Chapter 47: Bowel Elimination Exam
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Solved
Which of the following would the nurse expect as a normal change in the bowel elimination as a
person ages?
1. Absorptive processes are increased in the intestinal mucosa.
2. Esophageal emptying time is increased.
3. Changes in nerve innervation and sensation cause diarrhea.
4. Mastication processes are less efficient.
ANS: 4
An expected change in bowel elimination is decreased chewing and decreased salivation, resulting in
less efficient mastication. There is decreased nutrient absorption of the small intestine in the older
adult. Esophageal emptying slows, as a result of reduced motility, especially in the lower third of the
esophagus. With decreased peristalsis and weakened musculature, the older adult is more prone to
constipation. Duller nerve sensations may place the older adult at increased risk for fecal
incontinence.
An 8-month-old infant is hospitalized with severe diarrhea. The nurse knows that the major problem
associated with severe diarrhea is:
1. Pain in the abdominal area
2. Electrolyte and fluid loss
3. Presence of excessive flatus
4. Irritation of the perineal and rectal area
ANS: 2
Excess loss of colonic fluid because of diarrhea can result in serious fluid and electrolyte or acid-base
imbalances. Infants and older adults are particularly susceptible to associated complications. Pain
from abdominal cramping may occur with diarrhea, but it is not the major problem associated with
severe diarrhea. Excessive flatus is not the major problem associated with severe diarrhea. Because
repeated passage of diarrhea stools exposes the skin of the perineum and buttocks to irritating
intestinal contents, meticulous skin care and containment of fecal drainage are needed to prevent
skin breakdown. The greatest danger of severe diarrhea is a fluid and electrolyte or acid-base
imbalance.
A 50-year-old male client is having a screening colonoscopy. The nurse instructs the client that:
1. No special preparation is required
2. Light sedation is normally used
3. No metallic objects are allowed
4. Swallowing of an opaque liquid is required
ANS: 2
Light sedation is required for a colonoscopy. Special preparation is required before a colonoscopy.
Clear liquids are given the day before and then some form of bowel cleanser, such as GoLytely, is
administered. Enemas until clear may also be ordered. There is no restriction of metallic objects for a
colonoscopy, not does it require swallowing an opaque liquid.
A client is to have a stool test for occult blood. The nurse is instructing the nursing assistant in the
correct procedure for the test. The nursing assistant is correctly informed that:
1. Sterile technique is used for collection
2. Stool should be collected over a 3-day period
3. The specimen should be kept warm
4. A 1-inch sample of formed stool is needed
ANS: 4
, Tests performed by the laboratory for occult blood in the stool and stool cultures require only a small
sample. The nurse uses clean technique to collect about 1 inch of formed stool or 15 to 30 mL of
liquid stool. Unlike testing for occult blood, tests for measuring the output of fecal fat require a 3- to
5-day collection of stool, and tests that measure for ova and parasites require the stool to be warm.
A client who recently underwent surgery and now has a colostomy is correctly instructed by the nurse
that for the next few weeks the client's diet will include foods such as:
1. Vegetables
2. Fresh fruit
3. Whole grain breads
4. Poached eggs and rice
ANS: 4
During the first weeks after surgery, many health care providers recommend low-fiber diets because
the bowel requires time to adapt to the diversion. Low-fiber foods include bread, noodles, rice, cream
cheese, eggs (not fried), strained fruit juices, lean meats, fish, and poultry. Poached eggs and rice
would be appropriate for this client. After the ostomy heals, the client is allowed to eat whole grains,
fruits, and vegetables. High-fiber foods such as fresh fruits and vegetables help ensure a more solid
stool needed to achieve success at irrigation. Ostomy clients may benefit from avoiding foods that
cause gas and odor, including broccoli, cauliflower, dried beans, and Brussels sprouts.
The client has been admitted to an acute care unit with a diagnosis of biliary disease. The nurse
suspects that the feces will appear:
1. Bloody
2. Pus filled
3. Black and tarry
4. White or clay colored
ANS: 4
Stool that is white or clay colored indicates an absence of bile. Bloody feces is not an indication of
biliary disease. Pus-filled feces indicate infection. Black or tarry feces may indicate upper
gastrointestinal (GI) bleeding or iron ingestion.
The client asks the nurse to recommend bulk-forming foods that may be included in the diet. Which
of the following should be recommended by the nurse?
1. Whole grains
2. Fruit juice
3. Rare meats
4. Milk products
ANS: 1
Bulk-forming foods, such as grains, fruits, and vegetables, absorb fluids and increase stool mass. Fruit
juice, rare meats, and milk products are not bulk-forming foods.
The client is taking medications to promote defecation. Which of the following instructions should be
included by the nurse in the teaching plan for this client?
1. Increased laxative use often causes hyperkalemia.
2. Salt tablets should be taken to increase the solute concentration of the extracellular fluid.
3. Emollient solutions may increase the amount of water secreted into the bowel.
4. Bulk-forming additives may turn the urine pink.
ANS: 3
Emollient solutions are stool softeners that may increase the amount of water secreted into the
bowel. Laxative overuse can cause serious diarrhea that can lead to dehydration and hypokalemia.
Salt tablets should not be taken to increase the solute concentration of extracellular fluid. Bulk-
forming additives do not turn the urine pink. Phenolphthalein or danthron stimulant cathartics (e.g.,
Doxidan, Correctol, Ex-Lax) may cause pink or red urine.
Questions With Verified Answers 100%
Solved
Which of the following would the nurse expect as a normal change in the bowel elimination as a
person ages?
1. Absorptive processes are increased in the intestinal mucosa.
2. Esophageal emptying time is increased.
3. Changes in nerve innervation and sensation cause diarrhea.
4. Mastication processes are less efficient.
ANS: 4
An expected change in bowel elimination is decreased chewing and decreased salivation, resulting in
less efficient mastication. There is decreased nutrient absorption of the small intestine in the older
adult. Esophageal emptying slows, as a result of reduced motility, especially in the lower third of the
esophagus. With decreased peristalsis and weakened musculature, the older adult is more prone to
constipation. Duller nerve sensations may place the older adult at increased risk for fecal
incontinence.
An 8-month-old infant is hospitalized with severe diarrhea. The nurse knows that the major problem
associated with severe diarrhea is:
1. Pain in the abdominal area
2. Electrolyte and fluid loss
3. Presence of excessive flatus
4. Irritation of the perineal and rectal area
ANS: 2
Excess loss of colonic fluid because of diarrhea can result in serious fluid and electrolyte or acid-base
imbalances. Infants and older adults are particularly susceptible to associated complications. Pain
from abdominal cramping may occur with diarrhea, but it is not the major problem associated with
severe diarrhea. Excessive flatus is not the major problem associated with severe diarrhea. Because
repeated passage of diarrhea stools exposes the skin of the perineum and buttocks to irritating
intestinal contents, meticulous skin care and containment of fecal drainage are needed to prevent
skin breakdown. The greatest danger of severe diarrhea is a fluid and electrolyte or acid-base
imbalance.
A 50-year-old male client is having a screening colonoscopy. The nurse instructs the client that:
1. No special preparation is required
2. Light sedation is normally used
3. No metallic objects are allowed
4. Swallowing of an opaque liquid is required
ANS: 2
Light sedation is required for a colonoscopy. Special preparation is required before a colonoscopy.
Clear liquids are given the day before and then some form of bowel cleanser, such as GoLytely, is
administered. Enemas until clear may also be ordered. There is no restriction of metallic objects for a
colonoscopy, not does it require swallowing an opaque liquid.
A client is to have a stool test for occult blood. The nurse is instructing the nursing assistant in the
correct procedure for the test. The nursing assistant is correctly informed that:
1. Sterile technique is used for collection
2. Stool should be collected over a 3-day period
3. The specimen should be kept warm
4. A 1-inch sample of formed stool is needed
ANS: 4
, Tests performed by the laboratory for occult blood in the stool and stool cultures require only a small
sample. The nurse uses clean technique to collect about 1 inch of formed stool or 15 to 30 mL of
liquid stool. Unlike testing for occult blood, tests for measuring the output of fecal fat require a 3- to
5-day collection of stool, and tests that measure for ova and parasites require the stool to be warm.
A client who recently underwent surgery and now has a colostomy is correctly instructed by the nurse
that for the next few weeks the client's diet will include foods such as:
1. Vegetables
2. Fresh fruit
3. Whole grain breads
4. Poached eggs and rice
ANS: 4
During the first weeks after surgery, many health care providers recommend low-fiber diets because
the bowel requires time to adapt to the diversion. Low-fiber foods include bread, noodles, rice, cream
cheese, eggs (not fried), strained fruit juices, lean meats, fish, and poultry. Poached eggs and rice
would be appropriate for this client. After the ostomy heals, the client is allowed to eat whole grains,
fruits, and vegetables. High-fiber foods such as fresh fruits and vegetables help ensure a more solid
stool needed to achieve success at irrigation. Ostomy clients may benefit from avoiding foods that
cause gas and odor, including broccoli, cauliflower, dried beans, and Brussels sprouts.
The client has been admitted to an acute care unit with a diagnosis of biliary disease. The nurse
suspects that the feces will appear:
1. Bloody
2. Pus filled
3. Black and tarry
4. White or clay colored
ANS: 4
Stool that is white or clay colored indicates an absence of bile. Bloody feces is not an indication of
biliary disease. Pus-filled feces indicate infection. Black or tarry feces may indicate upper
gastrointestinal (GI) bleeding or iron ingestion.
The client asks the nurse to recommend bulk-forming foods that may be included in the diet. Which
of the following should be recommended by the nurse?
1. Whole grains
2. Fruit juice
3. Rare meats
4. Milk products
ANS: 1
Bulk-forming foods, such as grains, fruits, and vegetables, absorb fluids and increase stool mass. Fruit
juice, rare meats, and milk products are not bulk-forming foods.
The client is taking medications to promote defecation. Which of the following instructions should be
included by the nurse in the teaching plan for this client?
1. Increased laxative use often causes hyperkalemia.
2. Salt tablets should be taken to increase the solute concentration of the extracellular fluid.
3. Emollient solutions may increase the amount of water secreted into the bowel.
4. Bulk-forming additives may turn the urine pink.
ANS: 3
Emollient solutions are stool softeners that may increase the amount of water secreted into the
bowel. Laxative overuse can cause serious diarrhea that can lead to dehydration and hypokalemia.
Salt tablets should not be taken to increase the solute concentration of extracellular fluid. Bulk-
forming additives do not turn the urine pink. Phenolphthalein or danthron stimulant cathartics (e.g.,
Doxidan, Correctol, Ex-Lax) may cause pink or red urine.
