's ability to choose appropriate menu items. Which choice by the client indicates the need to review the material?

A) Chicken
B) Popcorn
C) Banana
D) Soda crackers

Question 13

The nurse is caring for an elderly client who has an ileostomy. When changing the ostomy appliance, what action by the nurse will promote skin health?

A) Change the adhesive flange only once a week.
B) Apply vitamin E oil before attaching the flange.
C) Use alcohol-based cleaning agents under the flange.
D) Use a silicone-based remover to take the flange off.

Question 14

A child has a cecostomy tube. What education does the nurse provide the child's parents?

A) Cecostomy tubes must be replaced every 2 to 3 years.
B) The cecostomy tube must be flushed daily.
C) Leakage around the site indicates the need for a larger tube.
D) A pouch must be worn over the end of the tubing.

Question 15

A nurse is providing anticipatory guidance to the parents of a preschool aged child. What information does the nurse provide?

A) Conditions causing fecal incontinence usually manifest at this age.
B) Increased socialization provides more exposure to communicable diseases.
C) Body image changes occur rapidly during these years.
D) Provision of elimination self-care takes on importance.

Question 16

The nurse is providing education to parents on obtaining a pinworm specimen. Which information by the nurse is accurate?

A) Pinworm eggs only survive on surfaces for 24 to 36 hours.
B) The best time to observe for pinworms is at night.
C) Tape the pinworm paddle to the child's anal area at bedtime.
D) Help your child wash the hands carefully in the morning.

Question 17

What action by the nurse is best to prevent a fecal impaction?

A) Prevent constipation.
B) Encourage regular bowel habits.
C) Mobilize clients as much as possible.
D) Provide privacy for defecation.

Question 18

A client is admitted with Giardia. What does the nurse include in this client's plan of care?

A) Administering antibiotics
B) Providing fluids
C) Fecal occult blood testing
D) Stoma education

Question 19

The nurse assesses clients' stools for characteristics indicative of pathology. Which characteristics are correctly matched with potential health problems? (Select all that apply.)

A) Bright red blood: Lower GI bleed
B) Grayish-white: Biliary obstruction
C) Greasy yellow: High cholesterol
D) Tar-colored: Gastric cancer
E) Hard and small: Constipation

Question 20

The nurse is caring for a client with constipation who needs a digital rectal evacuation. What actions by the nurse are appropriate for this procedure? (Select all that apply.)

A) Stops the procedure for client report of dizziness.
B) Administer an oil retention enema before the procedure.
C) Monitor the client for bradycardia and hypotension.
D) Ensure there is a healthcare provider's order.
E) Check client's red blood cell count prior to beginning.

Question 21

A nurse is providing teaching to a client with chronic constipation. What information does the nurse provide? (Select all that apply.)

A) Increase fluids or fiber, but not both.
B) Stress can increase or decrease peristalsis.
C) Increased activity promotes peristalsis.
D) A high fiber diet will improve constipation.
E) Citrus is good for increasing peristalsis.

Question 22

The nurse understands the GI tract has defense mechanisms against infection. Which of the following do these include? (Select all that apply.)

A) Antibodies and enzymes produced in the GI tract
B) Neutral pH of gastrointestinal organs
C) Large, protective mucosal lining
D) Anaerobic protective organisms in the colon
E) Smooth intestinal lining keeps organisms from "sticking."

Question 23

The nurse needs to perform a bedside fecal occult blood test on a stool sample. Prior to gathering the sample, the nurse assesses for which interfering factors? (Select all that apply.)

A) Vitamin C supplements
B) Eating a lot of chicken
C) Ingesting peroxidase-rich foods
D) Anticholesterol medications
E) Herbal cold preparations

Question 24

The nurse knows that which medications can lead to constipation? (Select all that apply.)

A) Diuretics
B) Antacids
C) Tricyclic antidepressants
D) Digitalis
E) Colchicine

Question 25

The nurse is teaching a client about dietary considerations with a new colostomy. Which foods does the nurse tell the client cause malodorous stool? (Select all that apply.)

A) Eggs
B) Cabbage
C) Nuts and seeds
D) Pineapple
E) Garlic