Bowel Elimination NCLEX Practice — Set B
NSG 3100: Fundamentals of Nursing I
Chapter 40 — Bowel Elimination
NCLEX-Style Practice Exam — Set B | 50 Questions
Instructions
Answer all 50 questions before checking the Answer Key & Rationales section at the end of this document. Questions
include standard multiple choice, Select All That Apply (SATA), priority, delegation, nursing process, and clinical
judgment/scenario-based items, written at an application/analysis level consistent with a Galen College of Nursing
Fundamentals exam. For SATA items, select every option that applies.
1. Which organ is primarily responsible for reabsorbing water, sodium, and chloride from intestinal contents to
form solid stool?
[Standard MC]
A. Stomach
B. Small intestine (jejunum)
C. Large intestine (colon)
D. Esophagus
2. A nursing student asks why the ileum is important for bowel function. What is the best response?
[Standard MC]
A. 'The ileum absorbs fat, bile salts, and water and empties into the cecum via the ileocecal valve.'
B. 'The ileum is where hydrochloric acid is produced.'
C. 'The ileum is the primary site of carbohydrate absorption.'
D. 'The ileum stores stool before defecation.'
3. A patient asks the nurse what causes hemorrhoids. Which response is most accurate?
[Standard MC]
A. 'Hemorrhoids are caused by a bacterial infection of the colon.'
B. 'Hemorrhoids form from repeated straining and pressure on distended veins in the anus/rectum.'
C. 'Hemorrhoids are always a sign of colorectal cancer.'
D. 'Hemorrhoids only occur in older adults.'
4. A newborn's first stool is described by the nurse as black, tarry, odorless, and sticky. How should the nurse
document this finding?
[Standard MC]
A. Abnormal — suspect GI bleeding and notify the provider
B. Normal — this is meconium, the newborn's first stool
C. Abnormal — suspect formula intolerance
D. Normal — expected only in breastfed infants
5. Which stool description would the nurse expect in an exclusively breastfed infant?
[Standard MC]
A. Dark yellow and well-formed
B. Light yellow/golden, soft or liquid
C. Black and tarry
D. Clay-colored and firm
Page 1
, Bowel Elimination NCLEX Practice — Set B
6. A patient reports taking daily aluminum-containing antacids for heartburn and now has new-onset constipation.
What is the most likely explanation?
[Standard MC]
A. Aluminum-containing antacids are a known cause of constipation
B. The constipation is unrelated and coincidental
C. Antacids always cause diarrhea, so another cause must be found
D. The patient likely has an undiagnosed bowel obstruction
7. A patient with a permanent transverse colostomy asks why they must wear an appliance at all times. What is
the nurse's best explanation?
[Standard MC]
A. 'Your stool is well-formed, so the appliance is just for odor control.'
B. 'Because a transverse colostomy produces semiliquid, malodorous stool with no control over frequency.'
C. 'It's simply hospital policy; medically it isn't necessary.'
D. 'Once healed, you won't need an appliance at all.'
8. Which type of ostomy carries the highest risk of skin breakdown from digestive enzymes in the effluent?
[Standard MC]
A. Sigmoid colostomy
B. Descending colostomy
C. Ileostomy
D. Transverse loop colostomy
9. A patient has a double-barrel colostomy. Which statement accurately describes this ostomy?
[Standard MC]
A. It is a single stoma with two openings supported by a bridge
B. It has two separate stomas — a proximal stoma that drains feces and a distal stoma that drains mucus —
with the bowel between them surgically severed
C. It is always permanent and used for colorectal cancer resection
D. It produces the most solid, formed stool of all colostomy types
10. Which finding on assessment of a stoma is considered normal and expected?
[Standard MC]
A. Dry, purple-black tissue
B. Whitish patches on the stoma surface
C. Moist, reddish-pink tissue that protrudes slightly ('budding') above skin level
D. Open areas with bleeding and a surrounding rash
11. The nurse is teaching a patient with a new ostomy about pouch wear time. Which statement reflects accurate
teaching for an established, intact system?
[Standard MC]
A. 'The pouching system must be changed every 24 hours regardless of condition.'
B. 'An established, intact pouching system may typically remain in place for 3–7 days.'
C. 'The pouch should never be changed unless it is leaking.'
D. 'Pouches must be changed hourly for the first month.'
12. Who should the nurse consult for a patient with a newly created, complicated ostomy requiring specialized
teaching?
[Standard MC]
Page 2
, Bowel Elimination NCLEX Practice — Set B
A. The hospital chaplain
B. The wound, ostomy, continence nurse (WOCN)
C. The physical therapist
D. The unit unlicensed assistive personnel
13. A patient scheduled for an upper GI series (barium swallow) asks the nurse what to expect afterward. What
should the nurse include in patient teaching?
[Standard MC]
A. 'Your stool may appear white or light-colored, and you may need increased fluids or a laxative to prevent
constipation from the barium.'
B. 'You will need to be NPO for 24 hours after the procedure.'
C. 'You should avoid driving for 12 hours after this exam.'
D. 'This procedure requires no special preparation beforehand.'
14. A patient is scheduled for an EGD (esophagogastroduodenoscopy) under conscious sedation. What is the
nurse's priority action before resuming oral intake after the procedure?
[Standard MC]
A. Assess the patient's gag reflex has returned
B. Immediately offer a full meal
C. Check the patient's blood glucose
D. Ask the patient to ambulate to the bathroom first
15. A patient asks the nurse the purpose of a stool culture. What is the nurse's best response?
[Standard MC]
A. 'It measures the amount of fat in your stool.'
B. 'It detects pathogens causing your diarrhea and helps identify an effective antibiotic through sensitivity
testing.'
C. 'It screens for colorectal cancer.'
D. 'It measures occult (hidden) blood in your stool.'
16. A patient with a history of severe rectal/anal surgery pain has been avoiding bowel movements to prevent
discomfort. What complication is this patient at greatest risk for developing?
[Standard MC]
A. Diarrhea
B. Constipation from suppressing the urge to defecate
C. Bowel incontinence
D. C. difficile infection
17. A pregnant patient reports new constipation and asks the nurse why this is happening. Which explanation is
most accurate?
[Standard MC]
A. 'Pregnancy hormones speed up peristalsis, causing constipation.'
B. 'Fetal pressure impairs passage of feces, and iron in your prenatal vitamins can increase constipation risk.'
C. 'Constipation during pregnancy is always a sign of a serious complication.'
D. 'This is unrelated to pregnancy and should be evaluated as a separate GI disorder.'
18. Which finding indicates a patient may be developing paralytic ileus after abdominal surgery?
[Standard MC]
A. Hyperactive bowel sounds and frequent loose stools
B. Absent bowel sounds, abdominal distention, and no flatus
Page 3
NSG 3100: Fundamentals of Nursing I
Chapter 40 — Bowel Elimination
NCLEX-Style Practice Exam — Set B | 50 Questions
Instructions
Answer all 50 questions before checking the Answer Key & Rationales section at the end of this document. Questions
include standard multiple choice, Select All That Apply (SATA), priority, delegation, nursing process, and clinical
judgment/scenario-based items, written at an application/analysis level consistent with a Galen College of Nursing
Fundamentals exam. For SATA items, select every option that applies.
1. Which organ is primarily responsible for reabsorbing water, sodium, and chloride from intestinal contents to
form solid stool?
[Standard MC]
A. Stomach
B. Small intestine (jejunum)
C. Large intestine (colon)
D. Esophagus
2. A nursing student asks why the ileum is important for bowel function. What is the best response?
[Standard MC]
A. 'The ileum absorbs fat, bile salts, and water and empties into the cecum via the ileocecal valve.'
B. 'The ileum is where hydrochloric acid is produced.'
C. 'The ileum is the primary site of carbohydrate absorption.'
D. 'The ileum stores stool before defecation.'
3. A patient asks the nurse what causes hemorrhoids. Which response is most accurate?
[Standard MC]
A. 'Hemorrhoids are caused by a bacterial infection of the colon.'
B. 'Hemorrhoids form from repeated straining and pressure on distended veins in the anus/rectum.'
C. 'Hemorrhoids are always a sign of colorectal cancer.'
D. 'Hemorrhoids only occur in older adults.'
4. A newborn's first stool is described by the nurse as black, tarry, odorless, and sticky. How should the nurse
document this finding?
[Standard MC]
A. Abnormal — suspect GI bleeding and notify the provider
B. Normal — this is meconium, the newborn's first stool
C. Abnormal — suspect formula intolerance
D. Normal — expected only in breastfed infants
5. Which stool description would the nurse expect in an exclusively breastfed infant?
[Standard MC]
A. Dark yellow and well-formed
B. Light yellow/golden, soft or liquid
C. Black and tarry
D. Clay-colored and firm
Page 1
, Bowel Elimination NCLEX Practice — Set B
6. A patient reports taking daily aluminum-containing antacids for heartburn and now has new-onset constipation.
What is the most likely explanation?
[Standard MC]
A. Aluminum-containing antacids are a known cause of constipation
B. The constipation is unrelated and coincidental
C. Antacids always cause diarrhea, so another cause must be found
D. The patient likely has an undiagnosed bowel obstruction
7. A patient with a permanent transverse colostomy asks why they must wear an appliance at all times. What is
the nurse's best explanation?
[Standard MC]
A. 'Your stool is well-formed, so the appliance is just for odor control.'
B. 'Because a transverse colostomy produces semiliquid, malodorous stool with no control over frequency.'
C. 'It's simply hospital policy; medically it isn't necessary.'
D. 'Once healed, you won't need an appliance at all.'
8. Which type of ostomy carries the highest risk of skin breakdown from digestive enzymes in the effluent?
[Standard MC]
A. Sigmoid colostomy
B. Descending colostomy
C. Ileostomy
D. Transverse loop colostomy
9. A patient has a double-barrel colostomy. Which statement accurately describes this ostomy?
[Standard MC]
A. It is a single stoma with two openings supported by a bridge
B. It has two separate stomas — a proximal stoma that drains feces and a distal stoma that drains mucus —
with the bowel between them surgically severed
C. It is always permanent and used for colorectal cancer resection
D. It produces the most solid, formed stool of all colostomy types
10. Which finding on assessment of a stoma is considered normal and expected?
[Standard MC]
A. Dry, purple-black tissue
B. Whitish patches on the stoma surface
C. Moist, reddish-pink tissue that protrudes slightly ('budding') above skin level
D. Open areas with bleeding and a surrounding rash
11. The nurse is teaching a patient with a new ostomy about pouch wear time. Which statement reflects accurate
teaching for an established, intact system?
[Standard MC]
A. 'The pouching system must be changed every 24 hours regardless of condition.'
B. 'An established, intact pouching system may typically remain in place for 3–7 days.'
C. 'The pouch should never be changed unless it is leaking.'
D. 'Pouches must be changed hourly for the first month.'
12. Who should the nurse consult for a patient with a newly created, complicated ostomy requiring specialized
teaching?
[Standard MC]
Page 2
, Bowel Elimination NCLEX Practice — Set B
A. The hospital chaplain
B. The wound, ostomy, continence nurse (WOCN)
C. The physical therapist
D. The unit unlicensed assistive personnel
13. A patient scheduled for an upper GI series (barium swallow) asks the nurse what to expect afterward. What
should the nurse include in patient teaching?
[Standard MC]
A. 'Your stool may appear white or light-colored, and you may need increased fluids or a laxative to prevent
constipation from the barium.'
B. 'You will need to be NPO for 24 hours after the procedure.'
C. 'You should avoid driving for 12 hours after this exam.'
D. 'This procedure requires no special preparation beforehand.'
14. A patient is scheduled for an EGD (esophagogastroduodenoscopy) under conscious sedation. What is the
nurse's priority action before resuming oral intake after the procedure?
[Standard MC]
A. Assess the patient's gag reflex has returned
B. Immediately offer a full meal
C. Check the patient's blood glucose
D. Ask the patient to ambulate to the bathroom first
15. A patient asks the nurse the purpose of a stool culture. What is the nurse's best response?
[Standard MC]
A. 'It measures the amount of fat in your stool.'
B. 'It detects pathogens causing your diarrhea and helps identify an effective antibiotic through sensitivity
testing.'
C. 'It screens for colorectal cancer.'
D. 'It measures occult (hidden) blood in your stool.'
16. A patient with a history of severe rectal/anal surgery pain has been avoiding bowel movements to prevent
discomfort. What complication is this patient at greatest risk for developing?
[Standard MC]
A. Diarrhea
B. Constipation from suppressing the urge to defecate
C. Bowel incontinence
D. C. difficile infection
17. A pregnant patient reports new constipation and asks the nurse why this is happening. Which explanation is
most accurate?
[Standard MC]
A. 'Pregnancy hormones speed up peristalsis, causing constipation.'
B. 'Fetal pressure impairs passage of feces, and iron in your prenatal vitamins can increase constipation risk.'
C. 'Constipation during pregnancy is always a sign of a serious complication.'
D. 'This is unrelated to pregnancy and should be evaluated as a separate GI disorder.'
18. Which finding indicates a patient may be developing paralytic ileus after abdominal surgery?
[Standard MC]
A. Hyperactive bowel sounds and frequent loose stools
B. Absent bowel sounds, abdominal distention, and no flatus
Page 3
