Exam Study Guide – Practice
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2026/2027 Update.
The internal anal sphincter is:
Select one:
a. A continuation of the longitudinal muscles.
b. Stimulated to contract by rectal filling.
c. Reflexively relaxes by rectal filling.
d. Under volitional control. - Ans✔✔-c. Reflexively relaxes by rectal filling.
The reflex that allows an individual to differentiate among stool, liquid and gas
is known as the:
Select one:
a. Gastrocolic reflex.
b. Sampling reflex.
,c. Rectoanal inhibitory reflex.
d. Wink reflex. - Ans✔✔-b. Sampling reflex.
During your initial assessment, Mr. Gutter complains of loss of gas and
occasional liquid stool. You know this is evidence of what type of fecal
incontinence and sphincter problems?
Select one:
a. Passive incontinence & internal anal sphincter damage.
b. Flatus incontinence & internal anal sphincter damage.
c. Urge incontinence & external anal sphincter damage.
d. Transient incontinence & external anal sphincter damage. - Ans✔✔-b. Flatus
incontinence & internal anal sphincter damage.
Upon initial assessment of the patient with bowel dysfunction or incontinence,
which of the following findings would initiate a referral for further evaluation?
Select one:
a. Unintentional weight loss.
b. Rectum full of firm stool.
c. Severe incontinence associated dermatitis.
d. Chronic use of laxatives. - Ans✔✔-a. Unintentional weight loss.
Bowel motility can be NEGATIVELY affected by:
Select one:
a. Diabetic autonomic neuropathy and Parkinson's Disease
,b. Cerebral palsy and melanosis coli.
c. Scleroderma and obesity.
d. Pregnancy and hyponatremia. - Ans✔✔-a. Diabetic autonomic neuropathy
and Parkinson's Disease
An essential assessment during the initial outpatient clinic evaluation of a
patient experiencing diarrhea and fecal incontinence is to:
Select one:
a. Recommend a containment device.
b. Request a stool sample to check for microbial imbalances.
c. Obtain a 7 to 14-day bowel and dietary diary.
d. Refer to primary care for further evaluation. - Ans✔✔-c. Obtain a 7 to 14-day
bowel and dietary diary.
During your initial interview, a patient reports his typical stool consistency to be
pellet-like and hard. This finding suggests the patient may have:
Select one:
a. Slow colonic transit.
b. Ineffective absorption of fluid by the bowel wall.
c. Excessive intake of dietary fiber.
d. Ineffective internal sphincter control. - Ans✔✔-a. Slow colonic transit.
An 85-year-old female with advanced dementia and no history of bowel
dysfunction is at risk for fecal incontinence PRIMARILY because dementia will
impair:
, Select one:
a. The sampling reflex.
b. Her ability to respond to the sensations of rectal fullness.
c. The ability of the internal sphincter to relax.
d. Colonic transit time. - Ans✔✔-b. Her ability to respond to the sensations of
rectal fullness.
The FIRST step in developing an effective comprehensive management plan for
a 5-year-old with retentive encopresis is to:
Select one:
a. Conduct radiographic defecography.
b. Clean out the gut with daily Dulcolax tablets.
c. Establish rapport with the parents and provide intensive education and
counseling.
d. Institute extensive dietary modifications. - Ans✔✔-c. Establish rapport with
the parents and provide intensive education and counseling.
A 54-year-old man reports occasional episodes of difficulty controlling his stool.
In the last year he has undergone pelvic radiation for prostate cancer. Which of
the following essential mechanisms for bowel continence is most likely
disrupted?
Select one:
a. Functioning of the pelvic floor musculature.
b. Compliance of the rectum.
c. Integrity of neural pathways.