Chapter 47: Bowel

Question 1

The nurse is teaching a health class about the gastrointestinal tract. The nurse will explain that which portion of the digestive tract absorbs most of the nutrients?

Answer 1

Duodenum

Question 2

The nurse is caring for patients with ostomies. In which ostomy location will the nurse expect very liquid stool to be present?

Answer 2

Ascending

Question 3

A nurse is teaching a patient about the large intestine in elimination. In which order will the nurse list the structures, starting with the first portion?

Answer 3

Cecum, ascending, transverse, descending, sigmoid, and rectum

Question 4

The nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel (NAP)?

Answer 4

Administering an enema

Question 5

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

Answer 5

Grape and walnut chicken salad sandwich on whole wheat bread

Question 6

A patient is using laxatives three times daily to lose weight. After stopping laxative use, the patient has difficulty with constipation and wonders if laxatives should be taken again. Which information will the nurse share with the patient?

Answer 6

Long-term laxative use causes the bowel to become less responsive to stimuli, and constipation may occur

Question 7

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

Answer 7

Raising the head of the bed

Question 8

Which patient is most at risk for increased peristalsis?

Answer 8

A 21-year-old female with three final examinations on the same day

Question 9

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

Answer 9

“Do you take iron supplements?”

Question 10

Which patient will the nurse assess most closely for an ileus?

Answer 10

A patient with surgery for bowel disease and anesthesia

Question 11

A patient has a fecal impaction. Which portion of the colon will the nurse assess?

Answer 11

Rectum

Question 12

The nurse is managing bowel training for a patient. To which patient is the nurse most likely providing care?

Answer 12

A 70-year-old patient with stool incontinence

Question 13

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

Answer 13

Use a mobility device to place the patient on a bedside commode.

Question 14

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

Answer 14

The patient reports eliminating a soft, formed stool.

Question 15

The nurse is emptying an ileostomy pouch for a patient. Which assessment finding will the nurse
reportimmediately?

Answer 15

Presence of blood in the stool

Question 16

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

Answer 16

Endoscopy

Question 17

The nurse has attempted to administer a tap water enema for a patient with fecal impaction with no success. The fecal mass is too large for the patient to pass voluntarily. Which is the next priority nursing action?

Answer 17

Obtaining an order for digital removal of stool

Question 18

A nurse is checking orders. Which order should the nurse question?

Answer 18

A Kayexalate enema for a patient with severe hypokalemia

Question 19

The nurse is performing a fecal occult blood test. Which action should the nurse take?

Answer 19

Report a positive finding to the provider.

Question 20

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

Answer 20

Removing all of the patient’s metallic jewelry.

Question 21

A patient with a fecal impaction has an order to remove stool digitally. In which order will the nurse perform the steps, starting with the first one?

1. Obtain baseline vital signs.
2. Apply clean gloves and lubricate.
3. Insert index finger into the rectum.
4. Identify patient using two identifiers.
5. Place patient on left side in Sims’ position.
6. Massage around the feces and work down to remove.

Answer 21

4, 1, 5, 2, 3, 6

Question 22

Before administering a cleansing enema to an 80-year-old patient, the patient says “I don’t think I will be able to hold the enema.” Which is the next priority nursing action?

Answer 22

Positioning the patient in the dorsal recumbent position on a bedpan

Question 23

A nurse is providing care to a group of patients. Which patient will the nurse see first?

Answer 23

An older patient with glaucoma about to receive an enema

Question 24

A patient is diagnosed with a bowel obstruction. Which type of tube is the best for the nurse to obtain for gastric decompression?

Answer 24

Salem sump

Question 25

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

Answer 25

Turkey meatloaf with white rice and apple juice

Question 26

A nurse is pouching an ostomy on a patient with an ileostomy. Which action by the nurse is most appropriate?

Answer 26

Emptying the pouch if it is more than one-third to one-half full

Question 27

The nurse will irrigate a patient’s nasogastric (NG) tube. Which action should the nurse take?

Answer 27

Immediately aspirate after instilling fluid.

Question 28

The nurse administers a cathartic to a patient. Which finding helps the nurse determine that the cathartic has a therapeutic effect?

Answer 28

Has a bowel movement.

Question 29

An older adult’s perineal skin is dry and thin with mild excoriation. When providing hygiene care after episodes of diarrhea, what should the nurse do?

Answer 29

Apply a skin protective ointment after perineal care.

Question 30

Which action will the nurse take to reduce the risk of excoriation to the mucosal lining of the patient’s nose from a nasogastric tube?

Answer 30

Lubricate the nares with water-soluble lubricant.

Question 31

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?

Answer 31

“If I get a blue color that means the test is negative.”

Question 32

A nurse is preparing to lavage a patient in the emergency department for an overdose. Which tube should the nurse obtain?

Answer 32

Ewald

Question 33

The nurse is caring for a patient with Clostridium difficile. Which nursing actions will have the greatest impact in preventing the spread of the bacteria?

Answer 33

Proper hand hygiene techniques

Question 34

A nurse is performing an assessment on a patient who has not had a bowel movement in 3 days. The nurse will expect which other assessment finding?

Answer 34

Hypoactive bowel sounds

Question 35

A nurse is caring for a patient who has had diarrhea for the past week. Which additional assessment finding will the nurse expect?

Answer 35

Decreased skin turgor

Question 36

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

Answer 36

Stoma is purple.

Question 37

A patient is receiving a neomycin solution enema. Which primary goal is the nurse trying to achieve?

Answer 37

Prevent colon infection

Question 38

A guaiac test is ordered for a patient. Which type of blood is the nurse checking for in this patient’s stool?

Answer 38

Microscopic

Question 39

A patient is receiving opioids for pain. Which bowel assessment is a priority?

Answer 39

Constipation

Question 40

Which nutritional instruction is a priority for the nurse to advise a patient about with an ileostomy?

Answer 40

Increase fluid intake.

Question 41

A nurse is preparing a bowel training program for a patient. Which actions will the nurse take? (Select all that apply.) a. Record times when the patient is incontinent. b. Help the patient to the toilet at the designated time. c. Lean backward on the hips while sitting on the toilet. d. Maintain normal exercise within the patient’s physical ability. e. Apply pressure with hands over the abdomen, and strain while pushing. f. Choose a time based on the patient’s pattern to initiate defecation-control measures.

Answer 41

A,B,D,F

Question 42

A nurse is teaching a health class about colorectal cancer. Which information should the nurse include in the teaching session? (Select all that apply.) a. A risk factor is smoking. b. A risk factor is high intake of animal fats or red meat. c. A warning sign is rectal bleeding. d. A warning sign is a sense of incomplete evacuation. e. Screening with a colonoscopy is every 5 years, starting at age 50. f. Screening with flexible sigmoidoscopy is every 10 years, starting at age 50.

Answer 42

A,B,C,D