Chapter 46: Bowel Elimination
Test Bank
MULTIPLE CHOICE
1. 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.
DIF: Remember REF: 1088
OBJ: Discuss the role of gastrointestinal organs in digestion and elimination.
TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
2. 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.
DIF: Remember REF: 1088
OBJ: Explain the physiological aspects of normal defecation. TOP: Assessment
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
3. 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.
DIF: Remember REF: 1088 OBJ: Describe three functions of the large intestine.
TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
4. 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 patient’s voiding
schedule should not be based on the staff’s convenience.
DIF: Understand REF: 1102
OBJ: List nursing interventions included in bowel training. TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
5. 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.
DIF: Apply REF: 1089
OBJ: List nursing interventions that promote normal elimination.
TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
, 6. 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.
DIF: Understand REF: 1091| 1106
OBJ: Use critical thinking in the provision of care to patients with alterations in bowel elimination.
TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
7. 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.
DIF: Apply REF: 1090
OBJ: Discuss psychological and physiological factors that influence the elimination process.
TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
8. Which patient is most at risk for increased peristalsis?
a. A 5-year-old child who ignores the urge to defecate owing to embarrassment
Test Bank
MULTIPLE CHOICE
1. 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.
DIF: Remember REF: 1088
OBJ: Discuss the role of gastrointestinal organs in digestion and elimination.
TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
2. 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.
DIF: Remember REF: 1088
OBJ: Explain the physiological aspects of normal defecation. TOP: Assessment
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
3. 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.
DIF: Remember REF: 1088 OBJ: Describe three functions of the large intestine.
TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
4. 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 patient’s voiding
schedule should not be based on the staff’s convenience.
DIF: Understand REF: 1102
OBJ: List nursing interventions included in bowel training. TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
5. 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.
DIF: Apply REF: 1089
OBJ: List nursing interventions that promote normal elimination.
TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
, 6. 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.
DIF: Understand REF: 1091| 1106
OBJ: Use critical thinking in the provision of care to patients with alterations in bowel elimination.
TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
7. 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.
DIF: Apply REF: 1090
OBJ: Discuss psychological and physiological factors that influence the elimination process.
TOP: Implementation
MSC: Physiological Integrity | Physiological Adaptation | Alterations in Body Systems | Bowel
Elimination
8. Which patient is most at risk for increased peristalsis?
a. A 5-year-old child who ignores the urge to defecate owing to embarrassment
