Chapter 38- Bowel Elimination Nursing School Test Banks

 

1.

The student nurse studying bowel elimination learns that the following statements accurately describe the process of peristalsis. Select all that apply.

A)

The sympathetic nervous system stimulates movement.

B)

The autonomic nervous system innervates the muscles of the colon.

C)

Peristalsis occurs every 3 to 12 minutes.

D)

Mass peristaltic sweeps occur one to four times each 24-hour period in most people.

E)

Mass peristalsis often occurs after food has been ingested.

F)

One-third to one-half of ingested food waste is normally excreted in the stool within 48 hours.

2.

Based on knowledge of the physiology of the gastrointestinal tract, what type of stools would the nurse assess in a patient with an illness that causes the stool to pass through the large intestine quickly?

A)

hard, formed

B)

black, tarry

C)

soft, watery

D)

dry, odorous

3.

What term is used to describe intestinal gas?

A)

feces

B)

stool

C)

peristalsis

D)

flatus

4.

Which of the following statements accurately describes the act of defecation?

A)

Defecation refers to the emptying of the small intestine.

B)

Centers in the medulla and the spinal cord govern the reflex to defecate.

C)

When sympathetic stimulation occurs, the internal anal sphincter relaxes and the colon contracts sending fecal content to the rectum.

D)

Rectal distention leads to a decrease in intrarectal pressure, causing the muscles to stretch and thereby stimulating the defecation reflex.

5.

A nurse is assessing the stools of a breastfed baby. What is the appearance of normal stools for this baby?

A)

yellow, loose, odorless

B)

brown, paste-like, some odor

C)

brown, formed, strong odor

D)

black, semiformed, no odor

6.

A hospitalized toddler, previously bowel trained, has been having incontinent stools. What would the nurse tell the parents about this behavior?

A)

When he does this, scold him and he will quit.

B)

I dont understand why this child is losing control.

C)

This is normal when a child this age is hospitalized.

D)

I will have to call the doctor and report this behavior.

7.

A nurse caring for elderly patients in an assisted-living facility encourages patients to eat a diet high in fiber to avoid which of the following developmental risk factors for this group?

A)

diarrhea

B)

fecal incontinence

C)

constipation

D)

flatus

8.

A patient is having difficulty having a bowel movement on the bedpan. What is the physiologic reason for this problem?

A)

It is painful to sit on a bedpan.

B)

The position does not facilitate downward pressure.

C)

The position encourages the Valsalva maneuver.

D)

The cause is unknown and requires further study.

9.

The following foods are a part of a patients daily diet: high-fiber cereals, fruits, vegetables, 2,500 mL of fluids. What would the nurse tell the patient to change?

A)

decrease high-fiber foods

B)

decrease amount of fluids

C)

omit fruits if eating vegetables

D)

nothing; this is a good diet

10.

A young woman comes to the Emergency Department with severe abdominal cramping and frequent bloody stools. Food poisoning is suspected. What diagnostic test would be used to confirm this diagnosis?

A)

routine urinalysis

B)

chest x-ray

C)

stool sample

D)

sputum sample

11.

A patient with terminal cancer is taking high doses of a narcotic for pain. The nurse will teach the patient or family about what common side effect of opioids?

A)

inability to change positions

B)

problems with communication

C)

diarrhea

D)

constipation

12.

A nurse is assessing a patient the first day after colon surgery. Based on knowledge of the effects of anesthesia and manipulation of the bowel during surgery, what focused assessment will be included?

A)

bowel sounds

B)

skin turgor

C)

pulse character

D)

urinary output

13.

A nurse has auscultated the abdomen in all four quadrants for 5 minutes and has not heard any bowel sounds. How would this be documented?

A)

Auscultated abdomen for bowel sounds, bowel not functioning.

B)

All four abdominal quadrants auscultated. Inaudible bowel sounds.

C)

Bowel sounds auscultated. Patient has no bowel sounds.

D)

Patient may have bowel sounds, but they cant be heard.

14.

A nurse is conducting an abdominal assessment. What is the rationale for palpating the abdomen last when conducting an abdominal assessment?

A)

it is the most painful assessment method

B)

it is the most embarrassing assessment method

C)

to allow time for the examiners hands to warm

D)

it disturbs normal peristalsis and bowel motility

15.

What are two essential techniques when collecting a stool specimen?

A)

hand hygiene and wearing gloves

B)

following policies and selecting containers

C)

wearing goggles and an isolation gown

D)

using a no-touch method and toilet paper

16.

A Hematest for occult blood in the stool has been ordered. What is occult blood?

A)

bright red visible blood

B)

dark black visible blood

C)

blood that contains mucus

D)

blood that cannot be seen

17.

A nurse is scheduling ordered diagnostic studies for a patient. Which of the following tests would be performed first?

A)

fecal occult blood test

B)

barium study

C)

endoscopic exam

D)

upper gastrointestinal series

18.

A patient has had frequent watery stools (diarrhea) for an extended period of time. The patient also has decreased skin turgor and dark urine. Based on these data, which of the following nursing diagnoses would be appropriate?

A)

Imbalanced Nutrition: Less than Body Requirements

B)

Deficient Fluid Volume

C)

Impaired Tissue Integrity

D)

Impaired Urinary Elimination

19.

An infant has had diarrhea for several days. What assessments will the nurse make to identify risks from the diarrhea?

A)

heart tones

B)

lung sounds

C)

skin turgor

D)

activity level

20.

A patient tells the nurse that he takes laxatives every day but is still constipated. The nurses response is based on which of the following?

A)

Habitual laxative use is the most common cause of chronic constipation.

B)

If laxatives are not effective, the patient should begin to use enemas.

C)

A laxative that works by a different method should be used.

D)

Chronic constipation is nothing to be concerned about.

21.

A patient who has been on a medication that caused diarrhea is now off the medication. What could the nurse suggest to promote the return of normal flora?

A)

stool-softening laxatives, such as Colace

B)

increasing fluid intake to 3,000 mL/day

C)

drinking fluids with a high sugar content

D)

eating fermented products, such as yogurt

22.

A patient is on bedrest, and an enema has been ordered. In what position should the nurse position the patient?

A)

Fowlers

B)

Sims

C)

Prone

D)

Sitting

23.

A patient is having liquid fecal seepage. He has not had a bowel movement for 6 days. Based on the data, what would the nurse assess?

A)

amount of intake and output

B)

color and amount of urine

C)

color of the feces

D)

consistency of the feces

24.

Which of the following would be an expected outcome for a patient when the nurse is conducting a bowel training program?

A)

Have a soft, formed stool at regular intervals without a laxative.

B)

Continue to use laxatives, but use one less irritating to the rectum.

C)

Use oil-retention enemas on a regular basis for elimination.

D)

Have a formed stool at least twice a day for 2 weeks.

25.

A patient tells the nurse, I increased my fiber, but I am very constipated. What further information does the nurse need to tell the patient?

A)

Just give it a few more days and you should be fine.

B)

Well, that shouldnt happen. Let me recommend a good laxative for you.

C)

When you increase fiber in your diet, you also need to increase liquids.

D)

I will tell the doctor you are having problems; maybe he can help.

26.

A nurse is caring for a patient with a colostomy. What type of stools would she expect to find in the colostomy bag?

A)

liquid

B)

watery

C)

formed

D)

none

27.

A nurse is documenting the appearance of feces from a patient with a permanent ileostomy. Which of the following would she document?

A)

Ileostomy bag half filled with liquid feces.

B)

Ileostomy bag half filled with hard, formed feces.

C)

Colostomy bag intact without feces.

D)

Colostomy bag filled with flatus and feces.

28.

A nurse is assessing the stoma of a patient with an ostomy. What would the nurse assess in a normal, healthy stoma?

A)

pallor

B)

purple-blue

C)

irritation and bleeding

D)

dark red and moist

29.

A nurse is caring for a patient who is 1 day postoperative for a temporary colostomy. The nurse assesses no feces in the collection bag. What should the nurse do next?

A)

Notify the physician immediately.

B)

Ask another nurse to check her findings.

C)

Nothing; this is normal.

D)

Recheck the bag in 2 hours.

30.

A nurse is providing discharge instructions for a patient with a new colostomy. Which of the following is a recommended guideline for long-term ostomy care?

A)

During the first 6 to 8 weeks after surgery, eat foods high in fiber.

B)

Drink at least 2 quarts of fluids, preferably water, daily.

C)

Use enteric-coated or sustained-release medications if needed.

D)

Use a mild laxative if needed.

Answer Key

1.

B, C, D, E

2.

C

3.

D

4.

B

5.

A

6.

C

7.

C

8.

B

9.

D

10.

C

11.

D

12.

A

13.

B

14.

D

15.

A

16.

D

17.

A

18.

B

19.

C

20.

A

21.

D

22.

B

23.

D

24.

A

25.

C

26.

C

27.

A

28.

D

29.

C

30.

B

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