Unit 5 Bowel Elimination

Question 1

A patient has recently complained of rectal pain and discussed with the nurse he hasn’t had a bowel movement in over a week. He still has the urge to go but nothing is excreted through his anus. He says he feels an oozing sensation every time on the toilet. What bowel abnormality is the pt going through?
A.Constipation
B .Diarrhea
C. Impaction
D. Melena

Answer 1

C. Impaction

Extra Info- FROM THE BOOK

Impaction refers to the presence of a hard fecal mass in the rectum or colon that the patient is incapable of expelling. Impaction is the result of unresolved constipation.
The cardinal sign of impaction is continuous oozing of liquid stool, with no normal stool. Oozing occurs as the liquid portion of feces higher in the intestines seeps around the mass

Question 2

What statement by nurse would require further teaching based on her nursing intervention for a patient with constipation?
A. Increase their physical activity
B. lower their fiber intake
C. Drink at least 8 8 oz glasses of water
D. Suggest a stool softener

Answer 2

B. lower their fiber intake

Question 3

Who is more at risk for Colorectal Cancer?
A. Asian 23 year old women
B. African American 15 year male who smokes cigarettes
C. Jewish women who acts on a TV show
D. African American Male who is 57 year and works at a land fill

Answer 3

D. African American Male who is 57 year and works at a land fill

EXTRA INFO - FROM THE BOOK

In the United States, African Americans have the highest incidence of colorectal cancer

Colorectal cancer screening should begin at age 50 for people at average risk without a personal or family history of colorectal cancer.

Blood in the stool is a symptom /sign of colorectal cancer

Question 4

In what cases would there be bright cherry blood in the stool of a pt?
A. If the patient has an inflamed esophagus.
B. If a patient has severe Hemorrhoids
C. A 16-year-old boy who drank Gatorade at the end of his workout
D. A woman who is 5 years postpartum

Answer 4

B. If a patient has severe Hemmroids

Question 5

What is NOT a cause of diarrhea?
A.increasing fiber intake
B. use of laxatives
C. taking antibiotic medications
D. a pt being lactose intolerant

Answer 5

A.increasing fiber intake

Extra info- FROM THE BOOK

. Many pathologic conditions and other factors may cause diarrhea, including allergies or intolerance to food, fluids, or drugs; antibiotic use; cathartic or laxative use; communicable foodborne pathogens; diseases of the colon; diagnostic testing of the lower GI tract; enteral nutrition usage; medications; psychological stress; surgery of the GI tract; and Clostridium difficile.

Question 6

What is a characteristics of diarrhea?
A. oozing
B.rectal pain
C. hyperactive bowel sounds
D. the absence of a bowel moment in a week

Answer 6

C. hyperactive bowel sounds

EXTRA INFO -FROM THE BOOK

Diarrhea is an intestinal disorder that is characterized by an abnormal frequency and fluidity of bowel movements. Hyperactive bowel sounds, urgency, abdominal pain, and cramping are characteristics.

Question 7

If a patient’s stool has the presence of blood but it is dark blood which diagnostic medication would you as the nurse recommend to the PCP?
A. Barium Swallow
B. Barium Enema
C. Laxative
D. Cathartic

Answer 7

A. Barium Swallow

Question 8

The patient was admitted with diarrhea. Which priority action will the nurse teach the patient?
A. Drinking at least eight glasses of fluid each day
B. Eating foods low in sodium and potassium
C. Limiting the amount of soluble fiber in the diet
D. Eliminating whole-wheat and whole-grain breads and cereal

Answer 8

A. Drinking at least eight glasses of fluid each day

Question 9

The nurse knows that the teaching for a patient who was recently diagnosed with constipation has been effective if the patient’s meal request specifies which food choice?
a. Hot dog on a bun
b. Grilled chicken
c. Tuna sandwich on white bread
d. Spinach salad with dressing

Answer 9

d. Spinach salad with dressing

Question 10

A patient complains of 4 days of frequent loose stools with abdominal cramping. What is the priority nursing diagnosis for this patient?
a. Impaired Skin Integrity
b. Fluid Imbalance
c. Acute Pain
d. Self-Care Deficit (i.e., toileting)

Answer 10

b. Fluid Imbalance

Question 11

A patient who has severe diarrhea what type of foods would you recommend.
A. Bland high bulk food
B. Low bulk food
C. Coffee
D. Tea

Answer 11

A. Bland high bulk food

Question 12

A patient is experiencing diarrhea. After patient education, which behavior by the patient shows that the teaching was effective?
a. Limiting fluid intake to 1000 mL/day
b. Administering a cathartic suppository
c. Increasing fiber in the diet
d. Limiting exercise

Answer 12

c. Increasing fiber in the diet

Question 13

While performing an abdominal assessment on an unconscious patient, the nurse notes presence of an ostomy. The fecal output is liquid in consistency, with a pungent odor, from the stoma that is located in the upper right quadrant of the abdomen. What hypothesis about the type of ostomy should the nurse conclude?
a. Descending colostomy
b. Ureterostomy
c. Ileostomy
d. Ascending colostomy

Answer 13

d. Ascending colostomy

EXTRA INFO -FROM THE BOOK Ascending colostomies are similar to ileostomies. Drainage is liquid and cannot be regulated. Digestive enzymes are present and cause an odor. Ascending colostomies are relatively rare. The opening is in the ascending portion of the colon and is located on the right side of the abdomen

-ANSWER KEY RATIONALE
An ascending colostomy meets the description of fecal output of liquid consistency and with a pungent odor, as well as location of the stoma in the upper right quadrant of the abdomen. Descending colostomies produce increasingly formed stool. An ileostomy will produce liquid stool but with less odor because enzyme activity is not present. Ureterostomies drain urine, not stool.

Question 14

Which outcome of the options presented is MOST appropriate for a client with perceived constipation?
A. Have a bowel movement without the use of a laxative.
B. Explain the rationale for the use of laxatives.
C.Drink 8 glasses of water per day.
D.Defecate every day.

Answer 14

A. Have a bowel movement without the use of a laxative.

Question 15

A nurse determines that the teaching about a guaiac test of stool is understood when the client states that it identifies the presence of which of the following?
A. Ova and parasites
B. Hidden blood
C. Bacteria
D. Bile

Answer 15

B. Hidden blood

Question 16

A nurse is caring for a client who is experiencing diarrhea. Which physiological response to diarrhea should the nurse be most concerned about?
A. Dehydration
B. Malnutrition
C.Excoriated skin
D.Urinary incontinence

Answer 16

A. Dehydration

Question 17

A client is admitted with lower gastrointestinal tract bleeding. Which characteristic of the client’s stool should the nurse assess for that supports this medical diagnosis?
A. Tarry stool
B. Orange stool
C. Green mucoid stool
D. Bright red-tinged stool

Answer 17

D. Bright red-tinged stool

Question 18

A nurse is caring for a group of clients. Which client factor should the nurse identify as placing a client at risk for bowel incontinence?
A. Being ninety years old
B. Taking a sedative for sleep
C. Disoriented to time, place, and person
D. Receiving multiple antibiotic medications

Answer 18

C. Disoriented to time, place, and person

Question 19

Info about Colorectal Cancer

Answer 19

Colorectal cancer screening should begin at age 50 for people at average risk without a personal or family history of colorectal cancer.
* The fecal immunochemical test (FIT), which uses antibodies to detect blood in the stool, or the guaiac-based fecal occult blood test, which uses the chemical guaiac to detect blood in the stool (gFOBT), may be performed annually.

Question 20

A nurse determines that the teaching about a guaiac test of stool is understood when the client states that it identifies the presence of which of the following?
1. Ova and parasites
2. Hidden blood
3. Bacteria
4. Bile

Answer 20

2. Hidden blood

A guaiac tests the presence of blood in the stool

Question 21

What is Melena?

Answer 21

The presence of blood in the stool , TARRY like color (Dark red/ brown)

Question 22

What is Steatorrhea?

Answer 22

A floating stool with a high content of fat.

Question 23

What causes a grey or pale stool?

Answer 23

Liver disease and bile obstruction

Question 24

A nurse is teaching a client with a history of constipation about the excessive use of laxatives. Which effect of laxatives should the nurse include as the primary reason why their use should be avoided?
1. Weakens the natural response to defecation
2. Results in distention of the intestines
3. Causes abdominal discomfort
4. Precipitates incontinence

Answer 24

1. Weakens the natural response to defecation

Question 25

When a test questions states “requires further teaching” would you select the right answer or the wrong answer?
A. Wrong answer
B. Right answer

Answer 25

A. Wrong answer

Question 26

A nurse identifies that a client has tarry stools. Which problem should the nurse conclude that the client is experiencing?
1. Upper gastrointestinal bleeding
2. Pancreatic dysfunction
3. Lactulose intolerance
4. Inadequate bile salts

Answer 26

1. Upper gastrointestinal bleeding

Question 27

A primary health-care provider prescribes a tap-water enema for a client. The client asks about the purpose of the enema. Which specific information about the purpose of a tap-water enema should be included in the nurse’s response?
1. “It reduces abdominal gas.”
2. “It drains the urinary bladder.”
3. “It empties the bowel of stool.”
4. “It limits nausea and vomiting.”

Answer 27

3. “It empties the bowel of stool.”

A tap-water enema instills fluid into the large intestine; the pressure of this volume stimulates peristalsis, causing the colon to evacuate stool.

Question 28

Which word is specific regarding how a soapsuds enema works on the mucosa of the bowel?
1. Dilating
2. Irritating
3. Softening
4. Lubricating

Answer 28

2. Irritating

Although a soapsuds enema works by increasing the volume in the colon, its unique attribute is that soap is irritating to the intestinal mucosa. Irritation of the mucosa precipitates peristalsis, which facilitates the evacuation of fecal material.

Question 29

A nurse is caring for a client with an intestinal stoma. Which intervention is most important?
1. Cleansing the stoma with cool water
2. Spraying an air-freshening deodorant in the room
3. Selecting a bag with an appropriate-size stomal opening
4. Wearing sterile, nonlatex gloves when caring for the stoma

Answer 29

3. Selecting a bag with an appropriate-size stomal opening

The opening of the appliance must be large enough to encircle the stoma to within 1 ⁄ 8 inch to protect the surrounding tissue from the enzymes present in the intestinal discharge without impinging on the stoma. Pressure against the stoma can damage delicate mucosal tissue or impede circulation to the stoma, both of which can impair the viability of the stoma.

Question 30

A nurse performs a physical assessment of a newly admitted client who is incontinent of stool. For which characteristic related to bowel incontinence should the nurse assess the client?
1. Frequent, soft stools
2. Involuntary passage of stool
3. Impaired anal sphincter control
4. Greenish-yellow color to the stool

Answer 30

2. Involuntary passage of stool

Question 31

Which should the nurse do before collecting a stool sample for occult blood?
1. Plan to collect the first specimen of the day.
2. Obtain a sterile specimen container.
3. Wash the client’s perianal area.
4. Ask the client to void.

Answer 31

4. Ask the client to void.

Emptying the urinary bladder before attempting to have a bowel movement prevents accidental contamination of the specimen by urine.

Question 32

According to gravity, would the rate of fluid from the enema be flowing in the patient faster if the enema bag was high or low?
A. High
B. Low

Answer 32

A. High