Fundamentals Bowel/Elimination Exam
Questions With Correct Answers
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?
A. It allows the nurse to plan for appropriate teaching measures.
B. It helps determine the number and type of enemas to be given.
C. It helps determine conditions that contraindicate the use of enemas.
D. It provides a baseline for determining the effectiveness of the enema.
D
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 preparing to administer an enema to a patient who is scheduled for a colonoscopy. Which
action taken by the nurse may lead to a complication?
A. Giving the enema with the patient sitting on the toilet
B. Giving the enema with the patient positioned on a bedpan
C. Refraining from sterile technique while administering the enema
D. Asking the patient to retain the enema solution for a specific length of time
A
The nurse should not give an enema to a patient sitting on the toilet because the position of the rectal
tubing could injure the rectal wall. When giving an enema to an immobilized patient, it is always
recommended that the patient be positioned on a bedpan. The use of sterile technique is not
necessary when administering an enema, because the colon already contains bacteria. However, the
nurse should wear gloves to prevent the transmission of fecal microorganisms. It is appropriate to ask
the patient to retain the enema solution for a specific length of time before defecation.
The health care provider prescribes methylcellulose to a patient with chronic constipation. Which
instruction provided by the nurse will help prevent complications?
A. "Do not use the medication on a regular basis."
B. "Mix the powder with 250 mL of water or juice and swallow it quickly."
C. "Report to the health care provider if you do not pass stool within 8 to 10 hours of taking the
medication."
D. "Stop taking the medication if you note increased gas formation and flatus when you first start
taking it."
B
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 part of the gastrointestinal tract plays a major role in bowel elimination?
A. Stomach
, B. Esophagus
C. Small intestine
D. Large intestine
D
The main functions of the large intestine, or colon, are absorption, secretion, and elimination.
Therefore, the large intestine plays a major role in bowel elimination. The small intestine is involved in
digestion and absorption, but not elimination. The main functions of the stomach include storage of
swallowed food and liquid, mixing of food with digestive juices into a substance, and regulated
emptying of its contents into the small intestine. The esophagus is the part of the gastrointestinal
tract through which food reaches the upper end of the stomach. It is not involved in elimination.
To which patient will the nurse most likely give a hypertonic solution enema?
A. An infant who is unable to defecate
B. A dehydrated patient who has constipation
C. A patient who cannot tolerate a large volume of fluid
D. A patient with a dangerously high serum potassium level
C
Enemas that uses hypertonic solutions are low volume and are designed for patients who cannot
tolerate a large volume of fluid. This type of enema is contraindicated in infants and dehydrated
patients. A patient with a dangerously high serum potassium level may receive a medicated enema
that contains sodium polystyrene sulfonate.
While assessing a patient with a bowel elimination problem, the nurse asks the patient, "Do you feel
as though your bowel movements are incomplete?" Which condition is the nurse trying to determine
in the patient?
A. Diarrhea
B. Indigestion
C. Constipation
D. Hemorrhoids
C
To determine constipation, the nurse should ask the patient about feelings of having incomplete
bowel movements. To determine indigestion, the nurse should ask the patient about a bloated feeling
after eating. To determine diarrhea, the nurse may ask whether the patient has taken any antibiotics
recently. Pain in the area around the anus may indicate hemorrhoids.
Which patient has the highest risk of constipation?
A. A patient who is taking antibiotics
B. A patient who is taking opioid analgesics
C. A patient who has undergone endoscopy
D. A patient who drinks only 1.5 L of fluids per day
B
Opioid analgesics slow peristalsis and contractions, thereby causing constipation. Therefore, a patient
taking opioid analgesics has the highest risk of constipation. A patient who is taking antibiotics may
have diarrhea because antibiotics decrease intestinal bacterial flora, resulting in diarrhea. Patients
who have undergone diagnostic procedures that require visualization of the gastrointestinal tract may
experience increased gas or loose stools, not constipation. A person should drink at least 1.5 L of
fluids per day to avoid constipation.
.Which bowel elimination problem is associated with abdominal fullness, cramping, distention, and
severe, sharp pain?
A. Diarrhea
B. Flatulence
C. Hemorrhoids
Questions With Correct Answers
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?
A. It allows the nurse to plan for appropriate teaching measures.
B. It helps determine the number and type of enemas to be given.
C. It helps determine conditions that contraindicate the use of enemas.
D. It provides a baseline for determining the effectiveness of the enema.
D
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 preparing to administer an enema to a patient who is scheduled for a colonoscopy. Which
action taken by the nurse may lead to a complication?
A. Giving the enema with the patient sitting on the toilet
B. Giving the enema with the patient positioned on a bedpan
C. Refraining from sterile technique while administering the enema
D. Asking the patient to retain the enema solution for a specific length of time
A
The nurse should not give an enema to a patient sitting on the toilet because the position of the rectal
tubing could injure the rectal wall. When giving an enema to an immobilized patient, it is always
recommended that the patient be positioned on a bedpan. The use of sterile technique is not
necessary when administering an enema, because the colon already contains bacteria. However, the
nurse should wear gloves to prevent the transmission of fecal microorganisms. It is appropriate to ask
the patient to retain the enema solution for a specific length of time before defecation.
The health care provider prescribes methylcellulose to a patient with chronic constipation. Which
instruction provided by the nurse will help prevent complications?
A. "Do not use the medication on a regular basis."
B. "Mix the powder with 250 mL of water or juice and swallow it quickly."
C. "Report to the health care provider if you do not pass stool within 8 to 10 hours of taking the
medication."
D. "Stop taking the medication if you note increased gas formation and flatus when you first start
taking it."
B
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 part of the gastrointestinal tract plays a major role in bowel elimination?
A. Stomach
, B. Esophagus
C. Small intestine
D. Large intestine
D
The main functions of the large intestine, or colon, are absorption, secretion, and elimination.
Therefore, the large intestine plays a major role in bowel elimination. The small intestine is involved in
digestion and absorption, but not elimination. The main functions of the stomach include storage of
swallowed food and liquid, mixing of food with digestive juices into a substance, and regulated
emptying of its contents into the small intestine. The esophagus is the part of the gastrointestinal
tract through which food reaches the upper end of the stomach. It is not involved in elimination.
To which patient will the nurse most likely give a hypertonic solution enema?
A. An infant who is unable to defecate
B. A dehydrated patient who has constipation
C. A patient who cannot tolerate a large volume of fluid
D. A patient with a dangerously high serum potassium level
C
Enemas that uses hypertonic solutions are low volume and are designed for patients who cannot
tolerate a large volume of fluid. This type of enema is contraindicated in infants and dehydrated
patients. A patient with a dangerously high serum potassium level may receive a medicated enema
that contains sodium polystyrene sulfonate.
While assessing a patient with a bowel elimination problem, the nurse asks the patient, "Do you feel
as though your bowel movements are incomplete?" Which condition is the nurse trying to determine
in the patient?
A. Diarrhea
B. Indigestion
C. Constipation
D. Hemorrhoids
C
To determine constipation, the nurse should ask the patient about feelings of having incomplete
bowel movements. To determine indigestion, the nurse should ask the patient about a bloated feeling
after eating. To determine diarrhea, the nurse may ask whether the patient has taken any antibiotics
recently. Pain in the area around the anus may indicate hemorrhoids.
Which patient has the highest risk of constipation?
A. A patient who is taking antibiotics
B. A patient who is taking opioid analgesics
C. A patient who has undergone endoscopy
D. A patient who drinks only 1.5 L of fluids per day
B
Opioid analgesics slow peristalsis and contractions, thereby causing constipation. Therefore, a patient
taking opioid analgesics has the highest risk of constipation. A patient who is taking antibiotics may
have diarrhea because antibiotics decrease intestinal bacterial flora, resulting in diarrhea. Patients
who have undergone diagnostic procedures that require visualization of the gastrointestinal tract may
experience increased gas or loose stools, not constipation. A person should drink at least 1.5 L of
fluids per day to avoid constipation.
.Which bowel elimination problem is associated with abdominal fullness, cramping, distention, and
severe, sharp pain?
A. Diarrhea
B. Flatulence
C. Hemorrhoids
