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NUR 155 Fundamentals of Nursing
Bowel & Urinary Elimination Test
Bank Yoost & Crawford 3rd Edition
MCQs with Rationales
Exam Structure:
Subject: Fundamentals of Nursing – Bowel & Urinary Elimination
Source: Test Bank for Fundamentals of Nursing: Active Learning for Collaborative
Practice, 3rd Edition (Yoost & Crawford)
Format: Multiple Choice & Multiple Response Questions with Rationales
1. The nurse is caring for a patient who periodically has small streaks
of fresh red blood in the stool. The patient denies abdominal pain or
loss of appetite. The nurse identifies what to be the most likely cause
of this patient's bleeding?
A. Hemorrhoids
B. Bleeding gastric ulcer
C. Colon polyps
D. Perforated colon
Correct Answer: A
Rationale:
1. Small streaks of fresh red blood in the stool are characteristic of
hemorrhoidal bleeding, which occurs in the lower rectum or anus.
2. Bleeding from a gastric ulcer would produce black, tarry stools
(melena) due to the digestion of blood as it passes through the GI
tract.
3. Colon polyps typically do not cause noticeable bleeding unless they
are large or ulcerated.
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4. A perforated colon would cause severe abdominal pain, fever, and
systemic symptoms, which the patient denies.
2. The nurse is caring for a patient who has diarrhea and identifies
which priority nursing diagnosis for this patient?
A. Lack of knowledge related to prescribed diet modifications
B. Impaired nutritional intake related to poor appetite
C. Diarrhea related to excessive loss of fluid through stool
D. Anxiety related to incontinence with loose stools and need for clothing
change
Correct Answer: C
Rationale:
1. The most immediate and life-threatening risk associated with
diarrhea is fluid and electrolyte imbalance leading to dehydration.
2. Addressing the actual problem of diarrhea takes precedence over
knowledge deficits, appetite changes, or anxiety.
3. Once fluid balance is restored, other nursing diagnoses can be
effectively managed.
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.
Correct Answer: B
Rationale:
1. Diphenoxylate-atropine is an antidiarrheal medication used to reduce
intestinal motility.
2. Administering it to a patient who is already constipated could worsen
the impaction or lead to a bowel obstruction.
3. The other findings are not contraindications for this medication.
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
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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 for a fecal impaction.
D. Administer antiemetic medication with a sip of water.
Correct Answer: C
Rationale:
1. Immobile patients are at high risk for fecal impaction, which can
present as paradoxical diarrhea (leakage of liquid stool around a hard
impaction).
2. Abdominal pain, nausea, and vomiting are common signs of
impaction that must be assessed first to rule out obstruction.
3. Other interventions are supportive but should follow after confirming
or ruling out impaction.
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.
Correct Answer: A
Rationale:
1. The return of bowel sounds in all quadrants and the passage of flatus
are objective signs that peristalsis has resumed following surgery.
2. These findings indicate that the GI tract is functioning adequately to
begin oral intake.
3. Hunger, absence of nausea, and NG tube removal are supportive but
not definitive indicators of GI readiness.
6. The nurse is caring for a patient who has an ileostomy. Which
Nursing diagnosis has the highest priority for the patient?
A. Impaired skin integrity r/t localized skin irritation from liquid stool
B. Social isolation r/t potential leakage of stool from ostomy appliance
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C. Lack of knowledge r/t care and maintenance of ostomy appliance
D. Disturbed body image r/t presence of stoma and altered elimination
Correct Answer: A
Rationale:
1. Liquid stool from an ileostomy is highly corrosive and can quickly
cause peristomal skin breakdown.
2. Impaired skin integrity poses an immediate risk for infection, pain,
and poor appliance adherence.
3. While other diagnoses are relevant, maintaining skin integrity is
foundational to overall ostomy management and patient comfort.
7. The nurse is caring for a patient who is taking narcotic pain
medication after surgery. Which breakfast choices will help prevent
constipation and promote return to regular bowel function?
A. Raisin bran with skim milk, fresh fruit, and wheat toast
B. Pancakes with maple syrup, bacon, and coffee with cream
C. Omelet with cheddar cheese, green pepper, and onions
D. Bagel with cream cheese, and strawberry nonfat yogurt
Correct Answer: A
Rationale:
1. Narcotic pain medications slow peristalsis and increase the risk of
constipation.
2. A high-fiber diet with adequate fluids promotes bowel motility and
prevents constipation.
3. Raisin bran, fresh fruit, and whole wheat toast are excellent sources
of dietary fiber, unlike low-fiber options like pancakes, omelets, or
bagels.
8. The nurse is caring for a patient who has not had a bowel movement
for 2 days. Which is the priority nursing intervention for this patient?
A. Obtain an order to administer a soap suds cleansing enema.
B. Teach the patient how to use the Valsalva maneuver.
C. Discontinue medications that can cause constipation.
D. Assess the patient's usual pattern of bowel movements.
Correct Answer: D
Rationale:
NUR 155 Fundamentals of Nursing
Bowel & Urinary Elimination Test
Bank Yoost & Crawford 3rd Edition
MCQs with Rationales
Exam Structure:
Subject: Fundamentals of Nursing – Bowel & Urinary Elimination
Source: Test Bank for Fundamentals of Nursing: Active Learning for Collaborative
Practice, 3rd Edition (Yoost & Crawford)
Format: Multiple Choice & Multiple Response Questions with Rationales
1. The nurse is caring for a patient who periodically has small streaks
of fresh red blood in the stool. The patient denies abdominal pain or
loss of appetite. The nurse identifies what to be the most likely cause
of this patient's bleeding?
A. Hemorrhoids
B. Bleeding gastric ulcer
C. Colon polyps
D. Perforated colon
Correct Answer: A
Rationale:
1. Small streaks of fresh red blood in the stool are characteristic of
hemorrhoidal bleeding, which occurs in the lower rectum or anus.
2. Bleeding from a gastric ulcer would produce black, tarry stools
(melena) due to the digestion of blood as it passes through the GI
tract.
3. Colon polyps typically do not cause noticeable bleeding unless they
are large or ulcerated.
, 2|Page
4. A perforated colon would cause severe abdominal pain, fever, and
systemic symptoms, which the patient denies.
2. The nurse is caring for a patient who has diarrhea and identifies
which priority nursing diagnosis for this patient?
A. Lack of knowledge related to prescribed diet modifications
B. Impaired nutritional intake related to poor appetite
C. Diarrhea related to excessive loss of fluid through stool
D. Anxiety related to incontinence with loose stools and need for clothing
change
Correct Answer: C
Rationale:
1. The most immediate and life-threatening risk associated with
diarrhea is fluid and electrolyte imbalance leading to dehydration.
2. Addressing the actual problem of diarrhea takes precedence over
knowledge deficits, appetite changes, or anxiety.
3. Once fluid balance is restored, other nursing diagnoses can be
effectively managed.
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.
Correct Answer: B
Rationale:
1. Diphenoxylate-atropine is an antidiarrheal medication used to reduce
intestinal motility.
2. Administering it to a patient who is already constipated could worsen
the impaction or lead to a bowel obstruction.
3. The other findings are not contraindications for this medication.
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
, 3|Page
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 for a fecal impaction.
D. Administer antiemetic medication with a sip of water.
Correct Answer: C
Rationale:
1. Immobile patients are at high risk for fecal impaction, which can
present as paradoxical diarrhea (leakage of liquid stool around a hard
impaction).
2. Abdominal pain, nausea, and vomiting are common signs of
impaction that must be assessed first to rule out obstruction.
3. Other interventions are supportive but should follow after confirming
or ruling out impaction.
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.
Correct Answer: A
Rationale:
1. The return of bowel sounds in all quadrants and the passage of flatus
are objective signs that peristalsis has resumed following surgery.
2. These findings indicate that the GI tract is functioning adequately to
begin oral intake.
3. Hunger, absence of nausea, and NG tube removal are supportive but
not definitive indicators of GI readiness.
6. The nurse is caring for a patient who has an ileostomy. Which
Nursing diagnosis has the highest priority for the patient?
A. Impaired skin integrity r/t localized skin irritation from liquid stool
B. Social isolation r/t potential leakage of stool from ostomy appliance
, 4|Page
C. Lack of knowledge r/t care and maintenance of ostomy appliance
D. Disturbed body image r/t presence of stoma and altered elimination
Correct Answer: A
Rationale:
1. Liquid stool from an ileostomy is highly corrosive and can quickly
cause peristomal skin breakdown.
2. Impaired skin integrity poses an immediate risk for infection, pain,
and poor appliance adherence.
3. While other diagnoses are relevant, maintaining skin integrity is
foundational to overall ostomy management and patient comfort.
7. The nurse is caring for a patient who is taking narcotic pain
medication after surgery. Which breakfast choices will help prevent
constipation and promote return to regular bowel function?
A. Raisin bran with skim milk, fresh fruit, and wheat toast
B. Pancakes with maple syrup, bacon, and coffee with cream
C. Omelet with cheddar cheese, green pepper, and onions
D. Bagel with cream cheese, and strawberry nonfat yogurt
Correct Answer: A
Rationale:
1. Narcotic pain medications slow peristalsis and increase the risk of
constipation.
2. A high-fiber diet with adequate fluids promotes bowel motility and
prevents constipation.
3. Raisin bran, fresh fruit, and whole wheat toast are excellent sources
of dietary fiber, unlike low-fiber options like pancakes, omelets, or
bagels.
8. The nurse is caring for a patient who has not had a bowel movement
for 2 days. Which is the priority nursing intervention for this patient?
A. Obtain an order to administer a soap suds cleansing enema.
B. Teach the patient how to use the Valsalva maneuver.
C. Discontinue medications that can cause constipation.
D. Assess the patient's usual pattern of bowel movements.
Correct Answer: D
Rationale:
