Chapter 47 Bowel Elimination Fundamentals of Nursing 11th Edition (Potter & Perry) 50 NCLEX-Style Exam Questions with Detailed Rationales

1. A nurse is assessing a patient with prolonged constipation. Which finding is most concerning and requires immediate action? A. Abdominal distension B. Hypoactive bowel sounds C. Hematochezia (bright red rectal bleeding) D. Hard, dry stool Correct Answer: C Rationale: Bright red rectal bleeding could indicate hemorrhoids, anal fissures, or colorectal pathology and requires prompt evaluation. ________________________________________ 2. A nurse is preparing a patient for a colonoscopy. What is the most important pre-procedure instruction? A. “Eat a regular diet the day before the test.” B. “Avoid all fluid intake 24 hours before.” C. “You’ll need to complete a bowel prep to empty your colon.” D. “Take your usual morning medications before the procedure.” Correct Answer: C Rationale: Colon cleansing is essential for visualizing the colon during a colonoscopy. ________________________________________ 3. Which assessment finding most likely indicates a fecal impaction? A. Watery diarrhea with no solid stool B. Flat abdomen with hyperactive bowel sounds C. Hematuria and constipation D. Patient reports no urge to defecate Correct Answer: A Rationale: Liquid stool may leak around a fecal mass, giving a false impression of diarrhea while impaction remains. ________________________________________ 4. The nurse is educating a patient about a high-fiber diet. Which food selection by the patient indicates understanding? A. White rice and chicken B. Apple with skin and oatmeal C. Pasta and cheese D. Iceberg lettuce and white bread Correct Answer: B Rationale: Apples with skin and oatmeal are rich in soluble and insoluble fiber, promoting bowel regularity. ________________________________________ 5. A nurse is teaching a patient about laxative use. Which statement indicates a need for further teaching? A. “I’ll use a laxative when I haven’t gone for a day or two.” B. “I’ll try to increase my fiber and water intake instead.” C. “Long-term laxative use can cause dependency.” D. “I’ll avoid using laxatives unless absolutely necessary.” Correct Answer: A Rationale: Daily use or reliance on laxatives for mild or short-term constipation may lead to dependence and should be discouraged. ________________________________________ 6. Which patient is most at risk for developing constipation? A. A patient taking opioid analgesics B. A patient on antibiotics C. A patient with diarrhea D. A patient eating a high-fiber diet Correct Answer: A Rationale: Opioids slow intestinal motility, increasing water absorption and leading to constipation. ________________________________________ 7. During a digital rectal exam, the nurse finds a hard mass in the rectum. What is the priority intervention? A. Encourage fluid intake B. Administer an oral stool softener C. Notify the provider and prepare for manual disimpaction D. Offer a bedpan immediately Correct Answer: C Rationale: Fecal impaction may require manual removal after provider evaluation and appropriate orders. ________________________________________ 8. What is the most appropriate nursing diagnosis for a patient with chronic constipation? A. Deficient fluid volume B. Risk for electrolyte imbalance C. Bowel incontinence D. Constipation related to decreased physical activity and low-fiber diet Correct Answer: D Rationale: This nursing diagnosis identifies a modifiable cause and appropriate intervention focus. ________________________________________ 9. What should the nurse include when teaching a patient with a colostomy about normal stoma appearance? A. “It should be pale pink and dry.” B. “A stoma should be dark purple to indicate good blood flow.” C. “It should be bright red and moist.” D. “You should expect constant bleeding from the stoma.” Correct Answer: C Rationale: A healthy stoma is red and moist due to vascularization. Pale or dusky stomas indicate poor perfusion.