Bowel Elimination NCLEX Practice — Set A
NSG 3100: Fundamentals of Nursing I
Chapter 40 — Bowel Elimination
NCLEX-Style Practice Exam — Set A | 50 Questions
Instructions
Answer all 50 questions before checking the Answer Key & Rationales section at the end of this document. Questions
include standard multiple choice, Select All That Apply (SATA), priority, delegation, nursing process, and clinical
judgment/scenario-based items, written at an application/analysis level consistent with a Galen College of Nursing
Fundamentals exam. For SATA items, select every option that applies.
1. The nurse is preparing to perform an abdominal assessment. Which sequence should the nurse follow?
[Standard MC]
A. Palpation, auscultation, percussion, inspection
B. Inspection, auscultation, percussion, palpation
C. Inspection, palpation, auscultation, percussion
D. Auscultation, inspection, palpation, percussion
2. A patient tells the nurse, 'I only have a bowel movement every 4 days, but it's soft and I don't have to strain.'
What is the nurse's best interpretation of this statement?
[Standard MC]
A. This is abnormal and requires immediate laxative therapy
B. This is a normal variation, since bowel patterns range from three times a week to several times a day
C. This indicates early fecal impaction
D. This suggests the patient has a paralytic ileus
3. A patient with chronic atrophic gastritis has lost a significant number of parietal cells in the stomach lining. The
nurse should monitor this patient for signs of which complication?
[Standard MC]
A. Steatorrhea
B. Vitamin B12 deficiency (pernicious anemia)
C. Hypokalemia
D. C. difficile colitis
4. The nurse is teaching a nursing student about the ileocecal valve. Which statement by the student reflects
correct understanding?
[Standard MC]
A. 'It regulates the release of bile into the duodenum.'
B. 'It prevents backflow of fecal material from the cecum into the ileum.'
C. 'It controls voluntary defecation.'
D. 'It produces intrinsic factor for B12 absorption.'
5. A patient asks the nurse the difference between a laxative and a cathartic. What is the nurse's best response?
[Standard MC]
A. 'They are the same medication with different brand names.'
B. 'A cathartic produces a stronger bowel effect than a laxative, which produces softer or liquid stool.'
C. 'A laxative works faster than a cathartic.'
D. 'A cathartic is used only for enemas, and laxatives are used only orally.'
Page 1
, Bowel Elimination NCLEX Practice — Set A
6. A hospitalized patient has watery, foul-smelling diarrhea occurring 4 times in the last 24 hours, 3 days after
starting IV clindamycin. What should the nurse suspect and do first?
[Standard MC]
A. Suspect lactose intolerance and hold the next tray
B. Suspect Clostridioides difficile infection and initiate contact precautions
C. Suspect irritable bowel syndrome and request a psychiatric consult
D. Suspect food poisoning and notify dietary services
7. Which patient is at greatest risk for a dangerous increase in intracranial pressure from straining during
defecation (Valsalva maneuver)?
[Standard MC]
A. A 30-year-old with a sprained ankle
B. A 68-year-old who is 2 days post-craniotomy
C. A 45-year-old with a fractured wrist
D. A 22-year-old with seasonal allergies
8. The nurse identifies that a patient's constipation is most likely related to opioid analgesic use. What is the
underlying mechanism?
[Standard MC]
A. Opioids increase intestinal secretions
B. Opioids decrease intestinal motility and slow peristalsis
C. Opioids increase water reabsorption only in the stomach
D. Opioids stimulate the gastrocolic reflex
9. A patient has not had a bowel movement in 6 days and now reports continuous seepage of liquid stool with no
formed stool passed. What should the nurse suspect?
[Standard MC]
A. Diarrhea from C. difficile
B. Fecal impaction
C. Bowel incontinence from neurologic disease
D. Normal bowel pattern variation
10. Which food should the nurse encourage for a patient trying to relieve mild constipation?
[Standard MC]
A. Cheese and pasta
B. Prunes and bran cereal
C. Lean chicken and eggs
D. White rice
11. A patient recovering from abdominal surgery has absent bowel sounds and abdominal distention on
postoperative day 1. The nurse recognizes this is most consistent with which condition?
[Standard MC]
A. Paralytic ileus
B. Diverticulitis
C. Bowel incontinence
D. Hemorrhoids
12. Which stool color finding should prompt the nurse to notify the provider of possible upper GI bleeding?
[Standard MC]
Page 2
, Bowel Elimination NCLEX Practice — Set A
A. Green stool
B. Bright red stool
C. Black, tarry stool (melena)
D. Clay-colored stool
13. A patient's stool is pale, greasy, and floats in the toilet water. The nurse should associate this finding with
which condition?
[Standard MC]
A. Steatorrhea from fat malabsorption
B. Upper GI bleeding
C. Lower GI bleeding
D. Normal variant related to diet
14. Which colostomy location produces the most solid, formed stool with the greatest ability to regulate
frequency?
[Standard MC]
A. Ascending colostomy
B. Transverse colostomy
C. Descending colostomy
D. Sigmoid colostomy
15. A patient has a new ascending colostomy. The nurse should prioritize which intervention related to the stoma
effluent?
[Standard MC]
A. Applying a barrier skin product because the stool contains digestive enzymes that irritate skin
B. Withholding oral fluids to reduce stool volume
C. Teaching the patient to irrigate the stoma daily
D. Explaining that stool output will be well-formed
16. During a pouch change, the nurse notes the patient's stoma is dusky purple-black in color. What is the nurse's
priority action?
[Standard MC]
A. Document the finding as an expected variant and continue the pouch change
B. Apply extra skin barrier paste and recheck in 24 hours
C. Notify the provider immediately, as this suggests stomal necrosis / compromised blood flow
D. Increase the patient's fluid intake and reassess in 8 hours
17. What is the correct technique for cleansing the peristomal skin during a pouching system change?
[Standard MC]
A. Use antibacterial soap and an alcohol wipe to fully disinfect the area
B. Use warm water only; avoid soaps with lotion/fragrance and alcohol-based products
C. Use hydrogen peroxide to clean the stoma directly
D. Use a premoistened baby wipe with fragrance to reduce odor
18. When cutting a new ostomy wafer opening, the nurse should size it:
[Standard MC]
A. Exactly the same size as the stoma to prevent any skin exposure
B. 1/16 to 1/8 inch larger than the stoma
C. 1 full inch larger than the stoma to allow for stoma growth
Page 3
NSG 3100: Fundamentals of Nursing I
Chapter 40 — Bowel Elimination
NCLEX-Style Practice Exam — Set A | 50 Questions
Instructions
Answer all 50 questions before checking the Answer Key & Rationales section at the end of this document. Questions
include standard multiple choice, Select All That Apply (SATA), priority, delegation, nursing process, and clinical
judgment/scenario-based items, written at an application/analysis level consistent with a Galen College of Nursing
Fundamentals exam. For SATA items, select every option that applies.
1. The nurse is preparing to perform an abdominal assessment. Which sequence should the nurse follow?
[Standard MC]
A. Palpation, auscultation, percussion, inspection
B. Inspection, auscultation, percussion, palpation
C. Inspection, palpation, auscultation, percussion
D. Auscultation, inspection, palpation, percussion
2. A patient tells the nurse, 'I only have a bowel movement every 4 days, but it's soft and I don't have to strain.'
What is the nurse's best interpretation of this statement?
[Standard MC]
A. This is abnormal and requires immediate laxative therapy
B. This is a normal variation, since bowel patterns range from three times a week to several times a day
C. This indicates early fecal impaction
D. This suggests the patient has a paralytic ileus
3. A patient with chronic atrophic gastritis has lost a significant number of parietal cells in the stomach lining. The
nurse should monitor this patient for signs of which complication?
[Standard MC]
A. Steatorrhea
B. Vitamin B12 deficiency (pernicious anemia)
C. Hypokalemia
D. C. difficile colitis
4. The nurse is teaching a nursing student about the ileocecal valve. Which statement by the student reflects
correct understanding?
[Standard MC]
A. 'It regulates the release of bile into the duodenum.'
B. 'It prevents backflow of fecal material from the cecum into the ileum.'
C. 'It controls voluntary defecation.'
D. 'It produces intrinsic factor for B12 absorption.'
5. A patient asks the nurse the difference between a laxative and a cathartic. What is the nurse's best response?
[Standard MC]
A. 'They are the same medication with different brand names.'
B. 'A cathartic produces a stronger bowel effect than a laxative, which produces softer or liquid stool.'
C. 'A laxative works faster than a cathartic.'
D. 'A cathartic is used only for enemas, and laxatives are used only orally.'
Page 1
, Bowel Elimination NCLEX Practice — Set A
6. A hospitalized patient has watery, foul-smelling diarrhea occurring 4 times in the last 24 hours, 3 days after
starting IV clindamycin. What should the nurse suspect and do first?
[Standard MC]
A. Suspect lactose intolerance and hold the next tray
B. Suspect Clostridioides difficile infection and initiate contact precautions
C. Suspect irritable bowel syndrome and request a psychiatric consult
D. Suspect food poisoning and notify dietary services
7. Which patient is at greatest risk for a dangerous increase in intracranial pressure from straining during
defecation (Valsalva maneuver)?
[Standard MC]
A. A 30-year-old with a sprained ankle
B. A 68-year-old who is 2 days post-craniotomy
C. A 45-year-old with a fractured wrist
D. A 22-year-old with seasonal allergies
8. The nurse identifies that a patient's constipation is most likely related to opioid analgesic use. What is the
underlying mechanism?
[Standard MC]
A. Opioids increase intestinal secretions
B. Opioids decrease intestinal motility and slow peristalsis
C. Opioids increase water reabsorption only in the stomach
D. Opioids stimulate the gastrocolic reflex
9. A patient has not had a bowel movement in 6 days and now reports continuous seepage of liquid stool with no
formed stool passed. What should the nurse suspect?
[Standard MC]
A. Diarrhea from C. difficile
B. Fecal impaction
C. Bowel incontinence from neurologic disease
D. Normal bowel pattern variation
10. Which food should the nurse encourage for a patient trying to relieve mild constipation?
[Standard MC]
A. Cheese and pasta
B. Prunes and bran cereal
C. Lean chicken and eggs
D. White rice
11. A patient recovering from abdominal surgery has absent bowel sounds and abdominal distention on
postoperative day 1. The nurse recognizes this is most consistent with which condition?
[Standard MC]
A. Paralytic ileus
B. Diverticulitis
C. Bowel incontinence
D. Hemorrhoids
12. Which stool color finding should prompt the nurse to notify the provider of possible upper GI bleeding?
[Standard MC]
Page 2
, Bowel Elimination NCLEX Practice — Set A
A. Green stool
B. Bright red stool
C. Black, tarry stool (melena)
D. Clay-colored stool
13. A patient's stool is pale, greasy, and floats in the toilet water. The nurse should associate this finding with
which condition?
[Standard MC]
A. Steatorrhea from fat malabsorption
B. Upper GI bleeding
C. Lower GI bleeding
D. Normal variant related to diet
14. Which colostomy location produces the most solid, formed stool with the greatest ability to regulate
frequency?
[Standard MC]
A. Ascending colostomy
B. Transverse colostomy
C. Descending colostomy
D. Sigmoid colostomy
15. A patient has a new ascending colostomy. The nurse should prioritize which intervention related to the stoma
effluent?
[Standard MC]
A. Applying a barrier skin product because the stool contains digestive enzymes that irritate skin
B. Withholding oral fluids to reduce stool volume
C. Teaching the patient to irrigate the stoma daily
D. Explaining that stool output will be well-formed
16. During a pouch change, the nurse notes the patient's stoma is dusky purple-black in color. What is the nurse's
priority action?
[Standard MC]
A. Document the finding as an expected variant and continue the pouch change
B. Apply extra skin barrier paste and recheck in 24 hours
C. Notify the provider immediately, as this suggests stomal necrosis / compromised blood flow
D. Increase the patient's fluid intake and reassess in 8 hours
17. What is the correct technique for cleansing the peristomal skin during a pouching system change?
[Standard MC]
A. Use antibacterial soap and an alcohol wipe to fully disinfect the area
B. Use warm water only; avoid soaps with lotion/fragrance and alcohol-based products
C. Use hydrogen peroxide to clean the stoma directly
D. Use a premoistened baby wipe with fragrance to reduce odor
18. When cutting a new ostomy wafer opening, the nurse should size it:
[Standard MC]
A. Exactly the same size as the stoma to prevent any skin exposure
B. 1/16 to 1/8 inch larger than the stoma
C. 1 full inch larger than the stoma to allow for stoma growth
Page 3
