Chapter 40 Bowel Elimination

Chapter 40  Bowel Elimination

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The nurse is caring for a patient who periodically has small streaks of fresh red blood in his stool. The patient denies abdominal pain or loss of appetite. What is the most likely cause of this patient’s bleeding?
a.
Hemorrhoids
b.
Bleeding gastric ulcer
c.
Colon polyps
d.
Perforated colon

ANS: A
Bleeding hemorrhoids can lead to small streaks of fresh red blood in the stool. Bleeding gastric ulcer would lead to black, tarry stools as the blood is digested. Colon polyps do not cause bleeding.

DIF: Understanding REF: p. 1046 TOP: Assessment
MSC: NCLEX Client Needs Category: Physiological Adaptation: Alterations in Body Systems
NOT: Concepts: Elimination

2. The nurse is caring for a patient who has diarrhea. What is the priority nursing diagnosis for this patient?
a.
Readiness for enhanced knowledge related to prescribed diet modifications
b.
Imbalanced nutrition: less than body requirements related to poor appetite
c.
Deficient fluid volume related to excessive loss of fluid through stool
d.
Anxiety related to incontinence with loose stools and need for clothing change

ANS: C
Dehydration is the priority nursing problem for this patient, so deficient fluid volume is the most important nursing diagnosis. Imbalanced nutrition, Readiness for enhanced knowledge, and Anxiety can be addressed once fluid balance is restored.

DIF: Applying REF: p. 1047 TOP: Diagnosis
MSC: NCLEX Client Needs Category: Physiological Adaptation: Fluid and Electrolyte Imbalances
NOT: Concepts: Elimination

3. The nurse is caring for a patient who is prescribed diphenoxylate-atropine (Lomotil). Which assessment finding by the nurse indicates a need to contact the prescriber and question the order?
a.
The patient has skin breakdown from loose stools
b.
The patient is constipated with last BM 3 days ago
c.
The patient is on a low-fiber, gluten-free diet
d.
The patient has painful bleeding hemorrhoids

ANS: B
Lomotil is an anti-diarrheal medication. It should not be given to patients who are constipated because it will make it even more difficult for the patient to pass soft, formed stools. The other assessment findings are not contraindications to Lomotil.

DIF: Understanding REF: p. 1047 | p. 1059
TOP: Assessment
MSC: NCLEX Client Needs Category: Pharmacological and Parenteral Therapies: Contraindications
NOT: Concepts: Elimination

4. The nurse is caring for an immobile patient who has abdominal pain and frequent small, liquid stools. The patient vomited his breakfast and is still nauseated. Which action by the nurse is the highest priority?
a.
Provide oral care after each episode of emesis.
b.
Apply a skin barrier to the patient’s perineal area.
c.
Check the patient to see if he has a fecal impaction.
d.
Administer antiemetic medication with a sip of water.

ANS: C
The patient who has abdominal pain and frequent small stools should be checked for fecal impaction, especially since the patient is vomiting. Immobility is a risk factor for the development of fecal impaction. The other actions can be performed once fecal impaction is ruled out.

DIF: Applying REF: p. 1047 TOP: Implementation
MSC: NCLEX Client Needs Category: Basic Care and Comfort: Elimination
NOT: Concepts: Elimination

5. The nurse is caring for a patient who is recovering from bowel surgery. Which assessment finding best indicates that the bowel is starting to resume function and the patient will be able to resume oral intake soon?
a.
The patient has bowel sounds x 4 quadrants and is passing gas.
b.
The patient has no nausea, and abdominal pain is minimal.
c.
The patient feels hungry for chicken soup and hot tea.
d.
The patient’s nasogastric tube was discontinued the previous day.

ANS: A
The presence of bowel sounds and passage of flatus indicate that the patient’s bowels are starting to resume function and the patient will be able to resume oral intake soon. Hunger, discontinuation of the NG tube, or absence of nausea are not definite indicators of readiness to resume oral feedings.

DIF: Applying REF: p. 1052 TOP: Assessment
MSC: NCLEX Client Needs Category: Reduction of Risk Potential: System Specific Assessments
NOT: Concepts: Nutrition