Deck 23: Bowel Elimination

Question 1

When assessing a client's stoma,the nurse notices it appears dark and dusky colored.The initial intervention is to

A)Do nothing,as this is normal.
B)Document findings and continue to assess the stoma.
C)Replace the pouch with a different type,as this is an allergic reaction.
D)Notify the physician that the stoma is not receiving adequate oxygen supply.

Answer 1

Notify the physician that the stoma is not receiving adequate oxygen supply.

Question 2

The purpose of administering a return flow enema is to

A)Stimulate peristalsis and expel flatus.
B)Soften stool for easier evacuation.
C)Decrease bowel motility and prevent flatus formation.
D)Cleanse the lower colon to facilitate x-ray studies.

Answer 2

Stimulate peristalsis and expel flatus.

Question 3

Normal bowel function is based on the client having which of the following? (select all that apply)

A)Functioning muscles and nerves.
B)Diet high in fiber.
C)Age.
D)Physical therapy.

Answer 3

Diet high in fiber.
Physical therapy.

Question 4

Which one of the following interventions assists in effective bowel evacuation?

A)Include more complex carbohydrates in the diet.
B)Administer bulk-forming medications.
C)Administer bowel training program before meals.
D)Maintain fluid intake at 2000 mL/day.

Question 5

When administering an enema,the nurse follows which one of the following nursing actions?

A)Warm the enema solution to 99°F.
B)Insert the enema tube 6-8 inches into the rectum.
C)Instill 100-200 mL solution slowly.
D)Raise the enema container to a height of 18 inches.

Question 6

Clinical Situation: You administer a Fleet’s enema to a client who expels only about half of the solution with small flecks of brown stool returned with the solution. The client states she needs another enema because she does not feel as though she has emptied her bowel completely.
To provide a more effective result if a repeat enema is ordered,the nurse instructs the client to

A)Use a bedpan for expulsion.
B)Hold the enema solution for 7 minutes.
C)Remain on her right side for 10 minutes.
D)Insert tip of enema tube at least 6 inches.

Question 7

The inflow-outflow process for the return flow enema is usually

A)Until return fluid is clear.
B)Five to six times.
C)Until stool is evacuated.
D)Until flatus has subsided.

Question 8

A tap-water enema is ordered for a client.The amount of fluid the nurse is most likely to administer is

A)250-300 mL.
B)300-500 mL.
C)500-750 mL.
D)750-1000 mL.

Question 9

When administering an enema to a child rather than an adult,the major difference is to

A)Insert the enema tube 2-3 inches.
B)Instill 50-100 mL of solution.
C)Instill solution from a height of 6 inches.
D)Place the child on his or her right side.

Question 10

What is the role of pancreatic juices in digestion?

Question 11

Tests frequently used to determine the cause of fecal incontinence includes

A)Ultrasound,proctoscopy,stool specimen analysis.
B)Electromyography,colonoscopy,MRI.
C)Barium enema,upper GI study.
D)Ultrasound,colonoscopy.

Question 12

Select the statement that best describes changes in motility.

A)Hypomotility is caused by direct stimulation or irritation of the autonomic nervous system.
B)Parasympathetic nervous system stimulation results in constipation.
C)Hypermotility can result from infectious agents.
D)Antihypertensive drugs cause constipation because of parasympathetic stimulation.

Question 13

Interventions to prevent constipation in the older adult include

A)Instruct client to use a mild laxative daily.
B)Maintain fluid intake of 1000 mL/day.
C)Instruct client to perform physical activity based on his/her ability.
D)Encourage 6 small feedings daily to stimulate GI motility and prevent constipation.

Question 14

State the two major activities to prepare the clean fecal pouch for application.
a.----------
b.---------

Question 15

Clinical Situation: You administer a Fleet’s enema to a client who expels only about half of the solution with small flecks of brown stool returned with the solution. The client states she needs another enema because she does not feel as though she has emptied her bowel completely.
Chart the enema procedure described in the clinical situation.

Question 16

After administering a tap-water enema,the solution was not returned.Which of the following interventions could be helpful in expelling the solution?

A)Gently massage the client's abdomen.
B)Instruct the client to turn side-to-side.
C)Replace the rectal tube and lower the bag below bed level.
D)Administer a stronger enema solution,such as soap suds.

Question 17

Describe the major reason for washing the area surrounding the stoma with warm water.

Question 18

One major difference between a colostomy and ileostomy is

A)An ileostomy is the result of long-standing history of diverticulitis.
B)A colostomy produces a semiliquid effluent.
C)Clients with an ileostomy require a greater fluid intake.
D)A colostomy client never has an irrigation performed.

Question 19

The only major difference in administering an enema and in irrigating a colostomy is
.

Question 20

The priority intervention after discontinuing the procedure for a client who exhibits signs and symptoms of a vagal response during removal of a fecal impaction is:

A)Place client in shock position.
B)Take BP and pulse and report findings to physician.
C)Instruct client to perform Valsalva maneuver.
D)Call for code team.

Question 21

The BMS is maintained throughout catheter insertion by:

A)Maintaining the free flow of stool by constant irrigation of the catheter through the flush/sampling port.
B)Keeping the BMS system positioned above level of anus at all times to promote drainage of stool.
C)Checking retention cuff daily by aspirating all fluid from retention cuff.
D)Checking BMS every 2 hours to ensure it is not occluded.

Question 22

Which of the following situations are considered a contraindication to the use of a Bowel Management system (BMS).
(Select all that apply)

A)Severe strictures of distal return.
B)Presence of impacted of formed stool.
C)History of loose stools.
D)Compromised rectal wall integrity.

Question 23

Rectal tubes are left in place no longer than ________ minutes.