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Exam (elaborations)

Bowel Elimination Chapter 47 Questions and Answers Graded A+

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Bowel Elimination Chapter 47 Questions and Answers Graded A+ Which of the following would the nurse expect as a normal change in the bowel elimination as a person ages? 1. Absorptive processes are increased in the intestinal mucosa. 2. Esophageal emptying time is increased. 3. Changes in nerve innervation and sensation cause diarrhea. 4. Mastication processes are less efficient. ANS: 4 An expected change in bowel elimination is decreased chewing and decreased salivation, resulting in less efficient mastication. There is decreased nutrient absorption of the small intestine in the older adult. Esophageal emptying slows, as a result of reduced motility, especially in the lower third of the esophagus. With decreased peristalsis and weakened musculature, the older adult is more prone to constipation. Duller nerve sensations may place the older adult at increased risk for fecal incontinence. An 8-month-old infant is hospitalized with severe diarrhea. The nurse knows that the major problem associated with severe diarrhea is: 1. Pain in the abdominal area 2. Electrolyte and fluid loss 3. Presence of excessive flatus 4. Irritation of the perineal and rectal area ANS: 2 Excess loss of colonic fluid because of diarrhea can result in serious fluid and electrolyte or acid- base imbalances. Infants and older adults are particularly susceptible to associated complications. Pain from abdominal cramping may occur with diarrhea, but it is not the major problem associated with severe diarrhea. Excessive flatus is not the major problem associated with severe diarrhea. Because repeated passage of diarrhea stools exposes the skin of the perineum and buttocks to irritating intestinal contents, meticulous skin care and containment of fecal drainage are needed to prevent skin breakdown. The greatest danger of severe diarrhea is a fluid and electrolyte or acid-base imbalance. A 50-year-old male client is having a screening colonoscopy. The nurse instructs the client that: 1. No special preparation is required 2. Light sedation is normally used 3. No metallic objects are allowed 4. Swallowing of an opaque liquid is required ANS: 2 Light sedation is required for a colonoscopy. Special preparation is required before a colonoscopy. Clear liquids are given the day before and then some form of bowel cleanser, such as GoLytely, is administered. Enemas until clear may also be ordered. There is no restriction of metallic objects for a colonoscopy, not does it require swallowing an opaque liquid. A client is to have a stool test for occult blood. The nurse is instructing the nursing assistant in the correct procedure for the test. The nursing assistant is correctly informed that: 1. Sterile technique is used for collection 2. Stool should be collected over a 3-day period 3. The specimen should be kept warm 4. A 1-inch sample of formed stool is needed ANS: 4 Tests performed by the laboratory for occult blood in the stool and stool cultures require only a small sample. The nurse uses clean technique to collect about 1 inch of formed stool or 15 to 30 mL of liquid stool. Unlike testing for occult blood, tests for measuring the output of fecal fat require a 3- to 5-day collection of stool, and tests that measure for ova and parasites require the stool to be warm. A client who recently underwent surgery and now has a colostomy is correctly instructed by the nurse that for the next few weeks the client's diet will include foods such as: 1. Vegetables 2. Fresh fruit 3. Whole grain breads 4. Poached eggs and rice ANS: 4

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