Chapter 31: Bowel Elimination
Fundamental Nursing Skills and Concepts 12th Edition, Timby
MULTIPLE CHOICE
1. A nurse is reinforcing teaching with a patient who will begin a bowel training program.
An intervention this program does not include is:
a. regularly scheduled time for toileting.
b. fluid intake of at least 2500 mL daily.
c. use of a suppository.
d. use of an enema.
ANS: D
Enemas and stronger laxatives are not considered a part of the program.
DIF: Cognitive Level: Comprehension REF: m 579, Box 30-3
OBJ: Theory #2 TOP: Bowel Training KEY: Nursing
Process Step: Implementation MSC: NCLEX: Physiological
Integrity: basic care and comfort
2. A nurse is assisting a patient with a new continent ileostomy to catheterize the internal
reservoir to drain the ileostomy. When the catheter meets resistance from the internal
valve, the nurse should:
a. have the patient take a deep breath and apply gentle pressure over the area.
b. withdraw the catheter and start again with a new one.
c. ask the patient to bear down and hold her breath.
d. coat the opening with petroleum jelly or a water-soluble lubricant.
ANS: A
For some patients the taking of a deep breath relaxes muscles and allows passage of
the catheter.
DIF: Cognitive Level: Application REF: m 581, Steps 30-2 OBJ:
Clinical Practice #7 TOP: Ileostomy KEY: Nursing Process
Step: Implementation MSC: NCLEX: Physiological Integrity
3. A nurse is caring for a patient who had bowel surgery 3 days ago and is now beginning to
have a well-functioning ostomy. The ostomy drainage bag should be emptied whenever it
is:
a. one-fourth full.
b. one-half full.
c. three-fourths full.
d. full.
ANS: B
The ostomy bag should be changed when it is one-third to one-half full so that the
weight of the bag will not detach it.
DIF: Cognitive Level: Knowledge REF: m 584, Skill 30-2 OBJ:
Clinical Practice #8 TOP: Ostomy Bag KEY: Nursing Process
Step: Planning MSC: NCLEX: Physiological Integrity: basic
care and comfort
, 4. A patient with a colostomy asks about foods that can be eaten that will reduce odor in the
ostomy drainage bag. The most informative response by the nurse is to say that ostomy
odor can be decreased with the intake of:
a. buttermilk.
b. eggs.
c. cucumbers.
d. beans.
ANS: A
Buttermilk is among the suggested foods that decrease ostomy bag odor.
DIF: Cognitive Level: Comprehension REF: m 582 OBJ: Clinical
Practice #8 TOP: Ostomy Bag KEY: Nursing Process Step:
Planning MSC: NCLEX: Physiological Integrity: basic care and comfort
5. The nurse is caring for an anxious patient who is scheduled for surgery for colostomy
placement. While the nurse is talking to the patient, the patient states, I am so scared. The
nurses most supportive response would be:
a. Surgeries like yours are very safe.
b. What about your colostomy scares you?
c. Why are you scared?
d. Sounds like someone has been telling you horror stories.
ANS: B
The nurse needs to address the patients anxiety and fear first by use of open-ended
questioning, because the patient might be focused on a variety of things, including
poor body image or the prospect of death. Asking a Why question is not therapeutic
and makes the patient defensive.
DIF: Cognitive Level: Application REF: m 580 OBJ: Theory #5
TOP: Preoperative Colostomy KEY: Nursing Process
Step: Implementation MSC: NCLEX: Psychosocial Integrity:
coping and adaptation
6. The nurse reminds the patient that digestion of food is a complex process with much of
the food breaking down in intestines. The small intestine functions to:
a. reabsorb sodium and chlorides.
b. propel waste material toward the anus.
c. absorb food substances from the bloodstream.
d. return water from the waste material to the bloodstream.
ANS: C
The small intestine processes the chyme into a more liquid state and absorbs food
substances into the bloodstream. All other listed functions are those of the large
intestine.
DIF: Cognitive Level: Knowledge REF: m 568 OBJ: Theory #5
TOP: Intestinal Digestion KEY: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity: physiological
adaptation
7. The nurse caring for a patient who had a colostomy 2 days ago assesses slight bleeding
Fundamental Nursing Skills and Concepts 12th Edition, Timby
MULTIPLE CHOICE
1. A nurse is reinforcing teaching with a patient who will begin a bowel training program.
An intervention this program does not include is:
a. regularly scheduled time for toileting.
b. fluid intake of at least 2500 mL daily.
c. use of a suppository.
d. use of an enema.
ANS: D
Enemas and stronger laxatives are not considered a part of the program.
DIF: Cognitive Level: Comprehension REF: m 579, Box 30-3
OBJ: Theory #2 TOP: Bowel Training KEY: Nursing
Process Step: Implementation MSC: NCLEX: Physiological
Integrity: basic care and comfort
2. A nurse is assisting a patient with a new continent ileostomy to catheterize the internal
reservoir to drain the ileostomy. When the catheter meets resistance from the internal
valve, the nurse should:
a. have the patient take a deep breath and apply gentle pressure over the area.
b. withdraw the catheter and start again with a new one.
c. ask the patient to bear down and hold her breath.
d. coat the opening with petroleum jelly or a water-soluble lubricant.
ANS: A
For some patients the taking of a deep breath relaxes muscles and allows passage of
the catheter.
DIF: Cognitive Level: Application REF: m 581, Steps 30-2 OBJ:
Clinical Practice #7 TOP: Ileostomy KEY: Nursing Process
Step: Implementation MSC: NCLEX: Physiological Integrity
3. A nurse is caring for a patient who had bowel surgery 3 days ago and is now beginning to
have a well-functioning ostomy. The ostomy drainage bag should be emptied whenever it
is:
a. one-fourth full.
b. one-half full.
c. three-fourths full.
d. full.
ANS: B
The ostomy bag should be changed when it is one-third to one-half full so that the
weight of the bag will not detach it.
DIF: Cognitive Level: Knowledge REF: m 584, Skill 30-2 OBJ:
Clinical Practice #8 TOP: Ostomy Bag KEY: Nursing Process
Step: Planning MSC: NCLEX: Physiological Integrity: basic
care and comfort
, 4. A patient with a colostomy asks about foods that can be eaten that will reduce odor in the
ostomy drainage bag. The most informative response by the nurse is to say that ostomy
odor can be decreased with the intake of:
a. buttermilk.
b. eggs.
c. cucumbers.
d. beans.
ANS: A
Buttermilk is among the suggested foods that decrease ostomy bag odor.
DIF: Cognitive Level: Comprehension REF: m 582 OBJ: Clinical
Practice #8 TOP: Ostomy Bag KEY: Nursing Process Step:
Planning MSC: NCLEX: Physiological Integrity: basic care and comfort
5. The nurse is caring for an anxious patient who is scheduled for surgery for colostomy
placement. While the nurse is talking to the patient, the patient states, I am so scared. The
nurses most supportive response would be:
a. Surgeries like yours are very safe.
b. What about your colostomy scares you?
c. Why are you scared?
d. Sounds like someone has been telling you horror stories.
ANS: B
The nurse needs to address the patients anxiety and fear first by use of open-ended
questioning, because the patient might be focused on a variety of things, including
poor body image or the prospect of death. Asking a Why question is not therapeutic
and makes the patient defensive.
DIF: Cognitive Level: Application REF: m 580 OBJ: Theory #5
TOP: Preoperative Colostomy KEY: Nursing Process
Step: Implementation MSC: NCLEX: Psychosocial Integrity:
coping and adaptation
6. The nurse reminds the patient that digestion of food is a complex process with much of
the food breaking down in intestines. The small intestine functions to:
a. reabsorb sodium and chlorides.
b. propel waste material toward the anus.
c. absorb food substances from the bloodstream.
d. return water from the waste material to the bloodstream.
ANS: C
The small intestine processes the chyme into a more liquid state and absorbs food
substances into the bloodstream. All other listed functions are those of the large
intestine.
DIF: Cognitive Level: Knowledge REF: m 568 OBJ: Theory #5
TOP: Intestinal Digestion KEY: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity: physiological
adaptation
7. The nurse caring for a patient who had a colostomy 2 days ago assesses slight bleeding
