Chapter 44 Bowel Elimination Potter et al Canadian Fundamentals of Nursing, 6th Edition Te, Exams of Nursing

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Chapter 44 Bowel Elimination Potter et

al Canadian Fundamentals of Nursing,

6th Edition Test Bank

The nurse knows that most nutrients are absorbed in which portion of the digestive tract? - ANS: Duodenum The nurse would expect the least formed stool to be present in which portion of the digestive tract? - ANS: Ascending colon.

3. Which of the following is not a function of the large intestine? - ANS: Absorbing nutrients. The nurse is caring for a patient who is bedridden. The nurse asks the patient whether he needs to have a bowel movement 30 minutes after eating a meal, for what reason? - ANS: Ingestion of food triggers the digestive system to begin peristalsis. A nurse is assisting a patient in making dietary choices that promote healthy bowel elimination. Which menu option should the nurse recommend? - ANS: Grape and walnut chicken salad sandwich on whole wheat bread. A patient informs the nurse that she was using laxatives three times daily to lose weight. After stopping use of the laxative, the patient had difficulty with constipation and wonders if she needs to take laxatives again. With which statement does the nurse educate the patient? - ANS: "Long-term laxative use causes the bowel to become less responsive to stimuli, and constipation may occur." 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? - ANS: Administering laxatives to the patient.
4. Which patient is most at risk for increased peristalsis? - ANS: A 21-year-old patient with three final examinations on the same day.

A patient expresses concerns over having black stool. The fecal occult test is negative. Which response by the nurse is most appropriate? - ANS: "Do you take iron supplements?" Which physiological change can cause a paralytic ileus? - ANS: Surgery with anaesthesia for Crohn's disease. Fecal impactions occur in which portion of the colon? - ANS: Rectum.

12. The nurse knows that a bowel elimination schedule would be most beneficial in the plan of care for which patient? - ANS: A 70-year-old patient with stool incontinence.
13. Which nursing intervention is most effective in promoting normal defecation for a patient who has muscle weakness in the legs that prevents ambulation? - ANS: Elevating the head of the bed 45 degrees 60 minutes after breakfast.
14. 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? - ANS: The patient reports eliminating a soft, formed stool.
15. The nurse is emptying an ileostomy pouch for a patient. Which assessment finding would the nurse report immediately? - ANS: Presence of blood in the stool.
16. The nurse would anticipate which diagnostic examination for a patient with black tarry stools? - ANS: Upper endoscopy.
17. 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? - ANS: Donning gloves for digital removal of the stool.
18. The nurse should question which order? - ANS: A sodium polystyrene sulfonate (Kayexalate) enema for a patient with hypokalemia.

19. The nurse is preparing to perform a fecal occult blood test. The nurse plans to properly perform the examination by doing which of the following? - ANS: Reporting any abnormal findings to the care provider.
20. A nurse is preparing a patient for magnetic resonance imaging (MRI). Which nursing action is most important? - ANS: Removing all of the patient's metallic jewellery.
21. After a patient returns from a barium swallow study, what is the nurse's priority? - ANS: Encourage the patient to increase fluids to flush out the barium.
22. A nurse is educating a patient on how to irrigate an ostomy bag. Which statement by the patient indicates the need for further instruction? - ANS: "I can use a Fleet enema to save money because it contains the same irrigation solution."
23. A patient had an ileostomy surgically placed 2 days ago. Which diet would the nurse recommend to the patient to ease the transition to use of the new ostomy? - ANS: Turkey meatloaf with white rice and apple juice.
24. The nurse knows that the ideal time to change an ostomy pouch is when? - ANS: Before the patient eats a meal, when the patient is comfortable.
25. The nurse administers a cathartic to a patient. The nurse determines that the cathartic has had a therapeutic effect when what happens? - ANS: The patient has a bowel movement.
26. An older person's perineal skin appears to be dry and thin with mild excoriation. When hygiene is provided after a bowel movement, what should the nurse do? - ANS: Apply a skin protective lotion after perineal care.
27. The patient is seen in the gastroenterology clinic after having experienced changes in his bowel elimination. A colonoscopy is ordered, and the patient has questions about the examination. What information should the nurse give the patient before the colonoscopy? - ANS: Light sedation is normally used.

28. 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? - ANS: "If I get a positive result, I have gastrointestinal bleeding."
29. A nurse is caring for an older patient with fecal incontinence caused by cathartic use. The nurse is most concerned about which complication that carries the greatest risk for severe injury? - ANS: Falls from attempts to reach the bathroom.
30. The nurse is caring for a patient with Clostridium difficile infection. Which of the following nursing actions will be most effective in preventing the spread of bacteria? - ANS: Proper hand hygiene techniques.
31. A nurse is caring for a patient who has had diarrhea for the past week. Which additional assessment finding would the nurse expect? - ANS: Decreased serum bicarbonate level.
32. The nurse is caring for a patient who had a colostomy placed yesterday. The nurse should report which assessment finding immediately? - ANS: Stoma is purple.
33. A patient has constipation and hypernatremia. The nurse prepares to administer which type of enema? - ANS: Tap water.
34. A guaiac test has been ordered. The nurse knows that this is a test for which of the following? - ANS: Blood that cannot be seen.
35. The nurse should place the patient in which position when preparing to administer an enema? - ANS: Left Sims's position.
36. The nurse is assessing a patient 2 hours after a colonoscopy. For this procedure, what focused assessment will the nurse include? - ANS: Bowel sounds. Most nutrients and electrolytes are absorbed in which part of the digestive system? - ANS: The small intestine.

During the nursing assessment, the patient reveals that he has diarrhea and cramping every time he eats ice cream. He attributes this to the cold temperature of the food. However, the nurse begins to suspect that these symptoms might be associated with which of the following? - ANS: Lactose intolerance. In the assessment of a 55-year-old patient who is in the clinic for a routine physical examination, under which of the following circumstances would the nurse instruct the patient about the need to provide a stool specimen for guaiac fecal occult blood testing? - ANS: As part of a routine screening for colon cancer. Diarrhea that occurs with a fecal impaction is the result of which of the following? - ANS: Seepage of stool around the impaction. A cleansing enema is ordered for a 55-year-old patient before intestinal surgery. What is the maximum amount of fluid used? - ANS: 750 to 1000 mL. During the enema, the patient begins to complain of pain. The nurse notes blood in the return fluid and rectal bleeding. Which of the following is the nurse's next action? - ANS: Stop the instillation and measure vital signs. A nurse trained to care for patients with ostomies is which of the following? - ANS: An enterostomal therapist. Soon after the patient's abdominal surgery, the nurse includes in the plan of care which of the following interventions, which is essential for promoting peristalsis? - ANS: Early ambulation. The nurse is instructing the patient about the use of opioids for pain relief. Included in the teaching is the information that opioids may cause which of the following? - ANS: Constipation When irrigating a colostomy, the nurse is sure to use which of the following equipment? - ANS: A cone- tipped irrigator. A patient who recently experienced a bout of diarrhea is requesting something to drink. There is an order to encourage clear liquids to prevent fluid and electrolyte imbalance. What does the nurse decide to give the patient? - ANS: Room-temperature bouillon.

The nurse is caring for a patient who has recently received a colostomy. Which of the following findings would require the nurse to notify the physician? - ANS: The ostomy site is purple in colour. A patient with a Salem sump tube begins to drain stomach contents from the blue pigtail. Which nursing action would be appropriate for the nurse to implement at this time? - ANS: Position the blue pigtail at the level of the patient's ear. The nurse is obtaining a patient's medication history. Which of the following medications may cause GI bleeding? (Select all that apply.) - ANS: Aspirin Nonsteroidal anti-inflammatory drugs. To prevent the patient from performing a Valsalva manoeuvre, the nurse might request a stool softener for a patient with which of the following conditions? (Select all that apply.) - ANS: Glaucoma. Cardiovascular disease. Risk for increased intracranial pressure. The nurse teaches patients with a new colostomy that they can eat whatever foods they like but that which of the following foods typically produce gas and should be consumed cautiously? (Select all that apply.) - ANS: Beans. Onions. Cauliflower. The nurse begins to suspect a fecal impaction in a patient who has not had a stool in 10 days when which of the following occurs? (Select all that apply.) - ANS: The patient feels nauseated. The patient oozes liquid stool. The patient has continuous bowel sounds. The nurse instructs the patient to avoid which of the following foods, which could give a false reading on the fecal occult blood test? (Select all that apply.) - ANS: Fish Raw vegetables