Chapter 10 Elimination

Chapter 10  Elimination

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which of the following is a true statement about elimination in older adults?
a.
Defecation less than once each day is not necessarily constipation.
b.
Mineral oil is recommended as a laxative for the older adult.
c.
Excessive sleep can be a symptom of constipation.
d.
Leaking liquid feces should be treated as diarrhea.

ANS: A
Constipation is present when fewer than three bowel movements occur per week or when the frequency decreases. Mineral oil and saline laxatives can be harmful. Fiber, fruit, and fluids are the first recommendations; stimulant laxatives such as senna and cascara can be used on a short-term basis. Altered cognitive status, increased agitation, and unexplained falls can be symptoms of constipation; these behaviors may be the only clinical symptom of constipation in cognitively impaired older persons. Excessive sleep has not been identified as a symptom. Liquid feces may be leaking around a fecal impaction, and antidiarrheal treatment can aggravate the impaction.

PTS: 1 DIF: Remember REF: 13-21
TOP: Nursing Process: Assessment MSC: Physiological Integrity

2. Which action should be included in all bladder-retraining programs?
a.
Toileting at bedtime
c.
Toileting every hour
b.
Using adult incontinence pads
d.
Providing 1000 ml of fluids daily

ANS: A
Toileting at bedtime should be incorporated for all patients. This intervention decreases the amount of urine in the bladder during the night. Incontinence pads are not encouraged during the retraining process. Toileting is not automatically scheduled every hour but is based on the individual’s needs. The volume of scheduled fluid intake is also based on the individual’s needs.

PTS: 1 DIF: Apply REF: 13-21 TOP: Nursing Process: Planning
MSC: Physiological Integrity

3. The nurse understands that stress incontinence occurs:
a.
With a urinary tract infection (UTI)
b.
Because of emotional strain
c.
As a result of increased intraabdominal pressure
d.
With a specific amount of urine in the bladder

ANS: C
If intraabdominal pressure increases, then the patient can have dribbling. A UTI causes frequency as a result of irritation in the bladder. Emotional strain can cause frequency. Specific volume of urine in the bladder triggers reflex incontinence.

PTS: 1 DIF: Understand REF: 5-7
TOP: Nursing Process: Assessment MSC: Health Promotion and Maintenance

4. What is the most important aspect of care for the nurse to maintain when assisting an older patient with urinary incontinence?
a.
Availability of protective rubber garments
b.
Using indwelling urinary catheters
c.
Using smooth muscle relaxants
d.
Maintaining an attitude that is respectful and positive about resolving the problem

ANS: D
The nurse recognizes that incontinence is a sign of an underlying problem and not an inevitable result of aging. In addition, the nurse offers dignity, hope, and understanding by maintaining a positive and respectful manner and by communicating that effective treatments are available. Rubber garments, in particular, are hot and can cause skin irritation. Internal catheters should be used only for a short time and under limited circumstances. Using a smooth muscle relaxant is indicated only for urge incontinence and for an overactive bladder.

PTS: 1 DIF: Understand REF: 32 Box 10-3
TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance