PrepU

Question 1

A nurse is educating a client on how to change his ostomy appliance. What is an accurate step that should be incorporated into the education plan?

Answer 1

Correct response: Use toilet tissue to remove any excess stool from the stoma

Question 2

The nurse is inserting a rectal tube to administer a large-volume enema. how do you administer the tube?

Answer 2

Slowly and gently insert the enema tube 3 to 4 inches (7.5 to 10 cm) for an adult.

Question 3

Sims’ position

Answer 3

in which the patient lies on the side with the knee and thigh drawn upward toward the chest. The chest and abdomen are allowed to fall forward.

Question 4

You are caring for a 68-year-old female patient who weighs 108 pounds. The patient has been worried about regularity of her bowel movements. You have just placed a regular bedpan under the patient and the patient states, “Please leave the bedpan in place until I have a bowel movement.” Which of the following responses is most appropriate?

Answer 4

“I will check back in 10 minutes and remove the bedpan for a period of time even if you have not had a bowel movement.”

A bedpan should not be left in place for extended periods of time because this can result in excessive pressure and irritation to the patient’s skin.

Question 5

The nurse is scheduling tests for a client who is experiencing bowel alterations. What is the most logical sequence of tests to ensure an accurate diagnosis?

Answer 5

fecal occult blood test, barium studies, endoscopic examination

Explanation:
There is a specific sequence that bowel tests must be performed due to the results of certain contrasts and other preps that must be given. The nurse would verify that the tests are done in the correct order: Fecal occult blood test, barium studies, and then endoscopic examination

Question 6

According to the Rome III criteria, symptoms must be present for 12 nonconsecutive weeks in the last 12 months for ___% of bowel movements.

Answer 6

25%

Question 7

A nurse is caring for a client with an abdominal injury at a health care facility. The client tells the nurse that he passed blood-stained stool. Which nursing action is appropriate when a client reports blood in the stool?

Answer 7

Perform a screening test on stool samples.

Question 8

(see full question) A client scheduled for a colonoscopy is scheduled to receive a hypertonic enema prior to the procedure. A hypertonic enema is classified as which type of enema?

Answer 8

cleansing enema

Question 9

The nurse inspects the stool of clients admitted to the hospital with abdominal distress. Which statements accurately describe the normal characteristics of stool and special considerations for observation? Select all that apply.

Answer 9

• The rapid rate of peristalsis in the breastfed infant causes the stool to be yellow.
• Antacids in the diet cause the stool to be whitish.
• A gastrointestinal obstruction may result in a narrow, pencil-shaped stool.

Question 10

Consistently large diarrheal stools suggest a disorder in the

Answer 10

small bowel or proximal colon

Question 11

small, frequent stools with urgency to pass them suggest a disorder of the

Answer 11

left colon or rectum

Question 12

A nurse is assessing the bowel elimination patterns of hospitalized clients. Which nursing actions related to the assessment process are performed correctly? Select all that apply.

Answer 12

• The nurse uses a warmed stethoscope to listen for bowel sounds in all abdominal quadrants.
• The nurse notes the character of bowel sounds, which are normally high-pitched, gurgling, and soft.
• The nurse places the client in the supine position with the abdomen exposed.

Question 13

The nurse is administering magnesium sulfate to a patient with constipation. What mechanism of action would the nurse expect from this drug?

Answer 13

Drawing water into the intestines to stimulate peristalsis

Question 14

The correct sequence for an abdominal assessment is from

Answer 14

inspection, auscultation (done before palpation because palpation may disturb normal peristalsis and bowel motility), and percussion to palpitation

Question 15

The nurse is preparing to administer a large-volume enema to an adult client. How far should the nurse insert the tubing?

Answer 15

3 inches

Question 16

When assessing an elderly client for constipation, the nurse learns that the client uses mineral oil daily to relieve constipation. Which is an effect of prolonged use of mineral oil to relieve constipation?

Answer 16

Affects absorption of fat-soluble vitamins

Question 17

What is the most common type of colostomy that needs to be irrigated to help promote regular evacuation of feces?

Answer 17

Sigmoid colostomy

Irrigations are infrequently used to promote regular evacuation of some colostomies. Various factors, such as the site of the colostomy in the colon (sigmoid colostomy) and the client’s and physician’s preferences, determine whether a colostomy is to be irrigated. Ileostomies are not irrigated because the fecal content of the ileum is liquid and cannot be controlled
pg. 1374

Question 18

A client has completed an upper gastrointestinal x-ray, small bowel series, and lower gastrointestinal x-ray. Following these x-rays, the nurse will need to administer:

Answer 18

a laxative.
Explanation:
Barium is ingested during these exams. Barium can cause constipation; therefore, laxatives are commonly ordered after the diagnostic test to facilitate barium removal.