Chapter 30 Bowel Elimination and Care

Chapter 30  Bowel Elimination and Care

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. The day after surgery a patient asked the nurse, “Why do the nurses keep listening to my abdomen? That’s not where I had surgery.” Which of the following responses best answers the patient’s question?
A.
“General anesthesia puts everything to sleep, including the bowel, so it is important to determine when bowel sounds have returned. When your bowel sounds return your surgeon will allow you to begin to eat and drink.”
B.
“Listening to your bowel sounds is just part of the physical assessment so it’s nothing you need to worry about. It will only take me a few minutes to listen then I’ll let you rest.”
C.
“We listen so we can let your surgeon know your gastrointestinal system wasn’t damaged by the anesthesia.”
D.
“Your surgeon has written orders to assess your abdomen every 4 hours. I’m sorry if it worries you but I must do my job.”

____ 2. Following diagnostic tests of the gastrointestinal system a patient with chronic constipation asks the nurse what is peristalsis and why it is important. The nurse explains,
A.
“Peristalsis works against gravity to swiftly propel food through the GI tract to decrease problems with constipation.”
B.
“Peristalsis releases enzymes that break food down and aids in the propulsion of food through the GI tract. These enzymes work hard to prevent constipation.”
C.
“Peristalsis is the contraction of circular and longitudinal muscles in the GI tract that propels food through the GI tract. If peristalsis slows it can cause problems with constipation.”
D.
“Peristalsis is stimulated by a food bolus, which results in the contraction of the pyloric sphincter to help keep food down. If unable to keep food down constipation can be the result.”

____ 3. A 68-year-old male has been admitted to the hospital for nutritional deficiencies. Approximately 6 months ago he had part of his duodenum surgically removed following a bowel obstruction. The nurse understands that the patient’s nutritional deficiencies are occurring because
A.
His diet is low in minerals and vitamins.
B.
Enzymes produced in the duodenum are not available.
C.
Removal of the duodenum made the colon too short for proper absorption.
D.
His ability to absorb nutrients is decreased.

____ 4. During the physical assessment the nurse questions the patient about his bowel elimination habits. The nurse’s goal is
A.
To assess the need for a laxative.
B.
To maintain the patient’s normal elimination habit.
C.
The collection of all pertinent patient data.
D.
To determine if further GI testing is necessary.

____ 5. A patient states, “Sometimes I have trouble with constipation and have to take a laxative.” Discussing ways to help avoid constipation the nurse replies, “Since an individual commonly gets the urge to have a bowel movement about 30 minutes after eating it is important to
A.
Not ignore the defecation reflex.”
B.
Skip meals when having a bowel movement is not an option.”
C.
Decrease fluids when you increase the amount of fiber in your meal.”
D.
Notify your physician if you do not experience that urge after every meal.”

Chapter 30. Bowel Elimination and Care
Answer Section

MULTIPLE CHOICE

1. ANS: A

Feedback
A
It is important that the nurse explains to the patient the effects of general anesthesia on the bowel, including how long the patient may expect to be NPO. Chapter Objective: Explain how different factors affect bowel elimination.
B
Although auscultation of bowel sounds is included in the assessment, the patient should be given an accurate explanation of the purpose of listening to bowel sounds.
C
Telling the patient that the gastrointestinal system might be damaged is incorrect and an inappropriate response.
D
Assessing the abdomen is a nursing implementation and doesn’t require a physician’s order. This response could cause the patient to question his or her post-surgery status.

PTS: 1 REF: Chapter: 30 | Page: 680 OBJ: Chapter Objective: 30-5
KEY: Content Area: Basic Care and Comfort | Integrated Process: Teaching and Learning | Client Need: Physiological Integrity/Basic Care and Comfort/Elimination | Cognitive Level: Analysis

2. ANS: C

Feedback
A
Gravity assists peristalsis to propel food through the gastrointestinal tract.
B
Peristalsis does not release enzymes.
C
Peristalsis is the contraction of circular and longitudinal muscles that propel food from the esophagus to the rectum, and constipation can be a result of slow peristalsis. Chapter Objective: Define key terms related to bowel elimination and care. Explain the digestion, absorption, and metabolism of nutrients.
D
The pyloric sphincter is a ring of smooth muscle which lets food pass slowly into the duodenum.

PTS: 1 REF: Chapter: 30 | Page: 676
OBJ: Chapter Objective: 30-1| Chapter Objectives: 30-2
KEY: Content Area: Physiological Adaptation | Integrated Process: Teaching and Learning | Client Need: Physiological Integrity/Physiological Adaptation/Alterations in Body Systems | Cognitive Level: Application

3. ANS: D

Feedback
A
Information about the patient’s diet is not provided.
B
Enzymes are dumped into the small intestine by the pancreas; they are not produced in the duodenum.
C
The duodenum is part of the small intestine, not the large intestine known as the colon.
D
Absorption of nutrients begins in the duodenum; without the duodenum absorption of nutrients will decrease. Chapter Objective: Explain the digestion, absorption, and metabolism of nutrients. Differentiate between normal and abnormal function in digestion and bowel elimination. Compare the different types of bowel diversions.

PTS: 1 REF: Chapter: 30 | Page: 676
OBJ: Chapter Objectives: 30-2| Chapter Objectives: 30-3| Chapter Objectives: 30-14
KEY: Content Area: Physiological Adaptation | Integrated Process: Nursing Process/Assessment | Client Need: Physiological Integrity/Physiological Adaptation/Basic Pathophysiology | Cognitive Level: Comprehension

4. ANS: B

Feedback
A
While it is important to assess the need for assistance with elimination, the purpose is for collecting bowel elimination data.
B
The goal of elimination care is to maintain the patient’s normal elimination pattern while hospitalized. Chapter Objectives: Enumerate independent nursing interventions to promote bowel elimination. Describe interventions that help to prevent and treat bowel elimination problems.
C
Collection of data is essential in determining patient needs but it is not the goal.
D
Determining if further testing is needed is not a nursing function, nor is it the goal of elimination care.

PTS: 1 REF: Chapter: 30 | Page: 677
OBJ: Chapter Objectives: 30-6| Chapter Objectives: 30-8
KEY: Content Area: Health Promotion and Maintenance | Integrated Process: Nursing Process/Assessment | Client Need: Health Promotion and Maintenance/Data Collection Techniques | Cognitive Level: Comprehension

5. ANS: A

Feedback
A
Bowel training can be accomplished by attempting to have a bowel movement when the defecation reflex is not ignored, which contributes to constipation. Chapter Objective: Enumerate independent nursing interventions to promote bowel elimination.
B
Skipping meals is not helpful in promoting good bowel habits.
C
If fiber in the diet is increased the fluids must be increased to prevent constipation.
D
Not experiencing the urge to defecate after every meal is normal in many individuals; typically it occurs in conjunction with a particular meal.

PTS: 1 REF: Chapter: 30 | Page: 677 OBJ: Chapter Objective: 30-6
KEY: Content Area: Reduction of Risk Potential | Integrated Process: Teaching and Learning | Client Need: Physiological Integrity/Reduction of Risk Potential/Potential for Alterations in Body Systems | Cognitive Level: Comprehension