fundamentals ch 30 bowel elimination care TEST QUESTIONS

While providing care for an older adult client, the nurse learns that the client has had only small, watery stools for several days. Which is the nurse's priority in providing care for this client? 1. Assess the client for an impaction. 2. Call the primary care physician and get an order for a laxative. 3. Administer medication to slow the diarrhea. 4. Collect a stool specimen for analysis.

Ans: 1 1 This is correct. Older adult clients are at risk for development of constipation and an impaction; small amounts of liquid stool seeps around an impaction, so the client should first be checked for an impaction. 2 This is incorrect. The first priority is to check for an impaction and call the primary care physician if one is present. Usually the impaction will need to be manually removed before a laxative is given. 3 This is incorrect. Undiagnosed diarrhea is not treated with an antidiarrheal. 4 This is incorrect. If an impaction is ruled out, then it may be necessary to obtain a stool specimen for culture, but it would not be the first priority.

The nurse is obtaining a health history from an older adult client. The client tells the nurse that a bowel movement occurs about every 2 to 3 days. Which question should the nurse ask to determine if this is normal functioning for the client? 1. What is the consistency of your stool? 2. Do you take laxatives to go more often? 3. What is a normal daily diet for you? 4. How do you feel if you don't go every day?

Ans: 1 1 This is correct. The nurse should ask about the consistency of the client's stool in order to determine if the client has constipation. If the stool is soft and easy to pass, the nurse can determine that the client's pattern of elimination is normal. 2 This is incorrect. The nurse may want to ask if the client routinely takes laxatives; however, the answer will not help the nurse to determine if the client's current pattern of elimination is normal. 3 This is incorrect. The nurse may ask about the client's normal daily diet; however, this information will not help the nurse to determine if the client's current pattern of elimination is normal. 4 This is incorrect. The nurse can ask if the client's bowel pattern causes distress; however, this information will not help the nurse to determine if the client's current pattern of elimination is normal.

The nurse is discussing ways to help prevent constipation. Which information is most important for the nurse to share? 1. Do not ignore the defecation reflex. 2. Plan to defecate prior to the next meal. 3. Decrease fluids if fiber is increased. 4. Use laxatives to better time defecation

Ans: 1 1 This is correct. The nurse should share that the client should not ignore the defecation reflex. Ignoring the reflex contributes to constipation. 2 This is incorrect. It is not accurate to expect defecation to occur before the next meal. It is more realistic for the client to expect the urge to defecate with 30 to 60 minutes after eating. 3 This is incorrect. If fiber in the diet is increased, the fluids must be increased to prevent constipation. 4 This is incorrect. The use of laxatives to better time defecation is not good practice and can lead to laxative dependency. When laxatives are discontinued, the client is at risk for constipation.

The nurse is assigned to provide client care to multiple clients. Which client does the nurse recognize as being at greatest risk for a fecal impaction? 1. An older adult client with poor fluid intake and a history of laxative abuse. 2. A client who is four days postoperative receiving an opioid drug for pain. 3. A client admitted for dehydration related to vomiting, receiving IV therapy. 4. A client ordered on bedrest for a pulmonary embolus who eats a regular diet.

Ans: 1 1 This is correct. The older adult client with a history of laxative abuse and a poor fluid intake is at greatest risk for fecal impaction. The client has three risk factors: age, decreased colon tone, and deficient fluid intake. 2 This is incorrect. A client who is four days postoperative who is receiving an opioid for pain is at risk for constipation, not fecal impaction. Opioid drugs decrease intestinal motility and cause constipation. 3 This is incorrect. A client who is admitted with dehydration related to vomiting and is receiving IV fluids is not at risk for either constipation or fecal impaction. 4 This is incorrect. A client who is on bedrest for pulmonary embolus but eats a regular diet is at low risk for a fecal impaction. The client should be encouraged to increase dietary fiber and fluids

A patient is on a bowel training program. At which times would the nurse assist the patient to defecate? (SATA) 1. Upon awakening 2. Any time the patient states that he or she has to move bowels 3. After breakfast, lunch, and supper 4. After drinks a pitcher of water 5. Upon bedtime

Ans: 1, 2, 3 1. When the patient arises each day, assist the patient to the commode. 2. Any time the patient says that his or her bowels have to move, assist the patient to the toilet. 3. The patient should be assisted to the commode after each meal. 4. Although this may help with urination, it is not a time for defecation during bowel training. 5. Bedtime is not the time for defecation during bowel training.

A patient is obtaining a stool specimen for occult blood from home. The nurse is reinforcing dietary restrictions for this test. Which items should the nurse tell the patient to avoid? (SATA) 1. Cherry limeade 2. Broiled steak 3. Vitamin D supplements 4. Steamed broccoli 5. Cooked carrots

Ans: 1, 2, 4

The patient is to receive a cleansing enema for relief of constipation. Which of the following factors must be assessed prior to administration of the enema? (SATA) 1. Type of solution to administer 2. Date of last bowel movement 3. Type of diet the patient has been receiving 4. Assessment of the bowel sounds 5. The patient's temperature

Ans: 1, 2, 4

The nurse is monitoring stools from different patients. Which findings would the nurse expect to observe? (SATA) 1. A patient with gallbladder disease has clay-colored stools. 2. A patient with steatorrhea has stools that float and are fluffy with a foul odor. 3. A patient with bleeding from the small intestine has bright red blood in the stools. 4. A patient with colon cancer has ribbon-shaped stools. 5. A patient with bleeding from the colon has melena.

Ans: 1, 2, 4 1: Stools that are pale or clay colored indicate a lack of bile in the intestine, which may be due to liver or gallbladder disease. 2: Stool that appears fluffy, floats on water, and has a foul odor is due to abnormal content of undigested fat and is called steatorrhea. It may be due to disorders such as Crohn's disease. 3: Larger amounts of bright red blood will indicate bleeding or hemorrhage from the colon. Large amounts of maroon-colored blood indicate bleeding from the small intestine. 4: Ribbon-shaped stools may indicate compression on the colon by a tumor, which may be colon cancer. 5: Stools that are black and tarry with foul odor indicate bleeding from the stomach; the blood has been partially digested, giving it the black, tarry appearance that is known as melena.

Which action is most appropriate for a client experiencing constipation? Select all that apply. 1. Increase intake of beans and legumes 2. Increase intake of lean meats 3. Increase intake of fruits and vegetables 4. Increase intake of bread and pasta 5. Increase intake of milk and cheese

Ans: 1, 3

Which are ways the nurse can promote regular defecation for clients? Select all that apply. 1. Provide privacy. 2. Remind the client that constipation could occur if he or she does not defecate regularly. 3. Take a matter-of-fact straightforward approach. 4. Control odors to prevent embarrassment. 5. Accompany the client and provide encouragement while he or she is attempting defecation.

Ans: 1, 3, 4 1. Provide privacy. (can help client relax and feel more comfortable during defecation) 3. Take a matter-of-fact straightforward approach. (f a nurse conveys comfort with this aspect of care, the client may be less self-conscious) 4. Control odors to prevent embarrassment. (pt may be embarrassed by the odors, and the nurse can assist by providing odor control)

In which ways can surgery or procedures contribute to sluggish bowel elimination? Select all that apply. 1. Anesthesia 2. Increased IV fluids 3. Stress 4. Decreased mobility 5. Manipulation of the bowel

Ans: 1, 3, 4, 5 1. Anesthesia (and sedating agents slow bowel motility) 3. Stress (stimulates autonomic nervous system and slows peristalsis) 4. Decreased mobility (due to pain or other restrictions can lead to decreased bowel function) 5. Manipulation of the bowel (surgery on the abdomen or a section of bowel may result in paralysis of part of the bowel, or paralytic ileus)

Which should be included in client teaching to support normal bowel elimination? Select all that apply. 1. Increase fluid intake. 2. Limit fiber intake. 3. Increase caffeine intake. 4. Increase physical activity. 5. Do not ignore the urge to defecate.

Ans: 1, 4, 5 1. Increase fluid intake. (help support normal bowel function by increasing fluid and maintaining water balance) 4. Increase physical activity. (help to support normal peristalsis) 5. Do not ignore the urge to defecate. (ignoring the urge to defecate can lead to constipation)

Several medications have GI side effects and may lead to diarrhea or constipation. Indicate which of the following medications would be most likely to cause constipation in the patient? (SATA) 1. Amphojel 2. Maalox 3. Magnesium citrate 4. Meperidine 5. Amoxicillin 6. Ferrous sulfate (iron) 7. Imodium AD 8. Milk of magnesia

Ans: 1, 4, 5, 7

The nurse would monitor which patients for diarrhea? (SATA) 1. One who eats ice cream and has lactose intolerance 2. One who has Clostridium difficile 3. One who has inflamed diverticula 4. One who is stressed about an upcoming surgery 5. One who is allergic to strawberries and does not eat strawberries

Ans: 1,2, 3, 4 1: Some people are unable to digest lactose, a sugar found in milk and other dairy products. If they do ingest lactose-containing foods, it will usually cause them to have diarrhea. 2: One of the more severe opportunistic infections is Clostridium difficile, otherwise known as C. diff., which causes diarrhea. 3: Diverticulitis, inflammation of colon pouches, can cause diarrhea and severe cramping sufficient to force a visit to a health-care provider. 4: High levels of stress or anxiety, as well as other emotional problems, can cause increased peristalsis and intestinal mucus production, which may result in diarrhea. 5: If the patient ate the strawberries, then diarrhea could occur; but because the patient did not eat them, diarrhea will not occur.

The nurse is reviewing the medical record of a client who has not had a bowel movement for 3 days. What factors are concerning? Select all that apply. 1. Client is on bedrest. 2. Client is in a semiprivate room. 3. Client took a laxative prior to hospitalization. 4. Client is receiving an iron supplement. 5. Client has not eaten for 48 hours.

Ans: 1,2,3,4,5

Place the anatomical parts of the digestive system in the appropriate order according to how digestion occurs. 1. Mastication 2. Stomach 3. Duodenum 4. Cecum 5. Ileum

Ans: 1,2,3,5,4

The nurse is collecting data from several patients. Which findings would cause the nurse to monitor closely for constipation? (SATA) 1. Is immobile due to skeletal traction 2. Eats three daily meals a day at 7 a.m., noon, and 5 p.m. 3. Is postoperative from a hip surgery 4. Takes hydrocodone to help with back pain 5. Is dehydrated from working out in the sun

Ans: 1,3,4,5

The nurse is preparing to collect a stool specimen ordered by the physician. Which client and reason defines the need for the specimen? 1. A client traveled outside the country and has lost weight since returning. 2. A client experiences bloating and flatus after consuming dairy products. 3. A client with hemorrhoids notices streaks of blood on the toilet paper. 4. A client is on iron therapy for anemia and the stools are dark in color

Ans: 1. A client traveled outside the country and has lost weight since returning 1 This is correct. The client who traveled outside the country and is now experiencing weight loss should be checked for parasites and/or parasite ova. The presence of either can be confirmed by microscopic examination of a stool specimen. 2 This is incorrect. A client who experiences bloating and flatus after consuming dairy products is likely to be lactose intolerant. A stool specimen is not needed from this client. 3 This is incorrect. When a client has hemorrhoids, it is expected to see streaks of blood on the toilet paper. A stool specimen is not needed from this client. 4 This is incorrect. It is expected that a client who is on iron therapy for anemia will see a color change of their feces. Dark, formed stool is not uncommon. A stool specimen is not needed from this client.

The nurse is administering an enema to a patient who is constipated. Which action should the nurse take? 1. Insert the tubing 3 to 4 inches (7.6 to 10.2 cm) into the rectum. 2. Warm water to 120° F (48.9° C). 3. Administer enema with patient on the toilet. 4. Check to make sure water feels cool on inner wrist.

Ans: 1. Insert the tubing 3 to 4 inches (7.6 to 10.2 cm) into the rectum. The normal length to insert the tip of the tubing is 3 to 4 inches (7.6 to 10.2 cm) for administration of a cleansing enema to an adult.

While inspecting a client's stool, a nurse notices a small amount of black, tarry blood with a distinctive old-blood odor that appears to have been partially digested. Which term does the nurses use to describe the client's stool? 1. Melena 2. Occult blood 3. Frank blood 4. Steatorrhea

Ans: 1. Melena 1 This is correct. Smaller amounts of blood that come from higher in the digestive tract, such as the stomach, having been partially digested, will have a distinctive old-blood odor and a black, tarry appearance known as melena. 2 This is incorrect. To determine the presence of occult blood, a guaiac test must be performed on the stool sample. 3 This is incorrect. Frank blood in the stool is bright red blood visible with the naked eye, whereas occult blood is hidden or not visible. 4 This is incorrect. Steatorrhea refers to stool containing an abnormally high amount of undigested fat.

A patient has a vagal response to administration of an enema. Which action by the nurse is priority? 1. Remove the tube from the rectum. 2. Place in high Fowler's position. 3. Leave the patient to go get help. 4. Slow the rate of the enema.

Ans: 1. Remove the tube from the rectum. 1: The tube must be removed from the rectum. 2: Place the patient in the supine position. 3: Call for immediate assistance, but do not leave the patient. 4: The enema should be stopped.

The nurse wants to determine if peristalsis is occurring in a patient. Which piece of equipment should the nurse obtain? 1. Stethoscope 2. Thermometer 3. Blood pressure cuff 4. Enema bag

Ans: 1. Stethoscope

During an admission physical assessment, a nurse questions a client about bowel elimination habits. Which client care goal is the nurse attempting to identify? 1. Assessment about the need for a laxative. 2. Maintain the client's normal elimination habit. 3. Complete collection of all pertinent client data. 4. Determine if further gastrointestinal testing is necessary

Ans: 2 1 This is incorrect. Although it is important to assess the need for assistance with elimination, the purpose is to collect bowel elimination data and the goal is to maintain normal functioning. 2 This is correct. The goal of the nurse's assessment related to elimination is to maintain the client's normal elimination pattern while hospitalized. 3 This is incorrect. Collection of data is essential in determining client needs, but it is not the goal. 4 This is incorrect. Determining whether further testing is needed is not a nursing function, nor is it the goal of elimination care

The nurse is admitting a client and performs a focused assessment. Which techniques will result in the nurse acquiring objective data related to bowel function? 1. Ask when the client last had a bowel movement. 2. Use the diaphragm of a stethoscope to hear bowel sounds. 3. Inquire about the characteristics of feces. 4. Ask the client to describe past abdominal pain.

Ans: 2 1 This is incorrect. Asking when the client last had a bowel movement is gathering subjective data.2 This is correct. When the nurse listens with the diaphragm of the stethoscope for bowel sounds, the nurse is gathering objective data. 3 This is incorrect. Inquiring the client about the characteristics of feces is gathering subjective data. 4 This is incorrect. Asking the client to describe past abdominal pain is gathering subjective data.

The nurse assists a client to the bathroom, and notices that the client's stool is clay colored. The client tells the nurse that this has occurred off and on for the last month or two. Which condition does the nurse suspect? 1. Poorly balanced diet 2. Gallstones or liver problems 3. History of gastrointestinal (GI) bleeding 4. Poor fluid intake

Ans: 2 1 This is incorrect. Diet does not remove color from feces. 2 This is correct. Gallstones or liver disease can prevent bile from entering the small intestine, and bile gives feces color. 3 This is incorrect. Lower GI bleeding turns feces a reddish color, whereas stools that are black indicate bleeding from the upper GI. 4 This is incorrect. Fluids typically do not affect the color of feces.

The nurse is administering different types of enemas to different patients. Based upon each patient's condition, which enemas would the nurse administer? (SATA) 1. Administer tap water enemas to a patient with congestive heart failure. 2. Heat milk and molasses together and then cool before administering to a patient with constipation. 3. Give a Harris flush to a patient with flatus. 4. Administer a steroid enema to a patient with inflammation in the rectum and colon. 5. Give hypertonic sodium phosphate enema 1 hour before removing the patient's impaction

Ans: 2, 3, 4

The nurse suspects a patient has occult bleeding and performs a guaiac test. Which actions should the nurse take? (SATA) 1. Put toilet paper in the specimen pan. 2. Obtain specimen from two different areas of the stool. 3. Watch for a bluish color, which is a positive result. 4. Place developer on opposite side of the card from the specimens. 5. Use sterile gloves.

Ans: 2, 3, 4 1: Tell the patient that toilet tissue should not be placed in the specimen pan or bedpan, whichever is used, to prevent contamination of the specimen. 2. Select the specimen from two different areas of the stool, especially any part of stool that is red, maroon, black, or tarry in appearance. 3. The test results are positive for the presence of blood if the feces smears turn a blue or bluish-purple color, similar to the control color. The test results are negative if the smears do not turn blue. 4. According to specific kit instructions, apply the designated number of developer drops onto the opposite side of the card from the specimens, directly over each of the two feces smears. 5: Clean examination gloves are used. - not sterile

Which are common gastrointestinal symptoms suggestive of food allergy? Select all that apply. 1. Nausea 2. Rash around the anus 3. Excessive gas 4. Intestinal bleeding 5. Severe vomiting

Ans: 2, 3, 4 2. Rash around the anus (rash around the anus is suggestive of normal allergy, as the immune system responds to the allergen) 3. Excessive gas (indicator of food allergy) 4. Intestinal bleeding (intestinal bleeding is often seen in true food)

The nurse is reviewing the medical record of a patient who has not had a bowel movement for 3 days. What factors may be contributing to the situation? Select all that apply. 1. Patient has hyperactive bowel sounds. 2. Patient is on bedrest. 3. Patient is receiving an iron supplement. 4. Patient is in a semiprivate room. 5. Patient is laxative dependent.

Ans: 2, 3, 4, 5

Which of the following signs and symptoms may be an indication of vagal stimulation during the digital removal of an impaction? (SATA) 1. Complaint of rectal pressure 2. Pulse rate of 42 bpm 3. Complaint of difficulty breathing 4. Moist skin 5. Complaint of abdominal cramping 6. Complaint of feeling faint

Ans: 2, 3, 6

The nurse needs to determine if a patient is experiencing tenesmus. Which question should the nurse ask? 1. "Do you have pain with defecation?" 2. "Do you have urgency or pressure in the rectum?" 3. "Do you have any abnormal color in your stools?" 4. "Do you have formed or unformed stools?"

Ans: 2. "Do you have urgency or pressure in the rectum?" Tenesmus is a persistent desire to empty the bowel when no feces are present, causing ineffective straining efforts.

A patient presents to the clinic with unexplained diarrhea. Which question should the nurse ask to help determine the cause of the diarrhea? 1. "How much fluid do you drink?" 2. "Have you taken an antibiotic recently?" 3. "How often do your bowels normally move?" 4. "Does your mother have diverticulosis?"

Ans: 2. "Have you taken an antibiotic recently?" Antibiotics administered to treat infection can also kill some of the good bacteria that the body needs to stay healthy, specifically the normal flora found in the bowel. When the level of normal flora decreases, other microorganisms such as fungi are allowed to grow disproportionately, causing what is called an opportunistic infection. Opportunistic infections grow in the bowel, causing diarrhea.

The nurse is assigning the administration of an enema to the unlicensed assistive personnel (UAP). Which statement by the UAP indicates the UAP is safe to administer the enema? 1. "I will gently insert the tube upon resistance." 2. "I will insert the tubing toward the umbilicus." 3. "I will insert the tube at least 6 inches (15.2 cm) into the rectum." 4. "I will gently insert the tubing with the patient in the right side-lying position."

Ans: 2. "I will insert the tubing toward the umbilicus." 1: Never force the enema tubing if resistance is met. 2: The UAP should direct the tip of the tubing toward the umbilicus to follow the natural direction of the sigmoid colon. 3: Never insert it farther than 4 to 6 inches (10.2 to 15.2 cm). 4: The patient should be in Sim's or left side-lying position.

A patient is incontinent of stool. How should the nurse respond? 1. "Not again." 2. "Let's get those briefs changed." 3. "What is wrong with you?" 4. "I will put this diaper on you quickly."

Ans: 2. "Let's get those briefs changed."

A patient diagnosed with a bowel infection asks the nurse why Lactobacillus acidophilus is prescribed in addition to antibiotics. How should the nurse respond? 1. "This makes the antibiotics stronger." 2. "This replaces the normal bacteria that is lost from the antibiotic." 3. "This coats the inside of the infectious bowel." 4. "This helps slow down the wavelike movement in the inflamed bowels."

Ans: 2. "This replaces the normal bacteria that is lost from the antibiotic." Lactobacillus acidophilus is a probiotic supplement that comes in several forms. It can be used to replace normal flora or used concurrently with antibiotics to prevent loss of normal flora.

A nurse is teaching wellness to a church group. How many daily milliliters of water should be encouraged for normal bowel health? 1. 1,000 to 1,600 mL 2. 1,500 to 2,400 mL 3. 2,000 to 3,200 mL 4. 2,500 to 3,400 mL

Ans: 2. 1,500 to 2,400 mL

The nurse is caring for multiple clients with a variety of bowel conditions. Which client does the nurse consider at greatest risk for surgery to place a colostomy? 1. A client with traumatic injury to the abdomen 2. A client with a portion of bowel without circulation 3. A client with a cancerous tumor in the transverse colon 4. A client who has experienced a ruptured diverticulum

Ans: 2. A client with a portion of bowel without circulation 1 This is incorrect. When a client experiences traumatic injury to the abdomen, surgery to place a colostomy may or may not be necessary. The decision will be based on the severity and location of any injury to the colon. 2 This is correct. When a portion of the bowel is without circulation, ischemia occurs which will progress to tissue death. This is the client that is most likely to need surgery for the placement of a colostomy. 3 This is incorrect. When a client has a cancerous tumor in the transverse colon, it may or may not be necessary to surgically place a colostomy. Due to the location, it may be possible to remove the tumor and reattach the two ends of the colon. Cancer in the descending colon or the sigmoid colon usually result in a colostomy. 4 This is incorrect. A client with a ruptured diverticulum may or may not need surgery for the placement of a colostomy. The location and damage will need to be surgically assessed.

The nurse is assessing a client immediately after the placement of a colostomy. Which assessment finding does the nurse expect to see? 1. The presence of effluence in the colostomy appliance 2. A stoma that is red, shiny, moist, and beefy in appearance 3. A slight skin irritation found under the appliance wafer 4. Drainage of mucus and purulent liquid from the stoma

Ans: 2. A stoma that is red, shiny, moist, and beefy in appearance 1 This is incorrect. The nurse would not expect to see effluence in the colostomy appliance immediately after the placement of a colostomy. Effluence is the term given to drainage from a colostomy instead of feces. 2 This is correct. The nurse should expect to see a stoma that is red, shiny, and moist. The beefy appearance is related to edema and should diminish with time. 3 This is incorrect. The appliance wafer is applied at the completion of the surgery to place a colostomy. It is unlikely that the wafer and appliance will be removed immediately after surgery. 4 This is incorrect. The nurse can expect to see drainage, which initially will consist of mucus and some blood. However purulent drainage is indicative of an infection, which is not expected immediately after surgical placement of a colostomy.

Which of the following would be the most accurate statement about digestion and elimination? 1. All individuals have at least 1 bowel movement daily 2. An infant may have up to 6 bowel movements daily 3. GI peristalsis increases with age, making incontinence a normal finding 4. A stool is only considering normal if the color is a shade of brown

Ans: 2. An infant may have up to 6 bowel movements daily

Undigested food first enters the large intestine through which structure? 1. Duodenum 2. Cecum 3. Rectum 4. Sigmoid colon

Ans: 2. Cecum is the first portion of the large intestine [WRONG] 1. Duodenum - first part of the small intestine 3. Rectum - last portion of the large intestine 4. Sigmoid colon - final, small section of the bowel

Which is the result of the passage of stool through the colon being slowed? 1. Diarrhea 2. Constipation 3.Distention 4. Ileus

Ans: 2. Constipation (occurs when stool passage through the colon is slowed, allowing more water absorption to result in hardened stool) [WRONG] 1. Diarrhea (result of stool passing through the colon quickly, not allowing enough water absorption) 3.Distention (occur with a variety of abnormal patterns of bowel elimination) 4. Ileus (paralytic ileus is the result of a portion of the colon being paralyzed)

The nurse is administering an enema to a patient. Which action should the nurse take? 1. Lubricate tube with petroleum-based lubricant. 2. Gradually raise the container 12 to 18 inches (30.5 to 45.7 cm) above the patient's hip level. 3. If resistance is felt, open the tubing to allow a large amount of fluid to flow. 4. Elevate the container if the patient reports cramping.

Ans: 2. Gradually raise the container 12 to 18 inches (30.5 to 45.7 cm) above the patient's hip level.

A patient has a Kock pouch. Which technique would the nurse use? 1. Replace the bag when one-third to one-half full. 2. Insert a catheter to drain the pouch. 3. Store the external pouch below the stoma. 4. Make sure the patient wears the bag constantly.

Ans: 2. Insert a catheter to drain the pouch. Several times a day, the patient inserts a catheter to drain the reservoir.

The nurse is preparing to administer an ordered enema to a client. Which intervention by the nurse is correct for this procedure? 1. Warm the water to a temperature between 115°F and 125°F. 2. Insert the tip of the enema tube approximately 3 to 4 inches into the rectum. 3. Give the enema while the client is in a sitting position on the toilet. 4. Have the client lie on the right side to facilitate the instillation of fluid.

Ans: 2. Insert the tip of the enema tube approximately 3 to 4 inches into the rectum. 1 This is incorrect. The temperature of the water for an enema should be between 105°F and 110°F to prevent burning the intestinal mucosa. 2 This is correct. Inserting the tip of the enema tubing farther than 3 to 4 inches could damage the intestinal mucosa or perforate the colon. 3 This is incorrect. Sitting changes the angle of curve of the rectum, making it easier to damage the intestinal mucosa or perforate the intestinal wall. 4 This is incorrect. An enema should be given with the client lying on the left side.

Which older adult patient should the nurse monitor closely for a fecal impaction? 1. One who eats fruits and vegetables every day 2. One who overuses laxatives 3. One who drinks 2500 mL of fluid a day 4. One who exercises at least three times a week

Ans: 2. One who overuses laxatives

Which type of nurses are caring for patients that are most prone to dehydration from diarrhea? 1. Long-term care facility 2. Pediatric unit 3. Adolescent unit 4. Assisted-living facility

Ans: 2. Pediatric unit

Which information would the nurse share with a patient who wants to increase fiber in the diet? 1. Eat 35 to 40 g/day of fiber. 2. Slowly increase fiber intake over 7 to 10 days. 3. Increase caffeine intake with the fiber. 4. Decrease intake of fluid when eating fiber.

Ans: 2. Slowly increase fiber intake over 7 to 10 days. 1: Teach the patient to increase the fiber in his or her diet to a minimum of 25 to 30 g/day. 2: Explain that the amount of fiber should be increased slowly over 7 to 10 days and that taking too much too quickly will cause excessive flatus. 3: Too much caffeine may also increase peristalsis and cramping, as well as production of excessive flatus. It is recommended that caffeine intake be limited to 300 mg daily. 4: Too much fiber without adequate fluids can contribute to constipation.

The well-baby clinic nurse is reinforcing teaching to a new breastfeeding mother about her infant's stool. The nurse should share which information about the infant's stools? 1. The stools will be meconium. 2. The stools will be bright yellow and seedy. 3. The stools will be tan-colored and firm. 4. The stools will be very dark brown and sticky.

Ans: 2. The stools will be bright yellow and seedy. Infants who are breastfed usually will have a bright yellow, pasty, seedy-appearing stool.

A client is diagnosed with an intestinal infection after traveling to a developing country. The nurse should encourage the intake of which food to optimize the gut's normal flora, creating a healthier environment? 1. Milk 2. Yogurt 3. Oatmeal 4. Bread

Ans: 2. Yogurt

The nurse is caring for a client who has fecal incontinence. The symptoms include intermittent periods when small amounts of liquid stool are passed, followed by periods of severe constipation requiring the use of enemas to resolve. Which intervention should the nurse perform first? 1. Assess for readiness to participate in a bowel training program. 2. Teach the client about increasing fiber and fluids in the daily diet. 3. Examine the client and check for the possibility of fecal impaction. 4. Inform the client of the multiple types of incontinence products available.

Ans: 3 1 This is incorrect. It is too early to assess for readiness for a bowel training program; other assessments should be performed first. 2 This is incorrect. Teaching the client about managing the periods of constipation is only addressing part of the client's problem. 3 This is correct. The periodic passage of small amounts of liquid stool is a cardinal indication that the client may have a fecal impaction. The alternating periods of constipation are expected. The nurse needs to first assess for this condition. 4 This is incorrect. There are multiple reasons why some clients need to use incontinence products; however, this client needs assessment and possible interventions to address the cause of the incontinence.

A female client has been admitted with ulcerative colitis. Which appearance of the client's stools will the nurse expect with the exacerbation of this condition? 1. Be black, tarry, and odiferous 2. Float, and be odorless and bloody 3. Contain pus, mucus, and blood 4. Be soft, but ribbon shaped

Ans: 3 1 This is incorrect. Stools with strong odor, which are black and tarry, could indicate upper gastrointestinal bleeding or large doses of iron supplements. 2 This is incorrect. Stools that are bloody are not odorless, nor do they float. 3 This is correct. Stools of individuals with ulcerative colitis typically contain pus, mucus, and blood. 4 This is incorrect. Soft, ribbon-shaped feces indicate pressure against or within the colon, such as seen with colon cancer

The nurse assisted with a staff education program about bowel elimination. Which statement by a staff member indicates successful teaching? 1. "The process of bowel elimination is feces." 2. "Most of the digestion occurs in the stomach." 3. "The sphincter between the stomach and the small intestine is the pyloric sphincter." 4. "The normal flora interacts with the chyme to produce peristalsis or wavelike movements."

Ans: 3. "The sphincter between the stomach and the small intestine is the pyloric sphincter."

The nurse is preparing to administer a cleansing enema to a small child. How many milliliters (mL) of fluid would the nurse administer? 1. 1000 2. 500 3. 150 4. 50

Ans: 3. 150 Generally, the volume is 100 to 250 mL for small children. 1: Never administer an adult large volume of 1000 mL to a small child. This could result in bowel rupture. 2: 250 to 500 mL is given to school-age children.

The unlicensed assistive personnel (UAP) is providing care to an elderly, confused patient with constipation. Which action by the UAP would the nurse praise? 1. Offers the patient fluid every hour 2. Provides privacy by leaving the patient alone on the bedside commode 3. Assists the patient with meals while sitting in the chair 4. Keeps head of bed flat when using the bedpan

Ans: 3. Assists the patient with meals while sitting in the chair

A patient is taking iron for low red blood cells. The nurse would expect the patient's feces to be which color? 1. Green 2. Red 3. Black 4. Tan

Ans: 3. Black 1: Eating green foods such as spinach may result in greenish-black streaks in the feces. 2: Eating beets may result in red-tinted stools. 3: Ingestion of iron supplements normally causes stools to be very dark brown or black. 4: Normal stools can be tan.

A patient is wearing a fecal incontinence pouch. Which action should the nurse take? 1. Drain the bag when it is three-fourths full. 2. Apply the water-soluble barrier ring to the patient's anus. 3. Change the bag every 2 to 3 days. 4. Document the contents as intake.

Ans: 3. Change the bag every 2 to 3 days.

The nurse is contributing to the community health program to parents of young children about bowel elimination. Which information should the nurse include? 1. Children develop bowel control around 5 years of age. 2. Infants have about six to eight bowel movements a day. 3. Children usually have about one to two stools a day. 4. Infants are prone to constipation.

Ans: 3. Children usually have about one to two stools a day. 1: Children accomplish voluntary control of elimination between the ages of 2 and 3 years after their neuromuscular structures are developed. 2: Infants will normally have between three and six bowel movements daily. 3: The frequency of bowel movements usually decreases to one or two bowel movements per day. This pattern usually is maintained throughout adulthood. 4: Peristalsis decreases as the individual ages, making elderly individuals more prone to constipation, or hard stools that are difficult to pass.

The nurse is collecting data about a patient's new stoma. Which finding would require the nurse to notify the health-care provider? 1. Edematous stoma 2. Red, shiny stoma 3. Dusky stoma 4. Moist stoma

Ans: 3. Dusky stoma The health care provider should be notified. Pallor, cyanosis, or a dusky color indicates impaired blood supply, and black depicts necrosis.

A female patient is recovering from abdominal surgery 2 days ago. Her abdomen is distended and firm, and she complains of moderate to severe cramping and abdominal discomfort. As of yet, she has been unable to pass much flatus rectally. Which type of enema would be most helpful for this patient? 1. Fleet Phospho-Soda enema 2. Oil retention enema 3. Harris flush enema 4. Small-volume enema

Ans: 3. Harris flush enema

Which procedure produces a surgical opening in the abdomen and bypasses the large intestine entirely? 1. Sigmoid colostomy 2. Kock pouch 3. Ileostomy 4. Loop colostomy

Ans: 3. Ileostomy (brings a portion of the ileum through a surgical opening in the abdomen, bypassing the colon completely) [WRONG] 1. Sigmoid colostomy (stoma placed in the distal segment of the colon) 2. Kock pouch (ileal reserve pouch that collects ileal drainage that is then manually emptied through a stoma) 4. Loop colostomy (consists of a segment of bowel brought out through the abdominal wall)

What is the effect of physical activity on normal defecation? 1. Increased physical activity can increase constipation. 2. Decreased physical activity can result in diarrhea. 3. Increased physical activity promotes normal defecation patterns. 4. Physical activity has no effect on defecation patterns.

Ans: 3. Increased physical activity promotes normal defecation patterns. (can promote normal defecation and can relieve constipation) x1. Increased physical activity can increase constipation. (constipation does not occur as a result of increased physical activity) x2. Decreased physical activity can result in diarrhea. (immobility usually leads to slowed peristalsis and constipation) x4. Physical activity has no effect on defecation patterns. (regular physical activity promotes normal defecation patterns. Decreased activity leads to constipation)

A client has undergone diagnostic tests of the gastrointestinal (GI) system. The client, who has chronic constipation, tells the nurse the physician is concerned about peristalsis, and asks why it is important. Which information will the nurse include? 1. Peristalsis counteracts gravity to prevent food from being propelled through the GI tract too swiftly. 2. Peristalsis is movement triggered by enzymes causing food to digest quickly and prevent constipation. 3. Peristalsis is contractions of circular and longitudinal muscles that propels food through the GI tract. 4. Peristalsis is an abnormal movement of the bowel which causes intractable nausea and vomiting.

Ans: 3. Peristalsis is contractions of circular and longitudinal muscles that propels food through the GI tract. 1 This is incorrect. Gravity assists peristalsis to propel food through the GI tract. 2 This is incorrect. Peristalsis is not triggered by the release of enzymes. 3 This is correct. Peristalsis is the contraction of circular and longitudinal muscles that propels food from the esophagus to the rectum. Constipation can be a result of slow peristalsis. 4 This is incorrect. Peristalsis is a normal movement that aids in the movement of food through the GI tract. Peristalsis does not cause intractable nausea and vomiting.

A patient is having hard, infrequent stools. Which action should the nurse take? 1. Restrict fluid 2. Place on bedrest 3. Suggest eating yogurt 4. Decrease fiber intake

Ans: 3. Suggest eating yogurt The active bacteria in yogurt help to stimulate peristalsis, making it an excellent addition to the diet for prevention of constipation.

The nurse is caring for a patient who has a colostomy. Which action should the nurse take? 1. Determine the correct size by letting 3/8 inch of peristomal skin show. 2. Rinse the bag in hot water before reapplying. 3. Wash the stoma and skin with warm water and soap. 4. Change the wafer faceplate every 7 days.

Ans: 3. Wash the stoma and skin with warm water and soap. 1: The correct size will fit around the stoma and allow only 1/16 to 1/8 inch of peristomal skin to show. 2: Some patients prefer to remove the bag and apply a new one; others prefer to empty the bag, rinse it in cool water, dry it, and reapply. 3: Use a soft washcloth, warm water, and mild soap to wash the stoma and skin, rinse thoroughly, and pat dry. 4: The faceplate is changed every 3 to 5 days or sooner if the adhesive backing begins to loosen from the skin.

After an initial assessment, a nurse documents that a client, admitted for abdominal pain, has hyperactive bowel sounds. Which type of bowel movement will the nurse expect this client to have? 1. Hard and shaped in small balls 2. Fluffy, with a tendency to float in the toilet 3. Ribbon-shaped and soft 4. Liquid or semi-liquid

Ans: 4 1 This is incorrect. Hard, small balls would indicate constipation, meaning the client would possibly have hypoactive bowel sounds. 2 This is incorrect. Fluffy and floating feces are normal following a diet high in fat. 3 This is incorrect. Ribbon-shaped stools could indicate pressure from a tumor, such as colon cancer. 4 This is correct. Increased peristalsis causes food to pass through the intestines much faster than normal, so less water is reabsorbed, causing stools to be liquid or semi-liquid.

An older adult client is admitted to the hospital for a bowel obstruction, and part of the client's duodenum was surgically removed. Which condition does the nurse recognize as a potential problem for the client? 1. Limited stomach capacity 2. Duodenum-produced enzymes are not available 3. Poor absorption from shortening of the colon 4. A decreased ability to absorb nutrients

Ans: 4 1 This is incorrect. The duodenum is part of the small intestine and removal will not affect the size of the stomach. 2 This is incorrect. Enzymes are dumped into the small intestine by the pancreas; they are not produced in the duodenum. 3 This is incorrect. The duodenum is part of the small intestine, not the large intestine (also known as the colon). 4 This is correct. Absorption of nutrients begins in the duodenum; without the duodenum, absorption of nutrients will decrease.

In response to a nurse's question about bowel function, a client shares that sometimes the feces are greenish black in color. Which answer by the nurse is correct? 1. "Large amounts of dairy products can cause your stools to turn green." 2. "If you take iron tablets, your stools can become greenish black." 3. "Typically our diet has very little to do with the color of our stools." 4. "Eating green foods, such as spinach, can cause your stools to have greenish black streaks."

Ans: 4 1 This is incorrect. Typically, large amounts of dairy products do not cause feces to turn green. 2 This is incorrect. Iron can make feces very dark or black, but not green. 3 This is incorrect. Diet can affect the color and consistency of feces. 4 This is correct. Eating dark green vegetables, such as spinach, can cause greenish-black streaks in the stool.

The nurse is preparing to administer a high enema. Place the steps in order the nurse should follow. 1. Finish administering the enema 2. Then turn patient to back 3. Then turn patient to the right side 4. Place patient in left Sim's position 5. Administer about half of the enema

Ans: 4,5,2,3,1

The unlicensed assistive personnel (UAP) reports to the nurse that a patient is having diarrhea. The nurse collects data from the patient and observes liquid stool seepage. How should the nurse interpret this finding? 1. "I should tell the UAP the difference between diarrhea and incontinence." 2. "I should praise the UAP and administer antidiarrheal medication to the patient." 3. "I should praise the UAP and notify the health-care provider of the diarrhea." 4. "I should tell the UAP the difference between diarrhea and a fecal impaction."

Ans: 4. "I should tell the UAP the difference between diarrhea and a fecal impaction."

The nurse reinforces teaching with a patient who has an ileostomy. Which statement by the patient indicates a correct understanding of the teaching? 1. "I will be able to remove the pouch after several months." 2. "I will just lose stool through the ostomy." 3. "I will have semisoft, mushy fluid from the ostomy." 4. "I will clean the stool from my skin because it can be harmful."

Ans: 4. "I will clean the stool from my skin because it can be harmful." 1: The effluent continually drains from the stoma, which requires that the patient constantly wear a pouch and empty it often. 2: A loss of a large amount of ileostomy drainage can lead to symptoms of malnutrition and electrolyte imbalance. 3: Effluent from an ileostomy is liquid because the majority of the water is not absorbed until it reaches the colon. 4: The effluent contains enzymes, making it very irritating to the skin surrounding the stoma.

A nurse is teaching wellness to a church group. How many daily 8-ounce servings of water should be encouraged for normal bowel health? 1. 10 to 12 servings 2. 4 to 6 servings 3. 8 to 10 servings 4. 6 to 8 servings

Ans: 4. 6 to 8 servings

The nurse is collecting data about a patient's bowel functioning. Which action should the nurse take? 1. Palpate the abdomen and then auscultate. 2. Listen to at least one of the four abdominal quadrants. 3. Inspect the abdomen last for distention. 4. Auscultate for at least 3 to 5 minutes if no bowel sounds are heard.

Ans: 4. Auscultate for at least 3 to 5 minutes if no bowel sounds are heard. 1: Avoid palpating the abdomen until after the nurse has assessed the bowel sounds because palpation may stimulate bowel sounds that were not there naturally. 2: All four quadrants should be assessed. 3: Inspection is first, not last. 4: If the nurse thinks that bowel sounds are absent, be certain to listen for at least 3 to 5 minutes in each of the four quadrants before declaring this

During digital removal of stool, which is the most serious complication the client is at risk of developing? 1. Bleeding 2. Decreased blood pressure 3. Hypertension 4. Decreased heart rate

Ans: 4. Decreased heart rate (digital disimpaction can stimulate the vagus nerve, which causes a reflex slowing of the heart rate)

The nurse is assisting a patient in irrigating a colostomy in order to train the bowel to have a bowel movement every day after breakfast. Which type of ostomy is the nurse helping the patient to train? 1. Left transverse colostomy 2. Right transverse colostomy 3. Ascending colostomy 4. Descending colostomy

Ans: 4. Descending colostomy

The nurse is checking the intake and output record for several patients. Which finding would alert the nurse to a potential problem? 1. Intake 2500 mL and output 2300 mL 2. Intake 1500 mL and output 1800 mL 3. Had three bowel movements on Tuesday and two bowel movements on Wednesday 4. Had last bowel movement on Monday and it is now Thursday

Ans: 4. Had last bowel movement on Monday and it is now Thursday The nurse must make certain the patient has a bowel movement at least every 3 days to prevent constipation.

The nurse suspects a patient had a vagal response to the cleansing enema. Which finding would support the nurse's conclusion? 1. Skin flushed 2. Temperature 103° F (39.4° C) 3. Blood pressure 160/110 4. Heart rate 35 beats per minute

Ans: 4. Heart rate 35 beats per minute When the vagus nerve is stimulated, it can drop the heart rate as low as 30 to 40 beats per minute and cause constriction of the bronchioles of the lungs.

The nurse is checking for blood in the stool. Which specimen should the nurse obtain? 1. One for a sensitivity test 2. One for an ova and parasite test 3. One for a culture test 4. One for a guaiac test

Ans: 4. One for a guaiac test

Knute is in a care center and tells the nurse he has not had a bowel movement for 2 days. The nurse suggests they go for a walk later. 1. promotes 2. Inhibits

Ans:1. promotes Physical activity increases peristalsis and promotes defecation. Minimally, a client should engage in exercise three to five times a week with daily walking or light activity. Hospitalized or institutionalized clients may need assistance with activity to prevent injury. For bedbound clients, range of motion, thigh strengthening, and abdominal tightening are most beneficial to improve peristalsis.

Jeremy has a digestive disorder that causes a lot of gas. He is in a semiprivate room and mentions how disturbing it must be for his roommate. The nurse sprays some odor-reducing product and leaves it with Jeremy to use as needed. 1. promotes 2. inhibits

Ans:1. promotes The embarrassment of the smell of flatus and stool can prevent clients from eliminating, causing them to become distended, constipated, impacted, and uncomfortable. Identifying the need for an odor-eliminating spray is the nurse's role.

The nurse assists Martha to the restroom and leaves the door open a crack so she can be heard if she needs help. 1. promotes 2. inhibits

Ans:2. inhibits Privacy is important to promote normal bowel movements; this should include closing doors, pulling curtains, and having visitors step out of the room. Although having the door open is helpful to the nurse, it is not helpful for the client. A better alternative would be to close the door but check back often, provide a call light, or stand outside the door to hear Martha ask for help.

Bonita tells the nurse she needs to use the restroom. The nurse cannot find adequate help to get Bonita out of bed so she is placed on a bedpan. 1. promotes 2. inhibits

Ans:2. inhibits The most natural position for elimination is sitting upright on a toilet. When the client is not able to ambulate to the bathroom, a commode chair placed at the client's bedside can be used. A bedpan should be used only if the client is unable to get out of bed.

The nurse has an order to deliver an enema to a constipated client. The nurse enters the room and slides the lunch tray to the side, explaining there is an order for an enema. 1. promotes 2. inhibits

Ans:2. inhibits Timing is an important part of normal bowel function. By interrupting the meal for this procedure, the timing is poor. A better option is to discuss the order for the enema after the client has finished eating so the nurse does not disturb his or her meal or appetite.

Clay is constipated, so the nurse suggests increasing his water intake to 1 liter per day. 1. promotes 2. inhibits

Ans:2. inhibits Water intake should be a minimum of 1,500 mL to 2,000 mL per day to keep the stool soft and aid in the production of mucus to lubricate the colon. Clay needs to drink more than 1 liter of water each day.

Which of the following factors is most likely to result in diarrhea? 1. Loss of intestinal normal flora 2. Drinking excessive fluids 3. Administration of opioid narcotics 4. Manipulation of intestines during colon surgery 5. Eating 10-15g of fiber per day

Ans: 1. Loss of intestinal normal flora

A patient reports having diarrhea for 12 hours. Which fluids would the nurse encourage the patient to drink? (SATA) 1. Apple juice 2. Sports drink containing electrolytes 3. Iced green tea 4. Chamomile tea 5. Frozen lemonade

Ans: 2, 4 2:Sports drinks containing electrolytes, such as Gatorade, help to replace fluid and electrolytes lost with diarrhea. 4:Chamomile may be used to soothe an inflamed colon and slow peristalsis.

The nurse is collecting data from several patients who have diarrhea. Which patient would the nurse monitor most closely for dehydration? 1. Teenager 2. Young adult 3. Middle-aged adult 4. Older adult patient

Ans: 4. Older adult patient

A patient has a fecal impaction that requires digital removal and an oil retention enema. Which actions should the nurse take? (SATA) 1. Assign fecal impaction removal to the unlicensed assistive personnel (UAP). 2. Administer pain medication before the digital removal. 3. Monitor for vagal nerve stimulation. 4. Administer the oil retention enema after digital removal. 5. Check for heart problems before the digital removal.

Ans: 2,3,5

What of the following would be the best enema to administer to a patient before digital removal of an impaction? 1. Siphon enema 2. Oil retention enema 3. Soapsuds enema 4. Harris flush enema

Ans: 2. Oil retention enema

A nurse is auscultating bowel sounds on a client who has had recent abdominal surgery. She hears approximately 1 to 2 sounds per minute in each quadrant. Which condition should the nurse expect? 1. Infection 2. Diarrhea 3. Constipation 4. Ileus

Ans: 3. Constipation [WRONG] 1. Infection 2. Diarrhea (usually accompanied by hyperactive bowel sounds) 4. Ileus (not indicated by a decrease in overall bowel sounds)

The nurse is caring for several patients who have colostomies. Which patient does the nurse expect to have the most liquid effluent? 1. One who has a transverse colostomy 2. One who has a sigmoid colostomy 3. One who has an ascending colostomy 4. One who has a descending colostomy

Ans: 3. One who has an ascending colostomy

A client with a known history of diverticulosis who is experiencing severe cramping and diarrhea is admitted to the hospital during the night with a diagnosis of diverticulitis. The client's pain increases, and the abdomen is distended and hard. The client has spiked a fever of 102.4°F. The nurse concludes the client may be developing a life-threatening complication and notifies the physician. Which possible complication concerns the nurse? 1. Crohn disease 2. Irritable bowel syndrome (IBS) 3. Fecal incontinence 4. Peritonitis

Ans: 4. Peritonitis 1 This is incorrect. Crohn disease is not a complication of diverticulosis; it is an autoimmune disorder. 2 This is incorrect. IBS is characterized by bloating and alternating episodes of diarrhea and constipation; it is not a complication of diverticulosis. 3 This is incorrect. Fecal incontinence results when an individual does not have voluntary sphincter control; it is not a complication of diverticulosis. 4 This is correct. Peritonitis is a life-threatening complication that can occur as a result of infected diverticula that perforate, allowing fecal material and bacteria to enter the sterile peritoneum.

The nurse is assisting a client in the emergency department who needs to use the restroom for a bowel movement. Which option is best? 1. Bedside commode 2. Public restroom 3. Bedpan 4. Private restroom

Ans: 4. Private restroom

With which type of bowel diversion is the client most likely to have control over bowel elimination and not need to wear an appliance? 1. Ileostomy 2. Ascending colon colostomy 3. Transverse colon colostomy 4. Sigmoid colostomy

Ans: 4. Sigmoid colostomy (closest to the rectum. Stool is most likely to be formed and can often be controlled without the use of appliance)

A client has a tendency to develop frequent constipation. Which dietary consideration should the nurse recommend? 1. The client should increase iron intake. 2. The client should decrease fiber intake. 3. The client should increase intake of fats. 4. The client should increase fiber intake.

Ans: 4. The client should increase fiber intake. (promotes peristalsis and defecation. An increase in dietary fiber can alleviate constipation)

A patient is having diarrhea. Which technique should the nurse use to clean the perineal area? 1. Use soap and water. 2. Use a cool washcloth. 3. Use alcohol wipes. 4. Use a patting motion to dry.

Ans: 4. Use a patting motion to dry. Patting the skin when drying will not irritate the skin compared with rubbing.

The nurse is preparing to administer an enema. Which patient findings would cause the nurse to notify the health-care provider or charge nurse? (SATA) 1. Has a history of unstable angina 2. Is admitted with Crohn's disease 3. Observes a rectal fissure 4. Has infrequent hard stools 5. Observes severely bleeding hemorrhoids

Ans:1, 2, 3, 5

Which are common disorders that are primary causes of bowel function? Select all that apply. 1. Food allergies 2. Diverticulosis 3. Pneumonia 4. Seasonal allergies 5. Food intolerance

Ans:1, 2, 5 1. Food allergies (true immune system response prompted by body in response to allergenic food) 2. Diverticulosis (occurs when the body must move highly compacted stool over time, enlarging the surrounding muscles. This causes them to balloon out, and fecal material is trapped in swollen areas, which become infected) 5. Food intolerance (specifically linked to GI symptoms, as opposed to a food allergy, which triggers the immune system) [wrong] 3. Pneumonia (can ultimately lead to alterations in intake which could affect elimination, but is not primary cause) 4. Seasonal allergies (not associated with bowel elimination disorders)

Joe is constipated and asking for a snack. The nurse offers an apple or orange. 1. promotes 2. inhibits

Ans:1. promotes Foods high in fiber promote peristalsis and bowel elimination. Daily fiber intake should be 25 to 30 grams of fiber to attract water to the stool. Good choices include fresh fruits, vegetables, whole-grain foods, legumes, and water.

Natasha is recovering from surgery and is constipated from the regular opioid pain medications she receives. The nurse requests high fiber in her diet from the dietitian. 1. promotes 2. inhibits

Ans:2. Inhibits Adding fiber to try to correct opioid-induced constipation can put the client at risk for bowel obstruction due to the opioid-induced decreased peristalsis, delayed gastric emptying, and prolonged intestinal transit time of the feces. This could lead to a mechanical bowel obstruction.