Question 1

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

A)  Administering laxatives to the patient 
B)  Raising the head of the bed 
C)  Preparing to administer a barium enema 
D)  Withholding narcotic pain medication

Question 2

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

Accepted Answer

A)  A 40-year-old patient with an ileostomy 
B)  A 25-year-old patient with Crohn's disease 
C)  A 30-year-old patient with C. difficile 
D)  A 70-year-old patient with stool incontinence

Question 3

Which patient is most at risk for increased peristalsis?

Accepted Answer

A)  A 5-year-old child who ignores the urge to defecate owing to embarrassment 
B)  A 21-year-old patient with three final examinations on the same day 
C)  A 40-year-old woman with major depressive disorder 
D)  An 80-year-old man in an assisted-living environment

Question 4

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

Accepted Answer

A)  Ensuring that the patient does not eat or drink 2 hours before the examination 
B)  Removing all of the patient's metallic jewelry 
C)  Administering a colon cleansing product 12 hours before the examination 
D)  Obtaining an order for a pain medication before the test is performed

Question 5

A patient had an ileostomy surgically placed 2 days ago.Which diet would the nurse recommend to the patient to ease the transition of the new ostomy?

Accepted Answer

A)  Eggs over easy, whole wheat toast, and orange juice with pulp 
B)  Chicken fried rice with stir fried vegetables and iced tea 
C)  Turkey meatloaf with white rice and apple juice 
D)  Fish sticks with macaroni and cheese and soda

Question 6

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)  Grape and walnut chicken salad sandwich on whole wheat bread 
B)  Broccoli and cheese soup with potato bread 
C)  Dinner salad topped with hard-boiled eggs, cheese, and fat-free dressing 
D)  Turkey and mashed potatoes with brown gravy

Question 7

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

Accepted Answer

A)  Liquid consistency of stool 
B)  Presence of blood in the stool 
C)  Noxious odor from the stool 
D)  Continuous output from the stoma

Question 8

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

Accepted Answer

A)  Ascending 
B)  Descending 
C)  Transverse 
D)  Sigmoid

Question 9

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

Accepted Answer

A)  Stomach 
B)  Duodenum 
C)  Ileum 
D)  Cecum

Question 10

A guaiac test has been ordered.The nurse knows that this is a test for

Accepted Answer

A)  Bright red blood. 
B)  Dark black blood. 
C)  Blood that contains mucus. 
D)  Blood that cannot be seen.

Question 11

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

A)  The patient reports eliminating a soft, formed stool. 
B)  The patient has quit taking opioid pain medication. 
C)  The patient's lower left quadrant is tender to the touch. 
D)  The nurse hears bowel sounds present in all four quadrants.

Question 12

Fecal impactions occur in which portion of the colon?

Accepted Answer

A)  Ascending 
B)  Descending 
C)  Transverse 
D)  Rectum

Question 13

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

A)  The digested food needs to make room for recently ingested food. 
B)  Mastication triggers the digestive system to begin peristalsis. 
C)  The smell of bowel elimination in the room would deter the patient from eating. 
D)  More ancillary staff members are available after meal times.

Question 14

The nurse should question which order?

Accepted Answer

A)  A normal saline enema to be repeated every 4 hours until stool is produced 
B)  A hypertonic solution enema with a patient with fluid volume excess 
C)  A Kayexalate enema for a patient with hypokalemia 
D)  An oil retention enema for a patient using mineral oil laxatives

Question 15

A nurse is providing discharge teaching for a patient who is going home with a guaiac test.Which statement by the patient indicates the need for further education?

Accepted Answer

A)  "If I get a positive result, I have gastrointestinal bleeding." 
B)  "I should not eat red meat before my examination." 
C)  "I should schedule to perform the examination when I am not menstruating." 
D)  "I will need to perform this test three times if I have a positive result."

Question 16

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

A)  Preparing the patient for a second tap water enema 
B)  Donning gloves for digital removal of the stool 
C)  Positioning the patient on the left side 
D)  Inserting a rectal tube

Question 17

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

A)  Elevate the head of the bed 45 degrees 60 minutes after breakfast. 
B)  Use a mobility device to place the patient on a bedside commode. 
C)  Give the patient a pillow to brace against the abdomen while bearing down. 
D)  Administer a soap suds enema every 2 hours.

Question 18

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

Accepted Answer

A)  "This is probably a false negative; we should rerun the test." 
B)  "Do you take iron supplements?" 
C)  "You should schedule a colonoscopy as soon as possible." 
D)  "Sometimes severe stress can alter stool color."

Question 19

After a patient returns from a barium swallow,the nurse's priority is to

Accepted Answer

A)  Encourage the patient to increase fluids to flush out the barium. 
B)  Monitor stools closely for bright red blood or mucus, which indicates trauma from the procedure. 
C)  Inform the patient that his bowel movements are radioactive, and that he should be sure to flush the toilet three times. 
D)  Thicken all patient drinks to prevent aspiration.

Question 20

The nurse is caring for a patient who had a colostomy placed yesterday.The nurse should report which assessment finding immediately?

Accepted Answer

A)  Stoma is protruding from the abdomen. 
B)  Stoma is moist. 
C)  Stool is discharging from the stoma. 
D)  Stoma is purple.

Exam 46: Bowel Elimination