Galen College NSG 3100 Exam 3 – Fundamentals of Nursing
Complete 190-Question Practice Exam, Correct Answers &
Evidence-Based Rationales|2027-2026
1. A nurse is administering a large-volume cleansing enema. Which patient
position is most appropriate?
a. Left side-lying with right knee flexed
b. Right side-lying with left knee flexed
c. Supine with legs flat
d. Prone with pillow under abdomen
✔Correct Answer: a
Rationale: Left side-lying (Sims' position) follows the natural sigmoid colon
direction, allowing easier flow of solution.
2. A patient has an order for a soapsuds enema. The nurse prepares 1000 mL of
solution at what temperature?
a. 80°F (26.7°C)
b. 100°F (37.8°C)
c. 120°F (48.9°C)
d. Room temperature
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,✔Correct Answer: b
Rationale: Enema solution should be warmed to 100°F–105°F (37.8°C–40.5°C) to
prevent cramping. Cold solution causes cramping; hot solution can burn mucosa.
3. Before administering an enema, which patient history finding requires the most
immediate modification of the procedure?
a. Vital signs: BP 110/70, HR 80
b. Last bowel movement 2 days ago
c. History of anorectal surgery
d. Patient reports mild abdominal discomfort
✔Correct Answer: c
Rationale: Prior anorectal surgery can cause strictures, fissures, or altered
anatomy, increasing perforation risk. This directly affects safety.
4. During an enema, the patient reports dizziness and nausea. What should the
nurse do first?
a. Increase flow rate to finish quickly
b. Stop the enema immediately
c. Reposition the patient to right side
d. Continue and monitor vital signs
✔Correct Answer: b
Rationale: Dizziness and nausea indicate vagal response or intolerance. Stop the
procedure immediately to prevent syncope or injury.
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,5. The nurse inserts an enema tube. How far should the tube be inserted for an
adult?
a. 1–2 inches (2.5–5 cm)
b. 3–4 inches (7.5–10 cm)
c. 5–6 inches (12.5–15 cm)
d. 7–8 inches (17.5–20 cm)
✔Correct Answer: b
Rationale: For an adult, insert 3–4 inches (7.5–10 cm). Insertion too deep can
damage rectal mucosa; too shallow causes solution leakage.
6. A patient complains of severe cramping during an enema. The nurse should:
a. Clamp the tubing for 30 seconds
b. Raise the enema bag higher
c. Remove the tubing immediately
d. Increase the flow rate
✔Correct Answer: a
Rationale: Clamping tubing temporarily stops flow, allowing muscles to relax and
reducing cramping. Raising the bag increases flow and worsens cramping.
7. Which patients are at higher risk for constipation? (Select all that apply)
a. Bedridden elderly patient
b. Patient taking opioids postoperatively
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, c. Young athlete drinking 3 L water daily
d. Patient with hypothyroidism
e. Patient on a high-fiber diet
✔Correct Answer: a, b, d
Rationale: Immobility, opioids, and hypothyroidism slow bowel motility. High-
fiber and hydration prevent constipation.
8. To prevent constipation in an inactive patient, early interventions include:
(Select all that apply)
a. Stool softener administration
b. Enema administration
c. Increasing fiber in diet
d. Increasing physical activity as tolerated
e. Increasing fluid intake
✔Correct Answer: a, c, d, e
Rationale: Enemas treat existing impaction, not prevention. Prevention includes
softeners, fiber, mobility, and hydration.
9. Signs and symptoms of enema intolerance include: (Select all that apply)
a. Abdominal cramping
b. Nausea
c. Feeling of warmth and comfort
4|Page
Complete 190-Question Practice Exam, Correct Answers &
Evidence-Based Rationales|2027-2026
1. A nurse is administering a large-volume cleansing enema. Which patient
position is most appropriate?
a. Left side-lying with right knee flexed
b. Right side-lying with left knee flexed
c. Supine with legs flat
d. Prone with pillow under abdomen
✔Correct Answer: a
Rationale: Left side-lying (Sims' position) follows the natural sigmoid colon
direction, allowing easier flow of solution.
2. A patient has an order for a soapsuds enema. The nurse prepares 1000 mL of
solution at what temperature?
a. 80°F (26.7°C)
b. 100°F (37.8°C)
c. 120°F (48.9°C)
d. Room temperature
1|Page
,✔Correct Answer: b
Rationale: Enema solution should be warmed to 100°F–105°F (37.8°C–40.5°C) to
prevent cramping. Cold solution causes cramping; hot solution can burn mucosa.
3. Before administering an enema, which patient history finding requires the most
immediate modification of the procedure?
a. Vital signs: BP 110/70, HR 80
b. Last bowel movement 2 days ago
c. History of anorectal surgery
d. Patient reports mild abdominal discomfort
✔Correct Answer: c
Rationale: Prior anorectal surgery can cause strictures, fissures, or altered
anatomy, increasing perforation risk. This directly affects safety.
4. During an enema, the patient reports dizziness and nausea. What should the
nurse do first?
a. Increase flow rate to finish quickly
b. Stop the enema immediately
c. Reposition the patient to right side
d. Continue and monitor vital signs
✔Correct Answer: b
Rationale: Dizziness and nausea indicate vagal response or intolerance. Stop the
procedure immediately to prevent syncope or injury.
2|Page
,5. The nurse inserts an enema tube. How far should the tube be inserted for an
adult?
a. 1–2 inches (2.5–5 cm)
b. 3–4 inches (7.5–10 cm)
c. 5–6 inches (12.5–15 cm)
d. 7–8 inches (17.5–20 cm)
✔Correct Answer: b
Rationale: For an adult, insert 3–4 inches (7.5–10 cm). Insertion too deep can
damage rectal mucosa; too shallow causes solution leakage.
6. A patient complains of severe cramping during an enema. The nurse should:
a. Clamp the tubing for 30 seconds
b. Raise the enema bag higher
c. Remove the tubing immediately
d. Increase the flow rate
✔Correct Answer: a
Rationale: Clamping tubing temporarily stops flow, allowing muscles to relax and
reducing cramping. Raising the bag increases flow and worsens cramping.
7. Which patients are at higher risk for constipation? (Select all that apply)
a. Bedridden elderly patient
b. Patient taking opioids postoperatively
3|Page
, c. Young athlete drinking 3 L water daily
d. Patient with hypothyroidism
e. Patient on a high-fiber diet
✔Correct Answer: a, b, d
Rationale: Immobility, opioids, and hypothyroidism slow bowel motility. High-
fiber and hydration prevent constipation.
8. To prevent constipation in an inactive patient, early interventions include:
(Select all that apply)
a. Stool softener administration
b. Enema administration
c. Increasing fiber in diet
d. Increasing physical activity as tolerated
e. Increasing fluid intake
✔Correct Answer: a, c, d, e
Rationale: Enemas treat existing impaction, not prevention. Prevention includes
softeners, fiber, mobility, and hydration.
9. Signs and symptoms of enema intolerance include: (Select all that apply)
a. Abdominal cramping
b. Nausea
c. Feeling of warmth and comfort
4|Page
