Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS
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The nurse instructs the patient that the health care
provider has
ordered an enema. The patient states, An enema! I'm
not constipated. What are other possible reasons for the
order?
(Select all that apply.) ade
a. Preparation for a diagnostic procedure
b. To increase fluid intake
c. To prevent laxative misuse
d. To administer a medication
e. Preparation for surgery
From the following, choose the correct equipment to
bring to the bedside to administer the commercially pre-
pared Fleet enema. (Select all that apply.)
a. Tubing with a rectal tip
b. Waterproof bed pad
c. Clean disposable gloves
bcdef
d. Water-soluble lubricant
e. Commercially prepared enema product
f. Toilet paper and/or basin with warm water, washcloth,
and towel
g. Enema bag
h. Sterile gloves
The NAP tells the nurse she doesn't want to care for a
certain patient because she is afraid of contracting C.
diflcile.
Which is the best response by the nurse?
c
a. "C. diflcile is the organism responsible for duodenal
ulcers."
b. "I can reassign you to care for à ditterent patient."
c. "Good hand hygiene with soap and water is your best
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Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS
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defense
against C. diflcile."
d. "C. diflcile can only be acquired through antibiotic
therapy,
chemotherapy, or invasive bowel procedures."
Which of the following would be inappropriate to dele-
gate to NAP?
a. Recording the amount of ostomy output
b. Administering a tap water enema c
c. Pouching a newly established ostomy
d. Administering a fleet type enema, commercially pre-
pared
How often should an ostomy pouch be changed?
a. Every 3 to 7 days
Every other day
b. a
c. Every two weeks
d. Every 2 to 3 weeks
e. Daily to prevent infection
The nurse understands the important role in helping the
patient with an ostomy accept their change in self-image.
Which
of the following indicates the patient is having diflculty
with this change in body
image?
a. The patient continues to rely on the nurse to change the a
ostomy
pouch
b. Patient holds a gas pad over the stoma while cleaning
the peristomal skin
c. The patient is asking many questions
d. The patient is willing to look at the stoma
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Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS
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Which of the following is considered a sterile procedure
and therefore requires sterile gloves?
a. Pouching an ostomy
b. c
Administering a cleansing enema
c. None of the mentioned
d. Preparing a soapsuds enema for administration
The patient is complaining of cramping during instillation
of the enema solution. What is the most appropriate ac-
tion by
the nurse?
a. Stop the installation and remove the tube from the
rectum
b. d
Raise the height of the enema container
c. Have the patient take deep breath's in and out through
the nose
d. Lower the height of the enema container or clamp the
tubing until
cramping subsides
Which of the following would be considered a normal
finding after the administration and evacuation of an en-
ema?
a. Abdominal distention is absent
b. a
High pitched, hyperactive bowel sounds are present
c. The patient complains of a firm and painful abdomen
d. The patient passes approximately 50 mL of bright red
blood
The nurse is reviewing enema administration with nursing
assistive personnel (NAP). Which of the following state-
ments by the NAP indicates further instruction is neces-
sary?
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Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS
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a. The rectal tube of an enema should be inserted 5 to 7.5
cm or 2 to 3 inches into the rectum of an adolescent
b. The rectal tube of an enema should be inserted 2.5 to
3.75 cm or
1 to 11/2 inches into the rectum of an infant
c. The rectal tube of an enema should be inserted 5 to 7.5 a
cm or 2 to
3 inches into the rectum of a child
d. The rectal tube of an enema should be inserted 7.5 to
10 cm or 3
to 4 inches into the rectum of an adult
A nurse is preparing to administer an soap suds enema.
Which of the following actions indicates correct under-
standing?
a. The nurse holds the tubing in the patient's rectum
constantly until
the end of fluid installation
b. The nurse places the patient in the prone for enema
administration
c. a
The nurse administers a normal saline enema without
a healthcare
providers order when the patient hasn't had a bowel
movement
after three days
d. The nurse fills the enema bag to the prescribed level
with warm
water
To which of the following patients would it be considered
acceptable to administer an enema without the nurse
needing
to question the order?