NR 224/226 FUNDAMENTALS FINAL EXAM QUESTIONS
WITH COMPLETE SOLUTION
Small Intestine
Absorb nutrients, many enzymes at work, acidic contents. Contains the duodenum,
jejunum, and ileum.
Large Intestine
Primary organ of bowel elimination, extends from ileocecal valve to the anus. Absorbs
water only (no nutrients)
Stool in Ascending Colon
Very liquid, no pattern
Stool in Transverse Colon
More formed, but still liquid
Stool in Descending Colon
Losing water to reabsorption, becoming thick and formed
Stool in Sigmoid Colon
Formed stool
Stool in Rectum
Most formed, stored here until evacuation occurs
Peristalsis
Under control of the nervous system, contractions occur ever 3-12 minutes. 1/3 - 1/2 of
stool is excreted in stool within 24 hours. Rapid transit times are from diarrhea. Delayed
transit times are from constipation
Bristol Stool Chart
Type 1: separate hard lumps, hard to pass
Type 2: sausage-shaped and lumpy
Type 3: sausage-shaped with cracks on surface
Type 4: sausage-shaped and smooth & soft
Type 5: soft blobs with clear-cut edges, passed easily
Type 6: fluffy pieces with ragged edges, mushy
Type 7: water, no solid pieces, entirely liquid
Constipating Foods
Cheese, lean meats, eggs, pasta
Foods with Laxative Effect
Fruits, vegetables, bran, chocolate, alcohol, coffee
Constipation
No BM in 3 days. A symptom, not a disease. Hard, dry stool that is difficult to eliminate.
Low or inactive bowel sounds heard over auscultation. Excessive straining, bloating,
and sensation of a full bowel. More common in women, adults over 65, and pregnancy.
Causes of Constipation
Not enough fiber in the diet, lack of physical activity, certain medications (opioids,
narcotics), milk, cheese, IBS, changes in life like pregnancy or aging, abuse of
,laxatives, ignoring the urge to have a BM, dehydration, specific diseases like a stroke,
or problems with the colon
Isotonic Enema
Normal saline, distends the colon, stimulates peristalsis, and softens feces
Soap Suds Enema
Irritates mucosa and distends the colon
Hypertonic Enema
Fleet phosphate, draws water into the colon
Hypotonic Enema
Tap water, distends the colon, stimulates peristalsis, and softens feces
Oil Retention Enema
Lubricates and softens stool
Kayexalate
Used to remove potassium very quickly, which is excreted through stool
Neomycin
An antibiotic used before surgery to prevent infection and kill bacteria in the colon and
bowels
Hemorrhoid
Dilated, engorged veins in the lining of the rectum. Can be internal or external. Common
in pregnancy, low fiber diets, low fluid, not enough exercise
Impaction
Results from unrelieved constipation. Often liquid stool is a symptom
Diarrhea
Increase in the number of stools and passage of liquid, unformed feces. Usually a
protective response to get rid of a pathogen. Large amounts of fluid and electrolytes lost
places risk for F&E imbalance
Causes of Diarrhea
Viruses and bacteria, C. diff, medications, patients receiving enteral nutrition, food
allergies and intolerances, and food-borne pathogens
Healthy Stoma
Looks deep reddish pink, moist, no areas of necrosis, no signs of infections, no erosion,
breakdown, or irritation.
Fecal Specimens
Medical aseptic technique is imperative. Wear disposable gloves, wash hands before
and after, do not contaminate outside the container, and label the bag.
Dysphagia
Difficulty swallowing
Nasogastric Tubes
Insert tube into nostril, down throat, and into stomach. Change tape daily, check
placement frequently before use. Lubricate nares. Provide excellent oral care. Check
tube for patency.
Verifying NG Tube
X-ray, pH test (5.5 or less), aspirate and inspect color (should be green, tan, beige, or
brown), ask patient to speak, put end of tube in water and check for no bubbling
Enteral Nutritiotn
, Delivers nutrients through an NG tube, gastrostomy tube, PEG tube, or jejunostomy
tube. Check placement, start slow at full strength. Increase every 8-12 hours if no signs
of intolerance
Parenteral Nutrition
Delivers nutrients through an IV. Used when enteral feedings can't be absorbed, like
sepsis, head injury, or burns.
Chain of Infection
Infectious agent or pathogen
Reservoir or source of pathogen to grow
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Direct Contact Transmission
Person to person
Person to source
Indirect Contact Transmission
Person to inanimate object
Droplet Transmission
Coughing, sneezing, talking
Large particles only, travel 3 ft
Airborne Transmission
Droplet nuclei or residue suspended in air carried on dust particles
Vehicles of Transmission
Food, water, drugs, and solutions (blood, fomites)
Vector
External transfer, internal transmission (parasite), mosquito, louse, flea, tick
Immunocompromised
Having an impaired immune system
Virulence
The ability to produce disease, how strong it is
Aerobic Bacteria
Requires oxygen for survival and multiplication sufficient to cause disease
Anaerobic Bacteria
Thrive where little or no free oxygen is available
Bacteriostasis
Prevention of growth and reproduction of bacteria
Bactericidal
Destructive to bacteria
Infectious Process
1. incubation period
2. prodromal stage
3. illness stage
4. convalescence
Incubation Period
WITH COMPLETE SOLUTION
Small Intestine
Absorb nutrients, many enzymes at work, acidic contents. Contains the duodenum,
jejunum, and ileum.
Large Intestine
Primary organ of bowel elimination, extends from ileocecal valve to the anus. Absorbs
water only (no nutrients)
Stool in Ascending Colon
Very liquid, no pattern
Stool in Transverse Colon
More formed, but still liquid
Stool in Descending Colon
Losing water to reabsorption, becoming thick and formed
Stool in Sigmoid Colon
Formed stool
Stool in Rectum
Most formed, stored here until evacuation occurs
Peristalsis
Under control of the nervous system, contractions occur ever 3-12 minutes. 1/3 - 1/2 of
stool is excreted in stool within 24 hours. Rapid transit times are from diarrhea. Delayed
transit times are from constipation
Bristol Stool Chart
Type 1: separate hard lumps, hard to pass
Type 2: sausage-shaped and lumpy
Type 3: sausage-shaped with cracks on surface
Type 4: sausage-shaped and smooth & soft
Type 5: soft blobs with clear-cut edges, passed easily
Type 6: fluffy pieces with ragged edges, mushy
Type 7: water, no solid pieces, entirely liquid
Constipating Foods
Cheese, lean meats, eggs, pasta
Foods with Laxative Effect
Fruits, vegetables, bran, chocolate, alcohol, coffee
Constipation
No BM in 3 days. A symptom, not a disease. Hard, dry stool that is difficult to eliminate.
Low or inactive bowel sounds heard over auscultation. Excessive straining, bloating,
and sensation of a full bowel. More common in women, adults over 65, and pregnancy.
Causes of Constipation
Not enough fiber in the diet, lack of physical activity, certain medications (opioids,
narcotics), milk, cheese, IBS, changes in life like pregnancy or aging, abuse of
,laxatives, ignoring the urge to have a BM, dehydration, specific diseases like a stroke,
or problems with the colon
Isotonic Enema
Normal saline, distends the colon, stimulates peristalsis, and softens feces
Soap Suds Enema
Irritates mucosa and distends the colon
Hypertonic Enema
Fleet phosphate, draws water into the colon
Hypotonic Enema
Tap water, distends the colon, stimulates peristalsis, and softens feces
Oil Retention Enema
Lubricates and softens stool
Kayexalate
Used to remove potassium very quickly, which is excreted through stool
Neomycin
An antibiotic used before surgery to prevent infection and kill bacteria in the colon and
bowels
Hemorrhoid
Dilated, engorged veins in the lining of the rectum. Can be internal or external. Common
in pregnancy, low fiber diets, low fluid, not enough exercise
Impaction
Results from unrelieved constipation. Often liquid stool is a symptom
Diarrhea
Increase in the number of stools and passage of liquid, unformed feces. Usually a
protective response to get rid of a pathogen. Large amounts of fluid and electrolytes lost
places risk for F&E imbalance
Causes of Diarrhea
Viruses and bacteria, C. diff, medications, patients receiving enteral nutrition, food
allergies and intolerances, and food-borne pathogens
Healthy Stoma
Looks deep reddish pink, moist, no areas of necrosis, no signs of infections, no erosion,
breakdown, or irritation.
Fecal Specimens
Medical aseptic technique is imperative. Wear disposable gloves, wash hands before
and after, do not contaminate outside the container, and label the bag.
Dysphagia
Difficulty swallowing
Nasogastric Tubes
Insert tube into nostril, down throat, and into stomach. Change tape daily, check
placement frequently before use. Lubricate nares. Provide excellent oral care. Check
tube for patency.
Verifying NG Tube
X-ray, pH test (5.5 or less), aspirate and inspect color (should be green, tan, beige, or
brown), ask patient to speak, put end of tube in water and check for no bubbling
Enteral Nutritiotn
, Delivers nutrients through an NG tube, gastrostomy tube, PEG tube, or jejunostomy
tube. Check placement, start slow at full strength. Increase every 8-12 hours if no signs
of intolerance
Parenteral Nutrition
Delivers nutrients through an IV. Used when enteral feedings can't be absorbed, like
sepsis, head injury, or burns.
Chain of Infection
Infectious agent or pathogen
Reservoir or source of pathogen to grow
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
Direct Contact Transmission
Person to person
Person to source
Indirect Contact Transmission
Person to inanimate object
Droplet Transmission
Coughing, sneezing, talking
Large particles only, travel 3 ft
Airborne Transmission
Droplet nuclei or residue suspended in air carried on dust particles
Vehicles of Transmission
Food, water, drugs, and solutions (blood, fomites)
Vector
External transfer, internal transmission (parasite), mosquito, louse, flea, tick
Immunocompromised
Having an impaired immune system
Virulence
The ability to produce disease, how strong it is
Aerobic Bacteria
Requires oxygen for survival and multiplication sufficient to cause disease
Anaerobic Bacteria
Thrive where little or no free oxygen is available
Bacteriostasis
Prevention of growth and reproduction of bacteria
Bactericidal
Destructive to bacteria
Infectious Process
1. incubation period
2. prodromal stage
3. illness stage
4. convalescence
Incubation Period
