Elimination Questions with correct answers
While assessing a patient before administering an enema, the nurse
inspects the patient's abdomen for distention. What is the purpose of this
nursing intervention?
A. It allows the nurse to plan for appropriate teaching measures.
B. It helps determine the number and type of enemas to be given.
C. It helps determine conditions that contraindicate the use of enemas.
D. It provides a baseline for determining the effectiveness of the enema.
Correct Answer.-D
Before administering an enema, the nurse should inspect the patient's
abdomen for distention. This provides a baseline for determining the
effectiveness of the enema. To plan for appropriate teaching measures,
the nurse should determine the patient's level of understanding of the
purpose of the enema. The nurse should review the health care provider's
order for the type of enema and the amount to be given. Before
administering an enema, the nurse should review the patient's medical
record for increased intracranial pressure, glaucoma, or recent
abdominal, rectal, or prostate surgery because these conditions
contraindicate the use of enemas.
A nurse is preparing to administer an enema to a patient who is
scheduled for a colonoscopy. Which action taken by the nurse may lead
to a complication?
A. Giving the enema with the patient sitting on the toilet
B. Giving the enema with the patient positioned on a bedpan
,C. Refraining from sterile technique while administering the enema
D. Asking the patient to retain the enema solution for a specific length of
time Correct Answer.-A
The nurse should not give an enema to a patient sitting on the toilet
because the position of the rectal tubing could injure the rectal wall.
When giving an enema to an immobilized patient, it is always
recommended that the patient be positioned on a bedpan. The use of
sterile technique is not necessary when administering an enema, because
the colon already contains bacteria. However, the nurse should wear
gloves to prevent the transmission of fecal microorganisms. It is
appropriate to ask the patient to retain the enema solution for a specific
length of time before defecation.
The health care provider prescribes methylcellulose to a patient with
chronic constipation. Which instruction provided by the nurse will help
prevent complications?
A. "Do not use the medication on a regular basis."
B. "Mix the powder with 250 mL of water or juice and swallow it
quickly."
C. "Report to the health care provider if you do not pass stool within 8 to
10 hours of taking the medication."
D. "Stop taking the medication if you note increased gas formation and
flatus when you first start taking it." Correct Answer.-B
Methylcellulose is a bulk-forming stool softener that absorbs water and
increases solid intestinal bulk. It is a drug of choice for chronic
constipation and is available in powder form. The nurse should instruct
the patient to mix the powder with at least 250 mL of water or juice and
swallow it quickly; if not, it could cause constipation. The nurse should
advise patients that prescribed stimulant laxatives should only be taken
,occasionally to prevent dependence on the stimulus for defecation.
Methylcellulose may cause the passage of stool 12 to 24 hours after
taking the medication. Therefore, the patient need not report to the
health care provider if he or she does not pass stool within 8 to 10 hours
of taking the medication. Increased gas formation and flatus may occur
when the patient first starts taking methylcellulose; this will subside
after 4 or 5 days. Therefore, the nurse should not instruct the patient to
stop taking the medication in such situations.
Which part of the gastrointestinal tract plays a major role in bowel
elimination?
A. Stomach
B. Esophagus
C. Small intestine
D. Large intestine Correct Answer.-D
The main functions of the large intestine, or colon, are absorption,
secretion, and elimination. Therefore, the large intestine plays a major
role in bowel elimination. The small intestine is involved in digestion
and absorption, but not elimination. The main functions of the stomach
include storage of swallowed food and liquid, mixing of food with
digestive juices into a substance, and regulated emptying of its contents
into the small intestine. The esophagus is the part of the gastrointestinal
tract through which food reaches the upper end of the stomach. It is not
involved in elimination.
To which patient will the nurse most likely give a hypertonic solution
enema?
A. An infant who is unable to defecate
, B. A dehydrated patient who has constipation
C. A patient who cannot tolerate a large volume of fluid
D. A patient with a dangerously high serum potassium level Correct
Answer.-C
Enemas that uses hypertonic solutions are low volume and are designed
for patients who cannot tolerate a large volume of fluid. This type of
enema is contraindicated in infants and dehydrated patients. A patient
with a dangerously high serum potassium level may receive a medicated
enema that contains sodium polystyrene sulfonate.
While assessing a patient with a bowel elimination problem, the nurse
asks the patient, "Do you feel as though your bowel movements are
incomplete?" Which condition is the nurse trying to determine in the
patient?
A. Diarrhea
B. Indigestion
C. Constipation
D. Hemorrhoids Correct Answer.-C
To determine constipation, the nurse should ask the patient about
feelings of having incomplete bowel movements. To determine
indigestion, the nurse should ask the patient about a bloated feeling after
eating. To determine diarrhea, the nurse may ask whether the patient has
taken any antibiotics recently. Pain in the area around the anus may
indicate hemorrhoids.
Which patient has the highest risk of constipation?
A. A patient who is taking antibiotics