Ch 37 Bowel Elimination Flashcards

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)“All four abdominal quadrants auscultated. Inaudible bowel sounds.”
b)“Bowel sounds auscultated. Client has no bowel sounds.”
c)“Client may have bowel sounds, but they can't be heard.”
d)“Auscultated abdomen for bowel sounds. Bowel not functioning.”

Which factor is related to developmental changes in bowel habits for older adult clients?
a)Weakened pelvic muscles lead to constipation.
b)Increase in dietary fiber can decrease peristalsis.
c)Older adults should peel fruits before eating.
d)Milk products cause constipation in clients with lactose intolerance.

While administering a cleansing enema, the client displays lightheadedness, nausea, and has clammy skin. The nurse would implement which priority action?
a)Stop the procedure, monitor heart rate and blood pressure.
b)Slow the infusion rate, withdraw the tubing slightly, then resume enema.
c)Slow the infusion rate, have the client take deep breaths, then resume enema.
d)Stop the procedure and reposition the client.

After data collection on a client, the nurse suspects that the client has diarrhea. Which data collection finding, if observed by the nurse, would confirm the nurse's suspicion?
a)Dry, hard stool
b)Hyperactive bowel sounds
c)Visible waves of abdominal peristalsis
d)Increased anal area pigmentation

During the inspection of a client's abdomen, the nurse notes that it is visibly distended. The nurse should proceed with the client's abdominal assessment by next performing:
a)light palpation.
b)auscultation.
c)deep palpation.
d)percussion.

The type of stool that will be expelled into the ostomy bag by a client who has undergone surgery for an ileostomy will be:
a)bloody.
b)soft semi-formed.
c)mucus-filled.
d)liquid consistency.

The nurse is changing a patient’s ostomy appliance and observes that the peristomal skin is excoriated. What would be the nurse’s priority intervention in this situation?
a)Make sure that the appliance is not cut too large.
b)Clean outside of bag thoroughly when emptying.
c)Suspect ischemia and notify the primary care provider immediately.
d)Notify the primary care provider.

An older adult woman who is incontinent of stool following a cerebrovascular accident will have which nursing diagnosis?
a)Bowel Incontinence related to loss of sphincter control, as evidenced by inability to delay the urge to defecate
b)Fecal Retention related to loss of sphincter control, and diminished spinal cord innervation related to hemiparesis
c)Constipation related to physiologic condition involving the deficit in neurologic innervation, as evidenced by fecal incontinence
d)Diarrhea related to tube feedings, as evidenced by hyperactive bowel sounds and urgency

The nurse is presenting a lecture on ostomy bowel elimination at a community clinic. When questioned by the clients, which foods would the nurse suggest as natural intestinal deodorizers?
a)Yogurt and buttermilk
b)Asparagus and turnip
c)Fish and dried lentils
d)Onions and garlic

A nurse is caring for a client with primary constipation. Which factor is responsible for primary constipation?
a)high intake of fiber
b)inadequate intake of liquid
c)constant urges to defecate
d)constant physical activity

A nurse is administering a prescribed solution of cottonseed oil to a client during an enema. What is the outcome of the use of cottonseed?
a)irritates local tissue
b)distends rectum and moistens stool
c)distends rectum and irritates local tissue
d)lubricates and softens stool

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?
a)fecal occult blood test, barium studies, endoscopic examination
b)barium studies, fecal occult blood test, endoscopic examination
c)endoscopic examination, barium studies, fecal occult blood test
d)barium studies, endoscopic examination, fecal occult blood test

The student nurse is caring for a client with a colostomy. When changing the ostomy appliance, the nurse faculty would intervene if which action by the student is observed?
a)Empties the pouch before changing the appliance
b)Applies a skin protectant to a 2-inch (5-cm) radius around the stoma and allows it to dry completely
c)Starts at the bottom of the appliance, holding abdominal skin taut gently removes the faceplate
d)Places a disposable pad on the work surface

A client's last bowel movement was 4 days ago and oral laxatives and dietary changes have failed to prompt a bowel movement. How should the nurse position the client in anticipation of administering a cleansing enema?
a)Prone
b)Right side-lying
c)Supine
d)Left side-lying

When caring for a client with fecal incontinence, the nurse knows that fecal incontinence is the result of which of the following reasons?
a)Nature and amount of food eaten by client
b)Social and emotional setting of client
c)Physiologic or lifestyle changes in client
d)Drinking and smoking habits of client

Which statement accurately describes the act of defecation?
a)Rectal distention leads to a decrease in intrarectal pressure, causing the muscles to stretch and thereby stimulating the defecation reflex.
b)Centers in the medulla and the spinal cord govern the reflex to defecate.
c)Defecation refers to the emptying of the small intestine.
d)When sympathetic stimulation occurs, the internal anal sphincter relaxes and the colon contracts, sending fecal content to the rectum.

A student nurse studying human anatomy knows that a structure of the large intestine is the:
a)jejunum
b)cecum
c)duodenum
d)ileum

The nurse is inserting a rectal tube to administer a large-volume enema. Which nursing action is performed correctly in this procedure?
a)Introduce solution quickly over a period of 3 to 5 minutes.
b)Encourage the client to hold the solution for at least 20 minutes.
c)Position the client on his back and drape properly.
d)Slowly and gently insert the enema tube 3 to 4 inches (7.5 to 10 cm) for an adult.

The health care provider prescribes a high fiber diet for a client to promote bowel elimination. Which foods, selected by the client, would indicate to the nurse that the client can identify high-fiber foods?
a)Hot tea and flavored water
b)Soda crackers and chicken noodle soup
c)Cream of wheat and applesauce
d)Whole wheat spaghetti and broccoli

A nurse is caring for a client who has a large, hardened mass of stool interfering with defecation, making it impossible for the client to pass feces voluntarily. How should the nurse document this condition?
a)Fecal impaction
b)Fecal incontinence
c)Iatrogenic constipation
d)Secondary constipation

Which symptom is a known side effect of antibiotics?
a)Diarrhea
b)Abdominal bloating
c)Fecal impaction
d)Constipation

While reading a client's history, the nurse notes that a client has a colostomy. When assessing the client, the nurse notes that the output is formed stool. What should the nurse do?
a)Contact the physician immediately
b)Assess for obstruction
c)Document the output, this is normal
d)Gvie the client the ordered laxative

The nurse has presented an educational in-service about caring for clients who have newly created ostomies. The nurse asks participants, "How will you know when a client begins to accept the altered body image?" Which responses by participants indicates a correct understanding of the material? Select all that apply.
a)"The client is willing to look at the stoma."
b)"The client uses spray deodorant several times an hour to mask odor."
c)"The client agrees to take prescribed antidepressants."
d)"The client expresses interest in learning self-care."
e)"The client makes neutral or positive statements about the ostomy."

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?
a)Return-flow enema
b)Retention enema
c)Cleansing enema
d)Carminative enema

Which enema solution lubricates the stool and intestinal mucosa without distending the intestine?
a)Water
b)Normal saline
c)Soap
d)Oil

A nurse is caring for a client with constipation. The incidence of constipation tends to be high among clients that follow which diet?
a)a diet lacking in meat and poultry products
b)a diet lacking in fruits and vegetables
c)a diet lacking in glucose and water
d)a diet consisting of whole grains, seeds, and nuts

Which statement best explains why digital removal of stool is considered a last resort after other methods of bowel evacuation have been unsuccessful?
a)Digital removal of stool may cause parasympathetic stimulation.
b)Nurses find the procedure distasteful and difficult to perform.
c)Most clients will not consent to have digital removal of stool.
d)It often causes rebound diarrhea and electrolyte loss.

When reviewing a client’s chart, which data related to a client experiencing diarrhea might suggest to the nurse a causative factor?
a)The client has a daily fluid intake of 2,000 to 3,000 mL.
b)The client consumes large qualities of fresh vegetables.
c)The client returned from a foreign country two days ago.
d)The client repeatedly ignores the urge to defecate.

For which one of the following patients would a hypertonic solution enema be contraindicated?
a)A patient who has cancer
b)A patient who is constipated
c)A patient with renal impairment
d)A patient who has diarrhea

When the nurse performs a Hemoccult test on a stool specimen, blood in the stool will change the color on the test paper to:
a)red.
b)brown.
c)blue.
d)green.

A 5-year-old client has a gastrointestinal infection. His mother plans to send him to school tomorrow. The school nurse knows that which nursing outcome is most important to include in the care plan of the client?
a)The client will not return to school until he is completely symptom free for 7 days.
b)The client will inform all contacts that he is ill.
c)The client will demonstrate good health practices by isolating himself from others.
d)The client will demonstrate good health practices to prevent spread of infection.

The nurse is preparing to auscultate the bowel sounds of a client with a nasogastric tube in place set to low intermittent suction. How shall the nurse approach the assessment of bowel sounds and manage the nasogastric tube?
a)Apply continuous suction to the nasogastric tube during assessment of bowel sounds.
b)Allow the low intermittent suction to continue during the assessment of bowel sounds.
c)Disconnect the nasogastric tube from suction during the assessment of bowel sounds.
d)Disconnect the nasogastric tube from the suction for 1 hour prior to the assessment of bowel sounds.

Which does not occur with the Valsalva maneuver?
a)contracting abdominal muscles
b)taking a deep breath against a closed glottis
c)contracting pelvic floor muscles
d)contraction of the external sphincter

A client with constipation has been instructed to increase his fluid intake. The client is unsure what type of fluid he should consume. The nurse's best response is that the client should increase his intake of:
a)iced tea.
b)sports drinks.
c)water.
d)grape juice.

A nurse is assessing the stoma of a client with an ostomy. Which intervention should the nurse perform when providing peristomal care to the client to preserve skin integrity?
a)Clean it with a dry, cotton bandage.
b)Wash it with a mild cleanser and water.
c)Avoid using commercial skin preparations.
d)Avoid applying a barrier substance.

A nurse is caring for a 65-year-old woman who has undergone a hernia operation. The client has a morphine PCA for postoperative pain. She also receives sulfamethoxazole-trimethoprim every 12 hours to treat a urinary tract infection, and an iron supplement for anemia. The client is on mobility restrictions because of the narcotics. She explains that while she usually stools once per day, she has stooled four times today. What is most likely contributing to her diarrhea?
a)sulfamethoxazole-trimethaprim
b)immobility
c)iron supplement
d)morphine

A client admitted with cellulitis of the leg has been prescribed amoxicillin-clavulanate potassium. After 3 days of antibiotic therapy, the client develops severe diarrhea, and the nurse notifies the physician. The nurse would anticipate which course of action in response to the client's diarrhea?
a)discontinuation of the amoxicillin and the administration of an antidiarrheal drug
b)discontinuation of the amoxicillin and the administration of a different antibiotic
c)administration of an antidiarrheal drug and continuance of the amoxicillin
d)increase in the client's dietary fiber and continued administration of amoxicillin

During data collection of a client with bowel elimination concerns, which appropriate questions would the nurse ask? Select all that apply.
a)“Where do you do your grocery shopping?”
b)“How often do you move your bowels?”
c)“How often do you go out to eat?"
d)“Do you prefer hot foods or cold foods?”
e)“Do you use anything to help move your bowels?”

A client informs a nurse that he has had difficulty defecating over the past 6 months. He describes his stools as firm and pebble-like and sometimes he must strain to relieve himself. In order to diagnose this client with constipation using the Rome III criteria, what percentage of stool must be affected?
a)50%
b)75%
c)5%
d)25%

Occult blood testing has been ordered for a hospitalized client. Which meal would be acceptable for a client receiving occult blood testing?
a)pot roast with potatoes, carrots, and gravy; applesauce; and gelatin with bananas
b)spaghetti with meat sauce, garlic bread, and chocolate cake
c)tofu with peanut sauce, snow peas, broccoli, and ginger snaps
d)macaroni and cheese, corn, lettuce salad, and vanilla pudding

A client who is postoperative Day 1 has rung the call light twice during the nurse's shift in order to request assistance transferring to a bedside commode. In both cases, however, the client has been unable to defecate. In light of the fact that the client's last bowel movement was the morning of surgery, what action should the nurse first take?
a)Position the client on his side and administer a glycerin suppository.
b)Facilitate a more private setting, such as assisting the client to a bathroom.
c)Administer a normal saline enema after obtaining the relevant order.
d)Obtain a diet change order to increase the amount of fiber in the client's meals.

A hypertonic enema solution lubricates the stool and intestinal mucosa, making stool passage more comfortable.

a)True
b)False

A woman age 76 years has informed the nurse that she has begun using over-the-counter laxatives because her friend told her it was imperative to have at least one bowel movement daily. How should the nurse best respond to this client's statement?
a)"That's correct, but be sure that you don't increase your laxative doses over time."
b)"Actually, people's bowel patterns can vary a lot and some people don't tend to go every day."
c)"Your friend is correct in her assessment, but it would likely be better to exercise and drink more instead of using medications."
d)"Most older adults only have a bowel movement every 2 to 3 days, actually, so I'd encourage you to taper off your laxatives."