Foundations Chapter 47 Bowel Elimination
Exam Questions And Answers (Verified And
Updated)
A registered nurse is educating nursing students about the required interventions while administering
an enema. Which statements if made by a student nurse indicate effective understanding? Select all
that apply.
1
"I'll place a waterproof pad under the patient's hips and buttocks."
2
"I'll assist the patient into the supine position with the right knee flexed."
3
"I'll stand on the left side of the patient's bed and raise the side rail on the opposite side."
4
"I'll cover the patient with a bath blanket, exposing only the rectal area, and clearly visualizing the
anus."
5
"If the patient has poor sphincter control, I'll position the patient on a bedpan in a comfortable dorsal
recumbent position."
1, 4, 5
The nurse should place a waterproof pad under the patient's hips and buttocks when administering an
enema. The nurse should also cover the patient with a bath blanket, exposing only the rectal area,
and clearly visualizing the anus. If the patient has poor sphincter control, the nurse should position
the patient on a bedpan in a comfortable dorsal recumbent position. While preparing a patient for an
enema, the nurse should assist the patient into the Sims' position with the right knee flexed and the
nurse should stand on the right side of the patient's bed and raise side rail on the opposite side.
While assessing a patient before administering an enema, the nurse inspects the patient's abdomen
for distention. What is the purpose of this nursing intervention?
1
It allows the nurse to plan for appropriate teaching measures.
2
It helps determine the number and type of enemas to be given.
3
It helps determine conditions that contraindicate the use of enemas.
4
It provides a baseline for determining the effectiveness of the enema.
4
Before administering an enema, the nurse should inspect the patient's abdomen for distention. This
provides a baseline for determining the effectiveness of the enema. To plan for appropriate teaching
measures, the nurse should determine the patient's level of understanding of the purpose of the
enema. The nurse should review the health care provider's order for the type of enema and the
amount to be given. Before administering an enema, the nurse should review the patient's medical
record for increased intracranial pressure, glaucoma, or recent abdominal, rectal, or prostate surgery
because these conditions contraindicate the use of enemas.
A nurse is assessing a patient with diarrhea. Which question will help determine the presence of other
symptoms?
1
"Do you feel bloated after eating?"
2
"Do you have to strain to have a bowel movement?"
,3
"Have you had fever, chills, weight loss, or abdominal pain recently?"
4
"Do you have abdominal or rectal pain when you have a bowel movement?"
3
Diarrhea may be associated with fever, chills, weight loss, or abdominal pain; therefore, the nurse
should ask the patient about the presence of these symptoms. A bloated feeling after eating may be
present in patients with indigestion. Patients with constipation may have to strain to have a bowel
movement and may have abdominal or rectal pain when they have a bowel movement.
A nurse is discussing common bowel elimination problems. Which statement indicates effective
understanding of the difference between fecal impaction and fecal incontinence?
1
Fecal impaction may occur due to antibiotic therapy, whereas fecal incontinence may occur due to
opiate therapy.
2
Fecal impaction is the accumulation of gas in the lumen of the intestines, whereas fecal incontinence
is the inability to control the passage of feces and gas from the anus.
3
Fecal impaction is common in debilitated, confused, or unconscious patients, whereas fecal
incontinence is common in patients with impaired cognitive function.
4
Fecal impaction is characterized by loss of appetite, nausea and/or vomiting, and rectal pain, whereas
fecal incontinence is characterized by abdominal distention and severe, sharp abdominal pain.
3
Debilitated, confused, or unconscious patients have an increased risk of fecal impaction, whereas
patients with impaired cognitive function are more likely to have fecal incontinence. Diarrhea, not
fecal impaction, may occur due to antibiotic therapy, whereas constipation may occur due to opiate
therapy. Flatulence is the accumulation of gas in the lumen of the intestines, whereas fecal
incontinence is the inability to control the passage of feces and gas from the anus. Fecal impaction is
characterized by a loss of appetite, nausea and/or vomiting, and rectal pain, whereas flatulence, not
fecal incontinence, is characterized by abdominal distention and severe, sharp abdominal pain.
Which is caused by straining on defecation? Select all that apply.
1
Pain
2
Impaction
3
Hemorrhoids
4
Dysrhythmias
5
Dry stool
3, 4
The Valsalva maneuver requires the patient to hold the breath while straining to defecate. This
maneuver increases venous pressure from straining. Over time, hemorrhoids result. In addition, this
maneuver increases the risk for dysrhythmias, which are often life threatening.
A student nurse is learning about the various factors that influence the process of bowel elimination.
Which statement if made by the student nurse indicates a need for further learning?
,1
"A woman should drink at least 1 L of fluid to maintain normal bowel elimination."
2
"Prolonged emotional stress increases peristalsis, causing diarrhea and gaseous distension."
3
"Older adults may have difficulty in controlling defecation due to weakened muscle tone in the
perineal floor and anal sphincter."
4
"A position that allows a person to lean forward exerts intraabdominal pressure, contracts the gluteal
muscles, and facilitates easy defecation."
1
Various factors such as fluid intake, stress, age, and position during defecation influence the process
of bowel elimination. A fluid intake of 2.2 L/day is recommended for women. During emotional stress,
the digestive process is accelerated, and peristalsis is increased; this may cause diarrhea and gaseous
distension. In older adults, muscle tone in the perineal floor and anal sphincter weakens, which
causes difficulty in controlling defecation. Squatting allows a person to lean forward, exert
intraabdominal pressure, and contract the gluteal muscles. This position facilitates easy defecation.
Which type of enema may cause electrolyte imbalances or damage to the intestinal mucosa in
pregnant women and older adults?
1
Soapsuds enema
2
Tap water enema
3
Oil-retention enema
4
Normal saline enema
1
The nurse is explaining to a patient with gastritis about the various physiological functions of the
stomach. Which statements pertain to the functions of the stomach? Select all that apply.
1
Storage of food
2
Reabsorption of nutrients
3
Secretion of intrinsic factor
4
Production of hydrochloric acid
5
Mucus secretion to aid protein digestion
1, 3, 4
The functions of the stomach include storage of food and liquids, as well as secretion of intrinsic
factor, which is responsible for absorption of vitamin B12. The stomach also produces hydrochloric
acid, which, along with pepsin, helps in protein digestion. Reabsorption of nutrients occurs in the
small intestine, not in the stomach. Mucus is secreted from the stomach, but it does not aid in protein
digestion. Instead, it forms a protective barrier on stomach mucosa.
The health care provider prescribes methylcellulose to a patient with chronic constipation. Which
instruction provided by the nurse will help prevent complications?
1
, "Do not use the medication on a regular basis."
2
"Mix the powder with 250 mL of water or juice and swallow it quickly."
3
"Report to the health care provider if you do not pass stool within 8 to 10 hours of taking the
medication."
4
"Stop taking the medication if you note increased gas formation and flatus when you first start taking
it."
2
Methylcellulose is a bulk-forming stool softener that absorbs water and increases solid intestinal bulk.
It is a drug of choice for chronic constipation and is available in powder form. The nurse should
instruct the patient to mix the powder with at least 250 mL of water or juice and swallow it quickly; if
not, it could cause constipation. The nurse should advise patients that prescribed stimulant laxatives
should only be taken occasionally to prevent dependence on the stimulus for defecation.
Methylcellulose may cause the passage of stool 12 to 24 hours after taking the medication. Therefore,
the patient need not report to the health care provider if he or she does not pass stool within 8 to 10
hours of taking the medication. Increased gas formation and flatus may occur when the patient first
starts taking methylcellulose; this will subside after 4 or 5 days. Therefore, the nurse should not
instruct the patient to stop taking the medication in such situations.
Which statement about fecal incontinence is correct?
1
It is the inability to control the passage of feces and gas from the anus.
2
It is an increase in the number of stools and the passage of liquid, unformed feces.
3
It results when a patient has unrelieved constipation and is unable to expel the hardened feces
retained in the rectum.
4
It is characterized by infrequent bowel movements (less than three per week) and hard, dry stools
that are difficult to pass.
1
Fecal incontinence is the inability to control the passage of feces and gas from the anus. Diarrhea is an
increase in the number of stools and the passage of liquid, unformed feces. Fecal impaction results
when a patient has unrelieved constipation and is unable to expel the hardened feces retained in the
rectum. Constipation is characterized by infrequent bowel movements (less than three per week) and
hard, dry stools that are difficult to pass.
A nurse is assisting an immobilized patient with bowel elimination to use a bedpan. Arrange the steps
of this process in the correct order.
1. Raise the side rail opposite the nurse.
2. Place a bedpan firmly against the buttocks.
3. Keeping one hand against the bedpan, place the other hand on the patient's hip.
4. Push bedpan down into mattress with the open rim toward the patient's feet.
5. Perform hand hygiene, apply clean gloves, and close the room curtain for privacy.
6. Lower the head of the bed flat and roll the patient onto his or her side facing away from the nurse.
Exam Questions And Answers (Verified And
Updated)
A registered nurse is educating nursing students about the required interventions while administering
an enema. Which statements if made by a student nurse indicate effective understanding? Select all
that apply.
1
"I'll place a waterproof pad under the patient's hips and buttocks."
2
"I'll assist the patient into the supine position with the right knee flexed."
3
"I'll stand on the left side of the patient's bed and raise the side rail on the opposite side."
4
"I'll cover the patient with a bath blanket, exposing only the rectal area, and clearly visualizing the
anus."
5
"If the patient has poor sphincter control, I'll position the patient on a bedpan in a comfortable dorsal
recumbent position."
1, 4, 5
The nurse should place a waterproof pad under the patient's hips and buttocks when administering an
enema. The nurse should also cover the patient with a bath blanket, exposing only the rectal area,
and clearly visualizing the anus. If the patient has poor sphincter control, the nurse should position
the patient on a bedpan in a comfortable dorsal recumbent position. While preparing a patient for an
enema, the nurse should assist the patient into the Sims' position with the right knee flexed and the
nurse should stand on the right side of the patient's bed and raise side rail on the opposite side.
While assessing a patient before administering an enema, the nurse inspects the patient's abdomen
for distention. What is the purpose of this nursing intervention?
1
It allows the nurse to plan for appropriate teaching measures.
2
It helps determine the number and type of enemas to be given.
3
It helps determine conditions that contraindicate the use of enemas.
4
It provides a baseline for determining the effectiveness of the enema.
4
Before administering an enema, the nurse should inspect the patient's abdomen for distention. This
provides a baseline for determining the effectiveness of the enema. To plan for appropriate teaching
measures, the nurse should determine the patient's level of understanding of the purpose of the
enema. The nurse should review the health care provider's order for the type of enema and the
amount to be given. Before administering an enema, the nurse should review the patient's medical
record for increased intracranial pressure, glaucoma, or recent abdominal, rectal, or prostate surgery
because these conditions contraindicate the use of enemas.
A nurse is assessing a patient with diarrhea. Which question will help determine the presence of other
symptoms?
1
"Do you feel bloated after eating?"
2
"Do you have to strain to have a bowel movement?"
,3
"Have you had fever, chills, weight loss, or abdominal pain recently?"
4
"Do you have abdominal or rectal pain when you have a bowel movement?"
3
Diarrhea may be associated with fever, chills, weight loss, or abdominal pain; therefore, the nurse
should ask the patient about the presence of these symptoms. A bloated feeling after eating may be
present in patients with indigestion. Patients with constipation may have to strain to have a bowel
movement and may have abdominal or rectal pain when they have a bowel movement.
A nurse is discussing common bowel elimination problems. Which statement indicates effective
understanding of the difference between fecal impaction and fecal incontinence?
1
Fecal impaction may occur due to antibiotic therapy, whereas fecal incontinence may occur due to
opiate therapy.
2
Fecal impaction is the accumulation of gas in the lumen of the intestines, whereas fecal incontinence
is the inability to control the passage of feces and gas from the anus.
3
Fecal impaction is common in debilitated, confused, or unconscious patients, whereas fecal
incontinence is common in patients with impaired cognitive function.
4
Fecal impaction is characterized by loss of appetite, nausea and/or vomiting, and rectal pain, whereas
fecal incontinence is characterized by abdominal distention and severe, sharp abdominal pain.
3
Debilitated, confused, or unconscious patients have an increased risk of fecal impaction, whereas
patients with impaired cognitive function are more likely to have fecal incontinence. Diarrhea, not
fecal impaction, may occur due to antibiotic therapy, whereas constipation may occur due to opiate
therapy. Flatulence is the accumulation of gas in the lumen of the intestines, whereas fecal
incontinence is the inability to control the passage of feces and gas from the anus. Fecal impaction is
characterized by a loss of appetite, nausea and/or vomiting, and rectal pain, whereas flatulence, not
fecal incontinence, is characterized by abdominal distention and severe, sharp abdominal pain.
Which is caused by straining on defecation? Select all that apply.
1
Pain
2
Impaction
3
Hemorrhoids
4
Dysrhythmias
5
Dry stool
3, 4
The Valsalva maneuver requires the patient to hold the breath while straining to defecate. This
maneuver increases venous pressure from straining. Over time, hemorrhoids result. In addition, this
maneuver increases the risk for dysrhythmias, which are often life threatening.
A student nurse is learning about the various factors that influence the process of bowel elimination.
Which statement if made by the student nurse indicates a need for further learning?
,1
"A woman should drink at least 1 L of fluid to maintain normal bowel elimination."
2
"Prolonged emotional stress increases peristalsis, causing diarrhea and gaseous distension."
3
"Older adults may have difficulty in controlling defecation due to weakened muscle tone in the
perineal floor and anal sphincter."
4
"A position that allows a person to lean forward exerts intraabdominal pressure, contracts the gluteal
muscles, and facilitates easy defecation."
1
Various factors such as fluid intake, stress, age, and position during defecation influence the process
of bowel elimination. A fluid intake of 2.2 L/day is recommended for women. During emotional stress,
the digestive process is accelerated, and peristalsis is increased; this may cause diarrhea and gaseous
distension. In older adults, muscle tone in the perineal floor and anal sphincter weakens, which
causes difficulty in controlling defecation. Squatting allows a person to lean forward, exert
intraabdominal pressure, and contract the gluteal muscles. This position facilitates easy defecation.
Which type of enema may cause electrolyte imbalances or damage to the intestinal mucosa in
pregnant women and older adults?
1
Soapsuds enema
2
Tap water enema
3
Oil-retention enema
4
Normal saline enema
1
The nurse is explaining to a patient with gastritis about the various physiological functions of the
stomach. Which statements pertain to the functions of the stomach? Select all that apply.
1
Storage of food
2
Reabsorption of nutrients
3
Secretion of intrinsic factor
4
Production of hydrochloric acid
5
Mucus secretion to aid protein digestion
1, 3, 4
The functions of the stomach include storage of food and liquids, as well as secretion of intrinsic
factor, which is responsible for absorption of vitamin B12. The stomach also produces hydrochloric
acid, which, along with pepsin, helps in protein digestion. Reabsorption of nutrients occurs in the
small intestine, not in the stomach. Mucus is secreted from the stomach, but it does not aid in protein
digestion. Instead, it forms a protective barrier on stomach mucosa.
The health care provider prescribes methylcellulose to a patient with chronic constipation. Which
instruction provided by the nurse will help prevent complications?
1
, "Do not use the medication on a regular basis."
2
"Mix the powder with 250 mL of water or juice and swallow it quickly."
3
"Report to the health care provider if you do not pass stool within 8 to 10 hours of taking the
medication."
4
"Stop taking the medication if you note increased gas formation and flatus when you first start taking
it."
2
Methylcellulose is a bulk-forming stool softener that absorbs water and increases solid intestinal bulk.
It is a drug of choice for chronic constipation and is available in powder form. The nurse should
instruct the patient to mix the powder with at least 250 mL of water or juice and swallow it quickly; if
not, it could cause constipation. The nurse should advise patients that prescribed stimulant laxatives
should only be taken occasionally to prevent dependence on the stimulus for defecation.
Methylcellulose may cause the passage of stool 12 to 24 hours after taking the medication. Therefore,
the patient need not report to the health care provider if he or she does not pass stool within 8 to 10
hours of taking the medication. Increased gas formation and flatus may occur when the patient first
starts taking methylcellulose; this will subside after 4 or 5 days. Therefore, the nurse should not
instruct the patient to stop taking the medication in such situations.
Which statement about fecal incontinence is correct?
1
It is the inability to control the passage of feces and gas from the anus.
2
It is an increase in the number of stools and the passage of liquid, unformed feces.
3
It results when a patient has unrelieved constipation and is unable to expel the hardened feces
retained in the rectum.
4
It is characterized by infrequent bowel movements (less than three per week) and hard, dry stools
that are difficult to pass.
1
Fecal incontinence is the inability to control the passage of feces and gas from the anus. Diarrhea is an
increase in the number of stools and the passage of liquid, unformed feces. Fecal impaction results
when a patient has unrelieved constipation and is unable to expel the hardened feces retained in the
rectum. Constipation is characterized by infrequent bowel movements (less than three per week) and
hard, dry stools that are difficult to pass.
A nurse is assisting an immobilized patient with bowel elimination to use a bedpan. Arrange the steps
of this process in the correct order.
1. Raise the side rail opposite the nurse.
2. Place a bedpan firmly against the buttocks.
3. Keeping one hand against the bedpan, place the other hand on the patient's hip.
4. Push bedpan down into mattress with the open rim toward the patient's feet.
5. Perform hand hygiene, apply clean gloves, and close the room curtain for privacy.
6. Lower the head of the bed flat and roll the patient onto his or her side facing away from the nurse.
