Question 1

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

Accepted Answer

No jewelry or metal products should be in the same room as an MRI machine because of the high-power magnet used in the machine.The patient needs to be NPO 4 to 6 hours before the examination.Colon cleansing products are not necessary for MRIs.Pain medication is not needed before the examination is performed.

Question 2

A patient informs the nurse that she was using laxatives three times daily to lose weight.After stopping use of the laxative,the patient had difficulty with constipation and wonders if she needs to take laxatives again.The nurse educates the patient that

Accepted Answer

Long-term laxative use can lead to constipation.Increasing fluid and fiber intake can help with this problem.Laxatives do not cause scarring.Natural laxatives like mineral oil come with their own set of risks,such as inability to absorb fat-soluble vitamins.Even if malnourished,the body will produce waste if substance is consumed.

Question 3

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

Accepted Answer

The best way to promote normal defecation is to assist the patient into a posture that is as normal as possible while defecating.Using a mobility device promotes nurse and patient safety.Elevating the head of the bed would be appropriate if the patient were to void with a bed pan.However,the patient's condition does not require use of a bed pan.Giving the patient a pillow may reduce discomfort,but this is not the best way to promote defecation.A soaps suds enema is indicated for a patient who needs assistance to stimulate peristalsis.It promotes non-natural defecation.

Question 4

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

Accepted Answer

A healthy diet for the bowel should include foods high in bulk-forming fiber.Whole grains,fresh fruit,and fresh vegetables are excellent sources.Foods without much fiber and with high levels of fat can slow down peristalsis,causing constipation.

Question 5

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

Accepted Answer

Blood in the stool may indicate a problem with the surgical procedure,and the physician should be notified.All other options are expected findings for an ileostomy.

Question 6

The nurse has attempted to administer a tap water enema for a patient with fecal impaction with no success.What is the next priority nursing action?

Accepted Answer

When enemas are not successful,digital removal of the stool may be necessary occasionally to break up pieces of the stool or to stimulate the anus to defecate.Tap water enemas should not be repeated because of risk of fluid imbalance.Positioning the patient on the left side does not promote defecation.A rectal tube is indicated for a patient with liquid stool incontinence but would not be applicable or effective for this patient.

Question 7

The nurse provides knows that a bowel elimination schedule would be most beneficial in the plan of care for which patient?

Accepted Answer

A bowel elimination program is helpful for a patient with incontinence.It helps the person who still has neuromuscular control defecate normally.An ileostomy,Crohn's disease,and C.difficile all relate to uncontrollable bowel movements,for which no method can be used to set up a schedule of elimination.

Question 8

Fecal impactions occur in which portion of the colon?

Accepted Answer

A fecal impaction is a collection of hardened feces wedged in the rectum that cannot be expelled.It results from unrelieved constipation.Feces at this point in the colon contain the least amount of moisture.Feces found in the ascending,transverse,and descending colon still consist mostly of liquid and do not form a hardened mass.

Question 9

The nurse would expect the least formed stool to be present in which portion of the digestive tract?

Accepted Answer

The path of digestion goes from the ascending,across the transverse,to the descending and finally passing into the sigmoid; therefore,the least formed stool would be in the ascending.

Question 10

The nurse knows that most nutrients are absorbed in which portion of the digestive tract?

Accepted Answer

Most nutrients are absorbed in the duodenum with the exception of certain vitamins,iron,and salt (which are absorbed in the ileum).Food is broken down in the stomach.The cecum is the beginning of the large intestine.

Question 11

A patient with a hip fracture is having difficulty defecating into a bed pan while lying in bed.Which action by the nurse would assist the patient in having a successful bowel movement?

Accepted Answer

Lying in bed is an unnatural position; raising the head of the bed assists the patient into a more normal position that allows proper contraction of muscles for elimination.Laxatives would not give the patient control over bowel movements.A barium enema is a diagnostic test,not an intervention to promote defecation.Pain relief measures should be given; however,preventative action should be taken to prevent constipation.

Question 12

A patient expresses concerns over having black stool.The fecal occult test is negative.Which response by the nurse is most appropriate?

Accepted Answer

Certain medications and supplements,such as iron,can alter the color of stool.The fecal occult test takes three separate samples over a period of time and is a fairly reliable test.A colonoscopy is health prevention screening that should be done every 5 to 10 years; it is not the nurse's initial priority.Stress alters GI motility and stool consistency,not color.

Question 13

The nurse is devising a plan of care for a patient with the nursing diagnosis of Constipation related to opioid use.Which of the following outcomes would the nurse evaluate as successful for the patient to establish normal defecation?

Accepted Answer

The nurse's goal is for the patient to be on opioid medication and to have normal bowel elimination.Normal stools are soft and formed.Ceasing pain medication is not a desired outcome for the patient.Tenderness in the left lower quadrant indicates constipation and does not further address bowel elimination.Present bowel sounds indicate that the bowels are moving; however,they are not an indication of defecation.

Question 14

Which of the following is not a function of the large intestine?

Accepted Answer

Nutrient absorption is done in the small intestine.The other options are all functions of the large intestine.

Question 15

Which physiological change can cause a paralytic ileus?

Accepted Answer

Surgical manipulation of the bowel can cause a paralytic ileus.The other options are incorrect.

Question 16

The nurse should question which order?

Accepted Answer

Kayexalate binds to and helps excrete potassium,so it would be contraindicated in patients who are hypokalemic (have low potassium).Normal saline enemas can be repeated without risk of fluid or electrolyte imbalance.Hypertonic solutions are intended for patients who cannot handle large fluid volume and are contraindicated for dehydrated patients.Because mineral oil laxatives and an oil retention enema have the same intended effect of lubricating the colon and rectum,an oil retention enema is not needed.

Question 17

The nurse is preparing to perform a fecal occult blood test.The nurse plans to properly perform the examination by

Accepted Answer

Abnormal findings such as a positive test should be reported to the provider.A fecal occult blood test is a clean procedure; sterile gloves are not needed.A thin specimen smear is all that is required.The quality control section should be developed after it is determined whether the sample is positive or negative.

Question 18

The nurse is caring for a patient who is confined to the bed.The nurse asks the patient if he needs to have a bowel movement 30 minutes after eating a meal because

Accepted Answer

Peristalsis occurs only a few times a day; the strongest peristaltic waves are triggered by mastication of the meal.The intestine can hold a great deal of food.A patient's voiding schedule should not be based on the staff's convenience.

Question 19

Which patient is most at risk for increased peristalsis?

Accepted Answer

Stress can stimulate digestion and increase peristalsis.Ignoring the urge to defecate,depression,and age-related changes of the elderly are causes of constipation.

Question 20

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

Accepted Answer

Black tarry stools are an indication of ulceration or bleeding in the upper portion of the GI tract; upper endoscopy would allow visualization of the bleeding.No other option would allow upper GI visualization.

Quiz 46: Bowel Elimination