Chapter 30: Promoting Bowel Elimination
MULTIPLE CHOICE
1. The nurse has assessed that a patient’s stool has changed from brown to dark black and
sticky. The nurse suspects:
a. blockage of the bile duct.
b. blockage of the pancreatic duct.
c. recent excessive intake of milk products.
d. presence of occult blood.
ANS: D
Occult or old blood is suspected when stool changes from a normal brown appearance to a
dark black color with a sticky appearance.
DIF: Cognitive Level: Analysis REF: p. 574 OBJ: Theory #2
TOP: Stool Characteristics KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. The nurse has documented that a patient has had two episodes of steatorrhea, which means
that the character of the stool is:
a. hard and clay colored.
b. frothy and foul smelling.
c. very liquid and streaked with blood.
d. soft and filled with mucus.
ANS: B
Steatorrhea is defined as stools with abnormally high fat content that are usually frothy, foul
smelling, and float on water.
DIF: Cognitive Level: Comprehension REF: p. 574 OBJ: Theory #2
TOP: Terminology KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. The nurse should plan interventions to combat constipation in a patient:
a. being treated for diabetes mellitus.
b. who has a routine order for Metamucil.
c. who just completed barium studies of the bowel.
d. with orders to ambulate with assistance.
ANS: C
A patient who is undergoing barium radiograph studies is more prone to constipation than
are the other patients.
DIF: Cognitive Level: Application REF: p. 575 OBJ: Theory #3
TOP: Abnormal Characteristics of Stool KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
4. An older adult patient who routinely takes the bulk forming laxative psyllium (Metamucil)
is counseled by the home health nurse that in order to prevent constipation and possible
fecal impaction, this patient should be sure to take:
a. extra vitamin C.
b. a fat-soluble vitamin.
c. the medication with a large amount of fluid.
d. an over the counter antacid.
ANS: C
A large amount of fluid should be taken to prevent constipation and fecal impaction when
using a product with psyllium.
DIF: Cognitive Level: Comprehension REF: p. 576
OBJ: Clinical Practice #1 TOP: Abnormal Characteristics of Stool
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. A patient calls the nurse at the health clinic and reports that since his trip to Mexico, he has
been experiencing diarrhea. The nurse suggests he try the antidiarrheal drug:
a. docusate sodium (Colace).
b. loperamide (Imodium).
c. polycarbophil (FiberCon).
d. senna (Senokot).
ANS: B
Loperamide (Imodium) is an antidiarrheal; the rest are used to prevent or treat constipation.
DIF: Cognitive Level: Comprehension REF: p. 576 OBJ: Theory #1
TOP: Medication for Diarrhea KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
6. An older adult resident in a long-term care facility has experienced constant diarrhea for 3
days and is now exhibiting signs and symptoms of dehydration. The nurse initiates an
intervention to offer small amounts of frequently.
a. a cola beverage
b. ginger ale
c. Gatorade
d. Kool-Aid
ANS: C
The patient may be developing electrolyte imbalance because of the diarrhea, so the best
fluid source to offer is Gatorade, which has sodium and potassium. This should be offered 1
to 2 ounces at a time.
DIF: Cognitive Level: Application REF: p. 576
OBJ: Clinical Practice #1 TOP: Abnormal Characteristics of Stool
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
MULTIPLE CHOICE
1. The nurse has assessed that a patient’s stool has changed from brown to dark black and
sticky. The nurse suspects:
a. blockage of the bile duct.
b. blockage of the pancreatic duct.
c. recent excessive intake of milk products.
d. presence of occult blood.
ANS: D
Occult or old blood is suspected when stool changes from a normal brown appearance to a
dark black color with a sticky appearance.
DIF: Cognitive Level: Analysis REF: p. 574 OBJ: Theory #2
TOP: Stool Characteristics KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. The nurse has documented that a patient has had two episodes of steatorrhea, which means
that the character of the stool is:
a. hard and clay colored.
b. frothy and foul smelling.
c. very liquid and streaked with blood.
d. soft and filled with mucus.
ANS: B
Steatorrhea is defined as stools with abnormally high fat content that are usually frothy, foul
smelling, and float on water.
DIF: Cognitive Level: Comprehension REF: p. 574 OBJ: Theory #2
TOP: Terminology KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. The nurse should plan interventions to combat constipation in a patient:
a. being treated for diabetes mellitus.
b. who has a routine order for Metamucil.
c. who just completed barium studies of the bowel.
d. with orders to ambulate with assistance.
ANS: C
A patient who is undergoing barium radiograph studies is more prone to constipation than
are the other patients.
DIF: Cognitive Level: Application REF: p. 575 OBJ: Theory #3
TOP: Abnormal Characteristics of Stool KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
4. An older adult patient who routinely takes the bulk forming laxative psyllium (Metamucil)
is counseled by the home health nurse that in order to prevent constipation and possible
fecal impaction, this patient should be sure to take:
a. extra vitamin C.
b. a fat-soluble vitamin.
c. the medication with a large amount of fluid.
d. an over the counter antacid.
ANS: C
A large amount of fluid should be taken to prevent constipation and fecal impaction when
using a product with psyllium.
DIF: Cognitive Level: Comprehension REF: p. 576
OBJ: Clinical Practice #1 TOP: Abnormal Characteristics of Stool
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. A patient calls the nurse at the health clinic and reports that since his trip to Mexico, he has
been experiencing diarrhea. The nurse suggests he try the antidiarrheal drug:
a. docusate sodium (Colace).
b. loperamide (Imodium).
c. polycarbophil (FiberCon).
d. senna (Senokot).
ANS: B
Loperamide (Imodium) is an antidiarrheal; the rest are used to prevent or treat constipation.
DIF: Cognitive Level: Comprehension REF: p. 576 OBJ: Theory #1
TOP: Medication for Diarrhea KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
6. An older adult resident in a long-term care facility has experienced constant diarrhea for 3
days and is now exhibiting signs and symptoms of dehydration. The nurse initiates an
intervention to offer small amounts of frequently.
a. a cola beverage
b. ginger ale
c. Gatorade
d. Kool-Aid
ANS: C
The patient may be developing electrolyte imbalance because of the diarrhea, so the best
fluid source to offer is Gatorade, which has sodium and potassium. This should be offered 1
to 2 ounces at a time.
DIF: Cognitive Level: Application REF: p. 576
OBJ: Clinical Practice #1 TOP: Abnormal Characteristics of Stool
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
