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A 54 yo M 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:
A- Functioning of the pelvic floor musculature
B- Compliance of the rectum
C- Integrity of neural pathways
D- Quality of IAS - CORRECT ANSWER ✔✔ -B- Compliance of the rectum
A clinic patient reports experiencing involuntary urine loss that is associated with increased
intra-abdominal pressure when sneezing. Your plan of care is developed based upon the
determination that this is most likely what type of incontinence?
A- Overflow that develops because the bladder is not completely emptying
B- Mixed urge and stress which occurs because the bladder is irritated and unstable contractions
are present
C- Stress which develops due to decreased bladder outlet resistance
D- Urge and occurs with increased bladder outlet resistance - CORRECT ANSWER ✔✔ -C-
Stress which develops due to decreased bladder outlet resistance
,A friend who just returned from a missionary trip in a third world country complains of sever
large volume diarrhea. She is most likely experiencing which of the following types of diarrhea?
A- Secretory
B- Absorptive
C- Motility
D- Mixed - CORRECT ANSWER ✔✔ -A-Secretory
Due to contaminated water supply , the gut secretes water and electrolytes into the lumen of the
bowel that overwhelms the bowels absorptive function. The body's way of flushing the system!
A patient complains of occasional constipation. Your initial recommendations included fluid,
increase activity, and a gradual daily intake of how much fiber?
A- 10-14g
B- 15-20g
C- 21-24g
D- 25-38G - CORRECT ANSWER ✔✔ -D- 25-38G
25 grams for women and 38 grams for men
children age +5 = grams of fiber
A patient describes losing small amounts of urine during an exercise routine. They deny any loss
of urine during the night. This history is typical of:
,A- Reflex incontinence
B-Mixed stress-urge incontinence
C- Stress incontinence
D- Urge incontinence - CORRECT ANSWER ✔✔ -C- Stress incontinence
A patient has sustained considerable damage to his sacral spine(S2-S4) due to repeat
laminectomies. What kind of bowel dysfunction can you anticipate for him?
A- Chronic constipation
B- Chronic diarrhea
C- Rapid transit of bowel contents
D- No bowel dysfunction - CORRECT ANSWER ✔✔ -A- Chronic constipation
Parasympathetic nervous system arises from S2-S4, which is responsible in stimulating
peristalsis
A patient recently admitted to the nursing home is experiencing frequent oozing of stool. The
patient has no neurological defects of pathologies, is not diabetic and is not taking any
medications that cause diarrhea. Before you go any further in your physical examination, what is
your initial assessment of the most likely etiology?
A- Inadequate fluid intake
B- Insufficient fiber intake
C- Fecal impaction
, D- Reaction to the stress of a new environment - CORRECT ANSWER ✔✔ -C- Fecal impaction
A prompted voiding program is characterized as:
A- The least studied of all 3 scheduled toileting programs
B- Effective at reducing the frequency of bladder contractions
C- A program that is individualized to the patient's previous voiding pattern
D- A form of behavioral modification using much praise when the patient is dry - CORRECT
ANSWER ✔✔ -D- A form of behavioral modification using much praise when the patient is dry
A routine dipstick of a urine specimen form a patient with urinary incontinence contains WBCs
and numerous epithelial calls. What should your next step be?
A- Refer the patient to a urologist
B- Send the urine for a culture and sensitivity test
C- Nothing, because a few WBCs and epithelial cells are to be expected
D- Ask the patient to clean peri-genital area, repeat the dipstick with a clean catch urine
specimen - CORRECT ANSWER ✔✔ -D- Ask the patient to clean peri-genital area, repeat the
dipstick with a clean catch urine specimen
A stimulated defecation program is indicated for the patient with:
A- Sensory or cognitive defects
B- Normal transit constipation
C- Weak pelvic floor musculature