2026 Update) Leadership and
Management Guide | Questions &
Answers| Grade A | 100% Correct | A
Grade – Fortis
Exam Description
NUR 204 Exam 5 Contains 350 Q&A. It typically covers Fluid & Electrolytes (including
osmolality, tonicity, hydrostatic/osmotic pressures, major ions like Sodium/Potassium,
and related hormones like ADH/Renin) and Gastrointestinal Elimination (constipation,
diarrhea, enemas, ostomies, fecal impaction, BPH, pelvic organ prolapse), focusing
heavily on the nursing process (Assessment, Diagnosis, Planning, Implementation,
Evaluation) for patient care in these areas, with a mix of content on women's
reproductive health cancers and legal/ethical aspects.
Key Topics You Should Expect:
• Fluid & Electrolyte Balance:
o Concepts: Osmosis, Osmolality, Tonicity (Isotonic, Hypertonic, Hypotonic),
Hydrostatic Pressure.
o Regulation: Renin-Angiotensin System, ADH, Osmoreceptors, Fluid
Homeostasis.
o Electrolytes: Sodium (Na+), Potassium (K+), Chloride (Cl-), Calcium (Ca2+),
Phosphate (PO4^3-) – roles, imbalances (hypo/hypervolemia).
o pH Balance: Buffers, Acid-Base regulation.
1
, o Nursing Care: Administering IV fluids (e.g., with blood transfusions), managing
SIADH, monitoring for electrolyte disturbances.
• Gastrointestinal Elimination:
o Assessment: Data collection for bowel elimination status, stoma assessment.
o Interventions: Enema administration (types, insertion depth), managing fecal
impaction, promoting regular bowel habits, diet.
o Problems: Constipation, Diarrhea, Foul-smelling flatus, Ostomy care, BPH,
Pelvic Organ Prolapse (Cystocele, Rectocele).
o Nursing Diagnoses: Impaired Skin Integrity (from diarrhea/incontinence),
Disturbed Body Image (ostomy).
• Reproductive Health (May overlap):
o Cancers (Breast, Ovarian, Cervical/HPV), Toxic Shock Syndrome, Uterine
Leiomyomas.
• Legal/Ethical Aspects:
o Nursing Practice Acts, Patient Confidentiality (HIPAA), Patient Safety Reporting.
• Nursing Process Application: Applying all 5 steps (Assessment, Diagnosis,
Planning, Implementation, Evaluation) to these conditions.
Quiz_________________?
The nurse instructs the patient that the health care provider has
ordered an enema. The patient states, An enema! I'm not
constipated. What are other possible reasons for the order?
(Select all that apply.)
a. Preparation for a diagnostic procedure
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, b. To increase fluid intake
c. To prevent laxative misuse
d. To administer a medication
e. Preparation for surgery -
Answer☑️
ade
Quiz_________________?
From the following, choose the correct equipment to bring to the
bedside to administer the commercially prepared Fleet enema.
(Select all that apply.)
a. Tubing with a rectal tip
b. Waterproof bed pad
c. Clean disposable gloves
d. Water-soluble lubricant
e. Commercially prepared enema product
f. Toilet paper and/or basin with warm water, washcloth, and towel
g. Enema bag
h. Sterile gloves -
Answer☑️
bcdef
3
, Quiz_________________?
The NAP tells the nurse she doesn't want to care for a certain
patient because she is afraid of contracting C. difficile.
Which is the best response by the nurse?
a. "C. difficile is the organism responsible for duodenal ulcers."
b. "I can reassign you to care for à different patient."
c. "Good hand hygiene with soap and water is your best defense
against C. difficile."
d. "C. difficile can only be acquired through antibiotic therapy,
chemotherapy, or invasive bowel procedures." -
Answer☑️
c
Quiz_________________?
Which of the following would be inappropriate to delegate to
NAP?
a. Recording the amount of ostomy output
b. Administering a tap water enema
c. Pouching a newly established ostomy
d. Administering a fleet type enema, commercially prepared -
Answer☑️
4