BSN205 Hallmark- Elimination/Ostomy
ISB EXAM 2023/2024 WITH 100%VERIFIED
ANSWERS
If a patient had to have part of the colon (large intestine) removed, which of the
following may result? - ANSWER>>The patient could experience an acid-base
imbalance.
-A primary function of the colon is secretion of bicarbonate for chloride and the
release of potassium. Any alteration in secretory function could result in an acid-
base imbalance. Another primary function of the colon is protection of the
sensitive tissue lining of the colon through the release of mucus. If a portion of
the colon is removed, there would be fewer mucus-secreting cells available. The
colon also absorbs water, sodium, and chloride. If less water is absorbed, the
patient would be at increased risk for diarrhea and an electrolyte imbalance.
A nurse is admitting a patient to the unit. The nurse is aware that the patient is at
increased risk for constipation if the following are present in the patient's health
history or admission assessment: - ANSWER>>The patient is an elderly woman.
The patient takes opioids for chronic back pain.
The patient takes daily iron and calcium supplements.
-As a person ages, peristalsis slows, which increases the risk for constipation.
Opioids, iron supplements, and calcium supplements slow colonic action. Laxative
misuse is a common cause for constipation. A diet high in animal fats and low in
fiber and fluid increases the risk for constipation. Lengthy bed rest or lack of
regular exercise are risk factors for constipation.
A student nurse is studying the GI system in preparation for an exam. Which
statement indicates correct understanding? - ANSWER>>The ascending colon
would be found in the right side of the patient s abdomen.
-The ascending colon is found in the right side of the abdomen. The order of the
colon is ascending colon, transverse colon, descending colon, sigmoid colon (then
, rectum and anus). Most nutrients are absorbed in the small intestine; most water
is absorbed in the large intestine. A patient's heart rate may decrease with
manipulation of the rectum that stimulates the vagus nerve (known as a vagal
response). Opioids (narcotic analgesics) cause constipation because of decreasing
peristalsis; antibiotic therapy places a person at risk for diarrhea as a result of
altered normal flora (as seen with Clostridium difficile infection).
An increase in venous pressure caused by liver disease can result in the
development of: - ANSWER>>Hemorrhoids
- Pressure leading to hemorrhoids can also occur from straining during defecation
and from pregnancy.
The comatose patient in the intensive care unit (ICU), who has not had a bowel
movement in 4 days, suddenly is incontinent of liquid stool. What should the
nurse suspect? - ANSWER>>Impaction
-Prolonged constipation followed by diarrhea that seeps around the impacted
stool are symptoms of a fecal impaction.
The nurse is monitoring the patient for a possible vagal response while removing
a fecal impaction. If the patient had a vagal response, what would the nurse most
likely observe? - ANSWER>>A decrease in heart rate.
A patient has a loop colostomy. The patient complains that the distal stoma looks
like it is secreting mucus. What is your best response? - ANSWER>>"The distal
stoma may secrete mucus and that would be normal."
-The distal stoma is the nonfunctional end. It may secrete mucus. The proximal
stoma of the loop colostomy is the functional end that excretes effluent. A loop
colostomy is a bowel diversion and is without connection to the urinary system.
A patient has been admitted for surgery for a colostomy. The patient states, "I
can't believe this has happened to me." What is the nurse's best response? -
ANSWER>>"It will be a change for you, but a normal lifestyle is still possible. What
concerns you the most?"
ISB EXAM 2023/2024 WITH 100%VERIFIED
ANSWERS
If a patient had to have part of the colon (large intestine) removed, which of the
following may result? - ANSWER>>The patient could experience an acid-base
imbalance.
-A primary function of the colon is secretion of bicarbonate for chloride and the
release of potassium. Any alteration in secretory function could result in an acid-
base imbalance. Another primary function of the colon is protection of the
sensitive tissue lining of the colon through the release of mucus. If a portion of
the colon is removed, there would be fewer mucus-secreting cells available. The
colon also absorbs water, sodium, and chloride. If less water is absorbed, the
patient would be at increased risk for diarrhea and an electrolyte imbalance.
A nurse is admitting a patient to the unit. The nurse is aware that the patient is at
increased risk for constipation if the following are present in the patient's health
history or admission assessment: - ANSWER>>The patient is an elderly woman.
The patient takes opioids for chronic back pain.
The patient takes daily iron and calcium supplements.
-As a person ages, peristalsis slows, which increases the risk for constipation.
Opioids, iron supplements, and calcium supplements slow colonic action. Laxative
misuse is a common cause for constipation. A diet high in animal fats and low in
fiber and fluid increases the risk for constipation. Lengthy bed rest or lack of
regular exercise are risk factors for constipation.
A student nurse is studying the GI system in preparation for an exam. Which
statement indicates correct understanding? - ANSWER>>The ascending colon
would be found in the right side of the patient s abdomen.
-The ascending colon is found in the right side of the abdomen. The order of the
colon is ascending colon, transverse colon, descending colon, sigmoid colon (then
, rectum and anus). Most nutrients are absorbed in the small intestine; most water
is absorbed in the large intestine. A patient's heart rate may decrease with
manipulation of the rectum that stimulates the vagus nerve (known as a vagal
response). Opioids (narcotic analgesics) cause constipation because of decreasing
peristalsis; antibiotic therapy places a person at risk for diarrhea as a result of
altered normal flora (as seen with Clostridium difficile infection).
An increase in venous pressure caused by liver disease can result in the
development of: - ANSWER>>Hemorrhoids
- Pressure leading to hemorrhoids can also occur from straining during defecation
and from pregnancy.
The comatose patient in the intensive care unit (ICU), who has not had a bowel
movement in 4 days, suddenly is incontinent of liquid stool. What should the
nurse suspect? - ANSWER>>Impaction
-Prolonged constipation followed by diarrhea that seeps around the impacted
stool are symptoms of a fecal impaction.
The nurse is monitoring the patient for a possible vagal response while removing
a fecal impaction. If the patient had a vagal response, what would the nurse most
likely observe? - ANSWER>>A decrease in heart rate.
A patient has a loop colostomy. The patient complains that the distal stoma looks
like it is secreting mucus. What is your best response? - ANSWER>>"The distal
stoma may secrete mucus and that would be normal."
-The distal stoma is the nonfunctional end. It may secrete mucus. The proximal
stoma of the loop colostomy is the functional end that excretes effluent. A loop
colostomy is a bowel diversion and is without connection to the urinary system.
A patient has been admitted for surgery for a colostomy. The patient states, "I
can't believe this has happened to me." What is the nurse's best response? -
ANSWER>>"It will be a change for you, but a normal lifestyle is still possible. What
concerns you the most?"
