Bowel Elimination Nclex Practice Questions
With Correct Answers
The nurse knows that most nutrients are absorbed in which portion of the digestive tract?
a. Stomach
b. Duodenum
c. Ileum
d. Cecum
ANS: B
Most nutrients are absorbed in the duodenum with the exception of certain vitamins, iron, and salt
(which are absorbed in the ileum). Food is broken down in the stomach. The cecum is the beginning
of the large intestine.
The nurse would expect the least formed stool to be present in which portion of the digestive tract?
a. Ascending
b. Descending
c. Transverse
d. Sigmoid
ANS: A
The path of digestion goes from the ascending, across the transverse, to the descending and finally
passing into the sigmoid; therefore, the least formed stool would be in the ascending.
Which of the following is not a function of the large intestine?
a. Absorbing nutrients
b. Absorbing water
c. Secreting bicarbonate
d. Eliminating waste
ANS: A
Nutrient absorption is done in the small intestine. The other options are all functions of the large
intestine.
The nurse is caring for a patient who is confined to the bed. The nurse asks the patient if he needs to
have a bowel movement 30 minutes after eating a meal because
a. The digested food needs to make room for recently ingested food.
b. Mastication triggers the digestive system to begin peristalsis.
c. The smell of bowel elimination in the room would deter the patient from eating.
,d. More ancillary staff members are available after meal times.
ANS: B
Peristalsis occurs only a few times a day; the strongest peristaltic waves are triggered by mastication
of the meal. The intestine can hold a great deal of food. A patients voiding schedule should not be
based on the staffs convenience.
A nurse is assisting a patient in making dietary choices that promote healthy bowel elimination. Which
menu option should the nurse recommend?
a. Grape and walnut chicken salad sandwich on whole wheat bread
b. Broccoli and cheese soup with potato bread
c. Dinner salad topped with hard-boiled eggs, cheese, and fat-free dressing
d. Turkey and mashed potatoes with brown gravy
ANS: A
A healthy diet for the bowel should include foods high in bulk-forming fiber. Whole grains, fresh fruit,
and fresh vegetables are excellent sources. Foods without much fiber and with high levels of fat can
slow down peristalsis, causing constipation.
A patient informs the nurse that she was using laxatives three times daily to lose weight. After
stopping use of the laxative, the patient had difficulty with constipation and wonders if she needs to
take laxatives again. The nurse educates the patient that
a. Long-term laxative use causes the bowel to become less responsive to stimuli, and constipation
may occur.
b. Laxatives can cause trauma to the intestinal lining and scarring may result, leading to decreased
peristalsis.
c. Natural laxatives such as mineral oil are safer than chemical laxatives for relieving constipation.
d. Laxatives cause the body to become malnourished, so when the patient begins eating again, the
body absorbs all of the food, and no waste products are produced.
ANS: A
Long-term laxative use can lead to constipation. Increasing fluid and fiber intake can help with this
problem. Laxatives do not cause scarring. Natural laxatives like mineral oil come with their own set of
risks, such as inability to absorb fat-soluble vitamins. Even if malnourished, the body will produce
waste if substance is consumed.
A patient with a hip fracture is having difficulty defecating into a bed pan while lying in bed. Which
action by the nurse would assist the patient in having a successful bowel movement?
a. Administering laxatives to the patient
b. Raising the head of the bed
c. Preparing to administer a barium enema
,d. Withholding narcotic pain medication
ANS: B
Lying in bed is an unnatural position; raising the head of the bed assists the patient into a more
normal position that allows proper contraction of muscles for elimination. Laxatives would not give
the patient control over bowel movements. A barium enema is a diagnostic test, not an intervention
to promote defecation. Pain relief measures should be given; however, preventative action should be
taken to prevent constipation.
Which patient is most at risk for increased peristalsis?
a. A 5-year-old child who ignores the urge to defecate owing to embarrassment
b. A 21-year-old patient with three final examinations on the same day
c. A 40-year-old woman with major depressive disorder
d. An 80-year-old man in an assisted-living environment
ANS: B
Stress can stimulate digestion and increase peristalsis. Ignoring the urge to defecate, depression, and
age-related changes of the elderly are causes of constipation.
.A patient expresses concerns over having black stool. The fecal occult test is negative. Which
response by the nurse is most appropriate?
a. This is probably a false negative; we should rerun the test.
b. Do you take iron supplements?
c. You should schedule a colonoscopy as soon as possible.
d. Sometimes severe stress can alter stool color.
ANS: B
Certain medications and supplements, such as iron, can alter the color of stool. The fecal occult test
takes three separate samples over a period of time and is a fairly reliable test. A colonoscopy is health
prevention screening that should be done every 5 to 10 years; it is not the nurses initial priority. Stress
alters GI motility and stool consistency, not color.
Which physiological change can cause a paralytic ileus?
a. Chronic cathartic abuse
b. Surgery for Crohns disease and anesthesia
c. Suppression of hydrochloric acid from medication
d. Fecal impaction
ANS: B
Surgical manipulation of the bowel can cause a paralytic ileus. The other options are incorrect.
, Fecal impactions occur in which portion of the colon?
a. Ascending
b. Descending
c. Transverse
d. Rectum
ANS: D
A fecal impaction is a collection of hardened feces wedged in the rectum that cannot be expelled. It
results from unrelieved constipation. Feces at this point in the colon contain the least amount of
moisture. Feces found in the ascending, transverse, and descending colon still consist mostly of liquid
and do not form a hardened mass.
The nurse provides knows that a bowel elimination schedule would be most beneficial in the plan of
care for which patient?
a. A 40-year-old patient with an ileostomy
b. A 25-year-old patient with Crohns disease
c. A 30-year-old patient with C. difficile
d. A 70-year-old patient with stool incontinence
ANS: D
A bowel elimination program is helpful for a patient with incontinence. It helps the person who still
has neuromuscular control defecate normally. An ileostomy, Crohns disease, and C. difficile all relate
to uncontrollable bowel movements, for which no method can be used to set up a schedule of
elimination.
Which nursing intervention is most effective in promoting normal defecation for a patient who has
muscle weakness in the legs that prevents ambulation?
a. Elevate the head of the bed 45 degrees 60 minutes after breakfast.
b. Use a mobility device to place the patient on a bedside commode.
c. Give the patient a pillow to brace against the abdomen while bearing down.
d. Administer a soap suds enema every 2 hours.
ANS: B
The best way to promote normal defecation is to assist the patient into a posture that is as normal as
possible while defecating. Using a mobility device promotes nurse and patient safety. Elevating the
head of the bed would be appropriate if the patient were to void with a bed pan. However, the
patients condition does not require use of a bed pan. Giving the patient a pillow may reduce
discomfort, but this is not the best way to promote defecation. A soaps suds enema is indicated for a
patient who needs assistance to stimulate peristalsis. It promotes non-natural defecation.
With Correct Answers
The nurse knows that most nutrients are absorbed in which portion of the digestive tract?
a. Stomach
b. Duodenum
c. Ileum
d. Cecum
ANS: B
Most nutrients are absorbed in the duodenum with the exception of certain vitamins, iron, and salt
(which are absorbed in the ileum). Food is broken down in the stomach. The cecum is the beginning
of the large intestine.
The nurse would expect the least formed stool to be present in which portion of the digestive tract?
a. Ascending
b. Descending
c. Transverse
d. Sigmoid
ANS: A
The path of digestion goes from the ascending, across the transverse, to the descending and finally
passing into the sigmoid; therefore, the least formed stool would be in the ascending.
Which of the following is not a function of the large intestine?
a. Absorbing nutrients
b. Absorbing water
c. Secreting bicarbonate
d. Eliminating waste
ANS: A
Nutrient absorption is done in the small intestine. The other options are all functions of the large
intestine.
The nurse is caring for a patient who is confined to the bed. The nurse asks the patient if he needs to
have a bowel movement 30 minutes after eating a meal because
a. The digested food needs to make room for recently ingested food.
b. Mastication triggers the digestive system to begin peristalsis.
c. The smell of bowel elimination in the room would deter the patient from eating.
,d. More ancillary staff members are available after meal times.
ANS: B
Peristalsis occurs only a few times a day; the strongest peristaltic waves are triggered by mastication
of the meal. The intestine can hold a great deal of food. A patients voiding schedule should not be
based on the staffs convenience.
A nurse is assisting a patient in making dietary choices that promote healthy bowel elimination. Which
menu option should the nurse recommend?
a. Grape and walnut chicken salad sandwich on whole wheat bread
b. Broccoli and cheese soup with potato bread
c. Dinner salad topped with hard-boiled eggs, cheese, and fat-free dressing
d. Turkey and mashed potatoes with brown gravy
ANS: A
A healthy diet for the bowel should include foods high in bulk-forming fiber. Whole grains, fresh fruit,
and fresh vegetables are excellent sources. Foods without much fiber and with high levels of fat can
slow down peristalsis, causing constipation.
A patient informs the nurse that she was using laxatives three times daily to lose weight. After
stopping use of the laxative, the patient had difficulty with constipation and wonders if she needs to
take laxatives again. The nurse educates the patient that
a. Long-term laxative use causes the bowel to become less responsive to stimuli, and constipation
may occur.
b. Laxatives can cause trauma to the intestinal lining and scarring may result, leading to decreased
peristalsis.
c. Natural laxatives such as mineral oil are safer than chemical laxatives for relieving constipation.
d. Laxatives cause the body to become malnourished, so when the patient begins eating again, the
body absorbs all of the food, and no waste products are produced.
ANS: A
Long-term laxative use can lead to constipation. Increasing fluid and fiber intake can help with this
problem. Laxatives do not cause scarring. Natural laxatives like mineral oil come with their own set of
risks, such as inability to absorb fat-soluble vitamins. Even if malnourished, the body will produce
waste if substance is consumed.
A patient with a hip fracture is having difficulty defecating into a bed pan while lying in bed. Which
action by the nurse would assist the patient in having a successful bowel movement?
a. Administering laxatives to the patient
b. Raising the head of the bed
c. Preparing to administer a barium enema
,d. Withholding narcotic pain medication
ANS: B
Lying in bed is an unnatural position; raising the head of the bed assists the patient into a more
normal position that allows proper contraction of muscles for elimination. Laxatives would not give
the patient control over bowel movements. A barium enema is a diagnostic test, not an intervention
to promote defecation. Pain relief measures should be given; however, preventative action should be
taken to prevent constipation.
Which patient is most at risk for increased peristalsis?
a. A 5-year-old child who ignores the urge to defecate owing to embarrassment
b. A 21-year-old patient with three final examinations on the same day
c. A 40-year-old woman with major depressive disorder
d. An 80-year-old man in an assisted-living environment
ANS: B
Stress can stimulate digestion and increase peristalsis. Ignoring the urge to defecate, depression, and
age-related changes of the elderly are causes of constipation.
.A patient expresses concerns over having black stool. The fecal occult test is negative. Which
response by the nurse is most appropriate?
a. This is probably a false negative; we should rerun the test.
b. Do you take iron supplements?
c. You should schedule a colonoscopy as soon as possible.
d. Sometimes severe stress can alter stool color.
ANS: B
Certain medications and supplements, such as iron, can alter the color of stool. The fecal occult test
takes three separate samples over a period of time and is a fairly reliable test. A colonoscopy is health
prevention screening that should be done every 5 to 10 years; it is not the nurses initial priority. Stress
alters GI motility and stool consistency, not color.
Which physiological change can cause a paralytic ileus?
a. Chronic cathartic abuse
b. Surgery for Crohns disease and anesthesia
c. Suppression of hydrochloric acid from medication
d. Fecal impaction
ANS: B
Surgical manipulation of the bowel can cause a paralytic ileus. The other options are incorrect.
, Fecal impactions occur in which portion of the colon?
a. Ascending
b. Descending
c. Transverse
d. Rectum
ANS: D
A fecal impaction is a collection of hardened feces wedged in the rectum that cannot be expelled. It
results from unrelieved constipation. Feces at this point in the colon contain the least amount of
moisture. Feces found in the ascending, transverse, and descending colon still consist mostly of liquid
and do not form a hardened mass.
The nurse provides knows that a bowel elimination schedule would be most beneficial in the plan of
care for which patient?
a. A 40-year-old patient with an ileostomy
b. A 25-year-old patient with Crohns disease
c. A 30-year-old patient with C. difficile
d. A 70-year-old patient with stool incontinence
ANS: D
A bowel elimination program is helpful for a patient with incontinence. It helps the person who still
has neuromuscular control defecate normally. An ileostomy, Crohns disease, and C. difficile all relate
to uncontrollable bowel movements, for which no method can be used to set up a schedule of
elimination.
Which nursing intervention is most effective in promoting normal defecation for a patient who has
muscle weakness in the legs that prevents ambulation?
a. Elevate the head of the bed 45 degrees 60 minutes after breakfast.
b. Use a mobility device to place the patient on a bedside commode.
c. Give the patient a pillow to brace against the abdomen while bearing down.
d. Administer a soap suds enema every 2 hours.
ANS: B
The best way to promote normal defecation is to assist the patient into a posture that is as normal as
possible while defecating. Using a mobility device promotes nurse and patient safety. Elevating the
head of the bed would be appropriate if the patient were to void with a bed pan. However, the
patients condition does not require use of a bed pan. Giving the patient a pillow may reduce
discomfort, but this is not the best way to promote defecation. A soaps suds enema is indicated for a
patient who needs assistance to stimulate peristalsis. It promotes non-natural defecation.
