NUR 3028 Final Exam 3 Questions and
Already Solved Solutions 2025-2026
Version.
mouth digestion - Answer mechanical: teeth
chemical: saliva; helps soften food
esophagus - Answer UES: prevents air from entering the esophagus and stomach, protects
against reflux of food into the airway
LES (cardiac) sphincter: prevents chyme from refluxing back into the esophagus, gastric reflux if
problems with cardiac sphincter
epiglottis - Answer closes over the trachea
-prevents food from entering the trachea when swallowing
-with dysphagia...epiglottis not properly closing over the trachea, risk of aspiration
stomach - Answer storage, mixing (peristalsis), emptying
secretions:
-HCl and pepsin breakdown proteins, form bolus into chyme
-mucus protective mechanism
-intrinsic factor (B12 absorption)
small intestine - Answer digestion and absorption occurs
-microvilli increase SA for absorption
1. duodenum (1 ft) absorbs fluids from stomach (pancreatic enzymes and bile) lots of vitamins
2. jejunum (8 ft) absorbs proteins, carbs, nutrients, electrolytes
3. ileum (12 ft) absorbs water, fats, iron, bile salts
why is insulin not given orally? - Answer GI secretions digest proteins in insulin making it
ineffective...this is why insulin is given subQ
large intestine - Answer cecum, ascending/transverse/descending/sigmoid, rectum, anus
,!!! gas production here bc of bacteria present
peristalsis - Answer happens 3-4x a day, the strongest being an hour after mealtime...imp to
know this so you can time activities better with your pt...if issues with immobility want to be
near pt to help w defecation
-fast peristalsis: watery stool
-slow peristalsis: constipation
physiology of elimination - Answer -stool in rectum causes distention
-relaxation of internal sphincter (involuntary)
-relaxation of external sphincter (voluntary control)
-abdominal muscles contract, allowing for the passage of stool
factors affecting bowel elimination - Answer -very young, very old (Azh and dementia pts may
not pick up on cues to go to bathroom)
-psychologic factors: once young children learn they can control their habits...they may hold in
their bowel contents leading to constipation and impaction
-immobility, sedentary lifestyle = constipation
-low fiber and low fluid intake = constipation
-pregnancy...intestines constrict from baby, leading to constipation
-meds (laxatives) increase GI motility
-surgery/anesthesia decrease GI motility (imp to auscultate for bowel sounds before feeding pt
after surgery)
-pain (use of meds like narcotics induce constipation)
hemorrhoids - Answer common in pregnancy and obese individuals
-increased pressure on veins leads to varicose veins in the rectum
"squatty potty" - Answer anatomically correct position for defecation
"knees flexed" helps increase intra-abdominal pressure and ease constipation
questions for pts about elimination patterns - Answer -any appetite changes?
-describe daily dietary/fluid intake
,Hx of cholecystitis/cholelithiasis/cirrhosis - Answer liver produces bile and galbladder stores it
(emulsifies fat in sm intestine)
-if probs w these 2 organs...fat digestion is altered
!!! make sure pt is watching their fat intake
questions for pregnant and older adults about elimination patterns - Answer -pregnancy: n/v?
constipation, heartburn, flatulence?
-older adults: constipation? incontinence? laxatives?
locations for a physical assessment - Answer mouth, abdomen, rectum
fecal occult blood testing - Answer measures microscopic amts of blood in stool sample
occult blood = not visual to naked eye
-put reagent on it...positive for blood if turns blue
-useful for colon cancer screening
(false positive can be from consuming red meat, vitamin C, some raw vegetables, or NSAIDs
invasive diagnostic exams - Answer 1. endoscopy: upper GI - inserted through the mouth to
look at the mouth, esophagus, and duodenum
-used if upper abdominal pain, dysphagia, n/v, tumor, ulcers
2. colonoscopy: lower GI - inserted through the rectum
-used if diverticulosis, cancer, rectal bleeding, ulcers
both use sedatives (not general anesthesia)
barium swallow or enema - Answer contrast either swallowed or inserted through rectum,
radiologic imaging shows contrast go through the GI
-other common non-invasive diagnostics: ultrasound, MRI, CT scan
MRI protocol - Answer NPO 4 to 6 hours before the examination
Colon cleansing products are not necessary for MRIs
, nursing diagnosis diarrhea: C.diff - Answer caused by an alteration in normal GI flora leading to
an overgrowth (from an antibiotic, bowel prep for an existing bowel problem, chemo)
-contact precautions!! HH with soap and water, clean surfaces with special antimicrobial wipes
with gloves on
-dx: 2-3 positive stool specimens; sigmoidoscopy
acute onset: abd cramping/pain, profuse water/stringy diarrhea
-tx: STOP the antibiotic being used (clindamycin, amoxicillin, ampicillin)
restore nutritional and f/e imbalance
-vancomycin, flagyl (parasitic infections), probiotics
-skincare!! c.diff can cause skin breakdown
patient centered goals for c.diff - Answer -educate client and family on cause of c.diff and
rationale behind tx protocol...explain how contagious
-keep rectal area free of any irritation/skin breakdown
-relieve cramping/lessen diarrhea
-maintain good skin turgor and weight (good fluid intake and daily weighing)
nursing interventions for c.diff - Answer -educate client on importance of washing hands with
soap and water
-encourage fluid intake
-review dietary intake
what can chronic laxative use lead to? - Answer constipation
patient centered goals for constipation - Answer LT: est/maintain normal bowel pattern w/in 1
month
reduce risk of constipation w/in 2 weeks
ST: state relief of constipation, passage of soft stool formed every 1-3 days, state 3 measures
that treat/prevent constipation
nursing interventions for constipation - Answer -establish routine an hour after a meal, or
maintain current routine
-help with positioning on bedpan
Already Solved Solutions 2025-2026
Version.
mouth digestion - Answer mechanical: teeth
chemical: saliva; helps soften food
esophagus - Answer UES: prevents air from entering the esophagus and stomach, protects
against reflux of food into the airway
LES (cardiac) sphincter: prevents chyme from refluxing back into the esophagus, gastric reflux if
problems with cardiac sphincter
epiglottis - Answer closes over the trachea
-prevents food from entering the trachea when swallowing
-with dysphagia...epiglottis not properly closing over the trachea, risk of aspiration
stomach - Answer storage, mixing (peristalsis), emptying
secretions:
-HCl and pepsin breakdown proteins, form bolus into chyme
-mucus protective mechanism
-intrinsic factor (B12 absorption)
small intestine - Answer digestion and absorption occurs
-microvilli increase SA for absorption
1. duodenum (1 ft) absorbs fluids from stomach (pancreatic enzymes and bile) lots of vitamins
2. jejunum (8 ft) absorbs proteins, carbs, nutrients, electrolytes
3. ileum (12 ft) absorbs water, fats, iron, bile salts
why is insulin not given orally? - Answer GI secretions digest proteins in insulin making it
ineffective...this is why insulin is given subQ
large intestine - Answer cecum, ascending/transverse/descending/sigmoid, rectum, anus
,!!! gas production here bc of bacteria present
peristalsis - Answer happens 3-4x a day, the strongest being an hour after mealtime...imp to
know this so you can time activities better with your pt...if issues with immobility want to be
near pt to help w defecation
-fast peristalsis: watery stool
-slow peristalsis: constipation
physiology of elimination - Answer -stool in rectum causes distention
-relaxation of internal sphincter (involuntary)
-relaxation of external sphincter (voluntary control)
-abdominal muscles contract, allowing for the passage of stool
factors affecting bowel elimination - Answer -very young, very old (Azh and dementia pts may
not pick up on cues to go to bathroom)
-psychologic factors: once young children learn they can control their habits...they may hold in
their bowel contents leading to constipation and impaction
-immobility, sedentary lifestyle = constipation
-low fiber and low fluid intake = constipation
-pregnancy...intestines constrict from baby, leading to constipation
-meds (laxatives) increase GI motility
-surgery/anesthesia decrease GI motility (imp to auscultate for bowel sounds before feeding pt
after surgery)
-pain (use of meds like narcotics induce constipation)
hemorrhoids - Answer common in pregnancy and obese individuals
-increased pressure on veins leads to varicose veins in the rectum
"squatty potty" - Answer anatomically correct position for defecation
"knees flexed" helps increase intra-abdominal pressure and ease constipation
questions for pts about elimination patterns - Answer -any appetite changes?
-describe daily dietary/fluid intake
,Hx of cholecystitis/cholelithiasis/cirrhosis - Answer liver produces bile and galbladder stores it
(emulsifies fat in sm intestine)
-if probs w these 2 organs...fat digestion is altered
!!! make sure pt is watching their fat intake
questions for pregnant and older adults about elimination patterns - Answer -pregnancy: n/v?
constipation, heartburn, flatulence?
-older adults: constipation? incontinence? laxatives?
locations for a physical assessment - Answer mouth, abdomen, rectum
fecal occult blood testing - Answer measures microscopic amts of blood in stool sample
occult blood = not visual to naked eye
-put reagent on it...positive for blood if turns blue
-useful for colon cancer screening
(false positive can be from consuming red meat, vitamin C, some raw vegetables, or NSAIDs
invasive diagnostic exams - Answer 1. endoscopy: upper GI - inserted through the mouth to
look at the mouth, esophagus, and duodenum
-used if upper abdominal pain, dysphagia, n/v, tumor, ulcers
2. colonoscopy: lower GI - inserted through the rectum
-used if diverticulosis, cancer, rectal bleeding, ulcers
both use sedatives (not general anesthesia)
barium swallow or enema - Answer contrast either swallowed or inserted through rectum,
radiologic imaging shows contrast go through the GI
-other common non-invasive diagnostics: ultrasound, MRI, CT scan
MRI protocol - Answer NPO 4 to 6 hours before the examination
Colon cleansing products are not necessary for MRIs
, nursing diagnosis diarrhea: C.diff - Answer caused by an alteration in normal GI flora leading to
an overgrowth (from an antibiotic, bowel prep for an existing bowel problem, chemo)
-contact precautions!! HH with soap and water, clean surfaces with special antimicrobial wipes
with gloves on
-dx: 2-3 positive stool specimens; sigmoidoscopy
acute onset: abd cramping/pain, profuse water/stringy diarrhea
-tx: STOP the antibiotic being used (clindamycin, amoxicillin, ampicillin)
restore nutritional and f/e imbalance
-vancomycin, flagyl (parasitic infections), probiotics
-skincare!! c.diff can cause skin breakdown
patient centered goals for c.diff - Answer -educate client and family on cause of c.diff and
rationale behind tx protocol...explain how contagious
-keep rectal area free of any irritation/skin breakdown
-relieve cramping/lessen diarrhea
-maintain good skin turgor and weight (good fluid intake and daily weighing)
nursing interventions for c.diff - Answer -educate client on importance of washing hands with
soap and water
-encourage fluid intake
-review dietary intake
what can chronic laxative use lead to? - Answer constipation
patient centered goals for constipation - Answer LT: est/maintain normal bowel pattern w/in 1
month
reduce risk of constipation w/in 2 weeks
ST: state relief of constipation, passage of soft stool formed every 1-3 days, state 3 measures
that treat/prevent constipation
nursing interventions for constipation - Answer -establish routine an hour after a meal, or
maintain current routine
-help with positioning on bedpan
