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NR224 224: FINAL EXAM WITH LATEST VERIFIED QUESTIONS AND CORRECT ANSWERS GRADED A+

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NR224 224: FINAL EXAM WITH LATEST VERIFIED QUESTIONS AND CORRECT ANSWERS GRADED A+ What is the most effective method to prevent the transfer of clostridium difficile (C. Difficile) ? - ANSHAND HYGIENE with soap and water is effective to physically remove C. difficile spores from the hands. (Potter 1092) What is the term for the [abnormal] method used to assist in stool passage by exerting pressure to expel fecal matter through voluntary contraction of the abdominal muscles while maintaining a forced expiration against a closed airway? - ANS-Valsalva Manuever *Normal passage of bowels should be painless, passing soft formed stool* Which patients are at greatest risk for cardiac dysrhythmia and high blood pressure with the Valsalva manuever and MUST avoid straining to pass stool? - ANS-Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound (Potter 1089) What is the term for a collection of hardened feces in the rectum that cannot be expelled due to unrelieved constipation? - ANS-Fecal Impaction Where does fecal impaction occur in the colon? - ANS-Rectum Least formed stool is present in which portion of the digestive tract? - ANS-Ascending Colon Most formed stool is present in which portion of the digestive tract? - ANS-Descending Colon Which position should the patient be in while administering an enema? - ANS-Left Side-Lying or Sim's Position Which factors would contribute to stopping enema administration? - ANS-If bleeding occurs, abdomen becomes rigid and distended, pain occurs, or resistance is felt Which enema solution is the safest for administration because it does NOT create a danger for excess fluid absorption? - ANS-Normal Saline [Isotonic Solution] Which enema solution is contraindicated in patients who are dehydrated or young infants because of risk for fluid imbalance? - ANS-Hypertonic Solution Which enema solution is considered to be hypotonic and should NOT be repeated because of the risk of water toxicity or circulatory overload if and because the body absorbs excessive amounts of water? - ANS-Tap Water [Hypotonic Solution] Which enema solution lubricates the rectum and allows the feces to absorb the oil making them soft and easier to pass? - ANS-Oil Retention Which enema solution creates intestinal irritation to stimulate peristalsis by using castile soap? - ANSSoapsuds Which enema solution should used in caution in pregnant women and elderly because it may cause an electrolyte imbalance or damage to intestinal mucosa? - ANS-Soapsuds Which laboratory test is used to measure microscopic amounts of blood in the feces (blood that cannot be seen) - ANS-Guaiac Fecal Occult Blood Test

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NR224 224: FINAL EXAM WITH LATEST
VERIFIED QUESTIONS AND CORRECT
ANSWERS GRADED A+ 2024-2025




What is the most effective method to prevent the transfer of clostridium difficile (C. Difficile) ? - ANS-
HAND HYGIENE with soap and water is effective to physically remove C. difficile spores from the hands.
(Potter 1092)



What is the term for the [abnormal] method used to assist in stool passage by exerting pressure to expel
fecal matter through voluntary contraction of the abdominal muscles while maintaining a forced
expiration against a closed airway? - ANS-Valsalva Manuever




*Normal passage of bowels should be painless, passing soft formed stool*



Which patients are at greatest risk for cardiac dysrhythmia and high blood pressure with the Valsalva
manuever and MUST avoid straining to pass stool? - ANS-Patients with cardiovascular disease,
glaucoma, increased intracranial pressure, or a new surgical wound

(Potter 1089)



What is the term for a collection of hardened feces in the rectum that cannot be expelled due to
unrelieved constipation? - ANS-Fecal Impaction



Where does fecal impaction occur in the colon? - ANS-Rectum

,Least formed stool is present in which portion of the digestive tract? - ANS-Ascending Colon



Most formed stool is present in which portion of the digestive tract? - ANS-Descending Colon



Which position should the patient be in while administering an enema? - ANS-Left Side-Lying or Sim's
Position



Which factors would contribute to stopping enema administration? - ANS-If bleeding occurs, abdomen
becomes rigid and distended, pain occurs, or resistance is felt



Which enema solution is the safest for administration because it does NOT create a danger for excess
fluid absorption? - ANS-Normal Saline [Isotonic Solution]



Which enema solution is contraindicated in patients who are dehydrated or young infants because of
risk for fluid imbalance? - ANS-Hypertonic Solution



Which enema solution is considered to be hypotonic and should NOT be repeated because of the risk of
water toxicity or circulatory overload if and because the body absorbs excessive amounts of water? -
ANS-Tap Water [Hypotonic Solution]



Which enema solution lubricates the rectum and allows the feces to absorb the oil making them soft
and easier to pass? - ANS-Oil Retention



Which enema solution creates intestinal irritation to stimulate peristalsis by using castile soap? - ANS-
Soapsuds



Which enema solution should used in caution in pregnant women and elderly because it may cause an
electrolyte imbalance or damage to intestinal mucosa? - ANS-Soapsuds



Which laboratory test is used to measure microscopic amounts of blood in the feces (blood that cannot
be seen) - ANS-Guaiac Fecal Occult Blood Test

,Repeat the test at least three times while the patient refrains from ingesting foods (e.g., some raw
vegetables, red meat, poultry, fish) and medications (e.g., vitamin C, aspirin, non steroidal anti-
inflammatory drugs) that cause false-positive results

(Potter 1100)



When analyzing a fecal specimens for ova and parasites, what is required of the stool? - ANS-The stool
MUST be warm.



If the stool specimen remains at room temperature, bacteriological changes can alter the test results



Which cathartic form is most effective because of its stimulant effect on the rectal mucosa

(Example: Dulcolax)? - ANS-Cathartic Suppositories



Which foods induce a constipating effect? - ANS-cheese, lean meats, eggs, and pasta



Which food induce a laxative effect? - ANS-fruits, vegetables, bran, chocolate, alcohol, and coffee



What are the assessment findings of a normal stoma? - ANS-bright pink or brick red



Notify HCP of stoma is blue, purple, brown, or black which indicates circulation problem to the stoma



How does the nurse measure the length of the NG tube for insertion? - ANS-Tip of the nose --> earlobe -
-> xiphoid process



What is the most reliable method of verification for placement of the NG tube? - ANS-X-ray



Other methods include: pH test (aspirate and inspect color)

, What are the ranges for body mass index? - ANS-Normal = 19-24

Overweight = 25-29

Obese = 30-39

Extremely Obese = > 40



When energy requirements are completely met or EQUALS kcal intake in food what occurs? - ANS-
Weight does not change



When kcal intake in food is LESS THAN energy requirements what occurs? - ANS-Loose weight



When kcal intake in food is GREATER THAN energy requirements what occurs? - ANS-Gain weight



Nutrients are absorbed in what portion of the digestive tract? - ANS-Small intestine [duodenum]



Proteins are necessary for _________ balance - ANS-Positive protein and nitrogen balance for healing,
growth, and tissue repair



1 gram of carbohydrates = ____ kcal - ANS-4 kcal



1 gram of fat = ____ kcal - ANS-9 kcal



Most calorie dense



< ___ % of fat intake of daily nutrition is considered a nutritional deficiency - ANS-< 10%



1 gram of protein = ___ kcal - ANS-4 kcal



Which amino acids are NOT manufactured by the body and MUST be obtained through diet or external
source are known as? - ANS-Indispensable amino acids

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