Chapter 47: Bowel Elimination
ra ra ra
MULTIPLE CHOICE ra
1. The nursing attendant is teaching a health class about the gastrointestinal tract. The nursin
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g attendant will explain that which portion of the digestive tract absorbs most of the nutrie
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
nts?
a. Ileum
b. Cecum
c. Stomach
d. Duodenum
ACCURATE ar
ANSWER:-D
The duodenum and jejunum absorb most nutrients and electrolytes in the small intestine. Th
ra ra ra ra ra ra ra ra ra ra ra ra ra
e ileum absorbs certain vitamins, iron, and bile salts. Food is broken down in the stomach. Th
ar ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
e cecum is the beginning of the large intestine.
ar ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
OBJ:Discuss the role of gastrointestinal organs and their physiological function in digestion and
ra ra ra ra ra ra ra ra ra ra ra ra ar
elimination. TOP:Teaching/Learning
MSC: Health Promotion and Maintenance
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2. The nursing attendant is caring for hospital client s with ostomies. In which ostomy location
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
will the nursing attendant expect very liquid stool to be present?
ra ra ra ra ra ra ra ra ra ra
a. Sigmoid
b. Transverse
c. Ascending
d. Descending
ACCURATE ar
ANSWER:-C
The path of digestion goes from the ascending, across the transverse, to the descending and finall
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
y passing into the sigmoid; therefore, the least formed stool (very liquid) would be in the ascending
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
.
DIF:Apply (application) ra
OBJ:Discuss how psychological and physiological factors may alter the elimination process. T
ra ra ra ra ra ra ra ra ra ra ar
OP:Assessment MSC: Physiological Adaptation ra ra
3. A nursing attendant is teaching a hospital client about the large intestine in elimination. I
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
n which order will the nursing attendant list the structures, starting with the first portion? a.
ar ra ra ra ra ra ra ra ra ra ra ra ra ra
Cecum, ascending, transverse, descending, sigmoid, and rectum
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b. Ascending, transverse, descending, sigmoid, rectum, and cecum ra ra ra ra ra ra
c. Cecum, sigmoid, ascending, transverse, descending, and rectum
ra ra ra ra ra ra
d. Ascending, transverse, descending, rectum, sigmoid, and cecum ra ra ra ra ra ra
ACCURATE ANSWER:-A ra
, The large intestine is divided into the cecum, ascending colon, transverse colon, descending col
ra ra ra ra ra ra ra ra ra ra ra ra ar
on, sigmoid colon, and rectum. The large intestine is the primary organ of bowel elimination.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
OBJ:Discuss the role of gastrointestinal organs and their physiological function in digestion and
ra ra ra ra ra ra ra ra ra ra ra ra ar
elimination. TOP:Teaching/Learning
MSC: Health Promotion and Maintenance
ra ra ra ra
4. The nursing attendant is planning care for a group of hospital client s. Which task will
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
the nursing attendant assign to the nursing assistive personnel (AP)? a.
ra ra ra ra ra ra ra ra ra
Performing the first postoperative pouch change ra ra ra ra ra
b. Maintaining a nasogastric tube ra ra ra
c. Administering an enema ra ra
d. Digitally removing stool ra ra
ACCURATE ANSWER:-C ra
The skill of administering an enema can be delegated to an AP. The skill of inserting and main
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
taining a nasogastric (NG) tube cannot be delegated to an AP. The nursing attendant should
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
do the first postoperative pouch change. Digitally removing stool cannot be delegated to nursi
ra ra ra ra ra ra ra ra ra ra ra ar ra
ng assistive personnel.
ra ra
DIF:Apply (application) ra
OBJ:Use critical thinking and clinical decision making when providing care to hospital client s with alter
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
at ions in bowel elimination. TOP:Planning MSC: Management of Care
ra ra ra ra ra ra ra ra
5. A nursing attendant is assisting a hospital client in making dietary choices that
ra ra ra ra ra ra ra ra ra ra ra ra ar
promote healthy bowel elimination. Which menu option should the nursing a
ra ra ra ra ra ra ra ra ra ra
ttendant recommend? ra
a. Broccoli and cheese soup with potato bread ra ra ra ra ra ra
b. Turkey and mashed potatoes with brown gravy ra ra ra ra ra ra
c. Grape and walnut chicken salad sandwich on whole wheat bread
ra ra ra ra ra ra ra ra ra
d. Dinner salad topped with hard-boiled eggs, cheese, and fat-free dressing
ra ra ra ra ra ra ra ra ra
ACCURATE ANSWER:-C ra
Grapes and whole wheat bread are high fiber and should be chosen. Cheese, eggs, potato brea
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
d, and mashed potatoes do not contain as much fiber as whole wheat bread. A healthy diet for t
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra
he bowel should include foods high in bulkforming fiber. Whole grains, fresh fruit, and fresh veg
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
etables are excellent sources. Foods wit ra ra ra ra ra
hout much fiber and with high levels of fat can slow down peristalsis, causing constipation.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Apply (application) ra
OBJ:Select individualized nursing interventions using your clinical judgment that promote norm
ra ra ra ra ra ra ra ra ra ra
al elimination in your hospital client s. TOP:Implementation MSC:
ar ra ra ra ra ra ra
Health Promotion and Maintenance ra ra ra
6. A hospital client is using laxatives 3 times daily to lose weight. After stopping laxative use, t
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
he hospital client has difficulty with constipation and wonders if laxatives should be taken
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
again. Which information will the nursing attendant share with the hospital client ? a. Long-
ra ra ra ra ra ra ra ra ra ra ra ra
term laxative use causes the bowel to become less responsive to stimuli, and consti
ra ra ra ra ra ra ra ra ra ra ra ra ar
pation may occur. ra ra
b. Laxatives can cause trauma to the intestinal lining and scarring may result, leading ra ra ra ra ra ra ra ra ra ra ra ra ar
to decreased peristalsis. ra ra
, c. Long-
term use of emollient laxatives is effective for treatment of chronic constip
ar ra ra ra ra ra ra ra ra ra ar
ation and may be useful in certain situations.
ra ra ra ra ra ra ra
d. Laxatives cause the body to become malnourished, so when the hospital client
ra ra ra ra ra ra ra ra ra ra ra ra
begins eating again, the body absorbs all of the food, and no waste products are produced.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
ACCURATE ANSWER:-A ra
Teach hospital client s about the potential harmful effects of overuse of laxatives, such as imp
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
aired bowel motility and decreased response to sensory stimulus. Make sure the hospital clie
ra ra ra ra ra ra ra ra ra ra ra ra ra
nt understands that laxatives are not to be used long term for maintenance of bowel function.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
Increasing fluid and fiber intake can help with this problem. Laxatives do not cause scarring.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra
Even if malnourished, the body will produce waste if any substance is consumed.
ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
OBJ:Discuss how psychological and physiological factors may alter the elimination process. T
ra ra ra ra ra ra ra ra ra ra ar
OP:Teaching/Learning MSC: Health Promotion and Maintenance ra ra ra ra
7. A hospital client recovering from a hip fracture is having difficulty defecating into a bedpa
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
n while lying in bed. Which action by the nursing attendant will assist the hospital client i
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
n having a successful bowel movement?
ra ra ra ra ra
a. Preparing to administer a barium enema ra ra ra ra ra
b. Withholding narcotic pain medication ra ra ra
c. Administering laxatives to the hospital client ra ra ra ra ra
d. Raising the head of the bed ra ra ra ra ra
ACCURATE ANSWER:-D ra
Lying in bed is an unnatural position; raising the head of the bed assists the hospital client int
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
o a more normal position that allows proper contraction of muscles for elimination.
ra ra ra ra ra ra ra ra ra ra ra ra
Laxatives would not give the hospital client control over bowel movements. A barium ene
ra ra ra ra ra ra ra ra ra ra ra ra ra
ma is a diagnostic test, not an intervention to promote defecation. Painrelief measures should be
ra ra ra ra ra ra ra ra ra ra ra ra ar ra ra
given; however, preventative action should be taken to prevent co nstipation.
ra ra ra ra ra ra ra ra ra
DIF:Apply (application) ra
OBJ:Discuss how psychological and physiological factors may alter the elimination process.
ra ra ra ra ra ra ra ra ra ra
TOP:Implementation MSC: Basic Care and Comfort ra ra ra
8. Which hospital client is most at risk for increased peristalsis?
ra ra ra ra ra ra ra ra ra
a. A 5-year-old child who ignores the urge to defecate owing to embarrassment
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b. A 21-year-old female with three final examinations on the same day
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c. A 40-year-old female with major depressive disorder
ra ra ra ra ra ra
d. An 80-year-old male in an assisted-living environment
ra ra ra ra ra ra
ACCURATE ANSWER:-B ra
Stress can stimulate digestion and increase peristalsis, resulting in diarrhea; three finals on th
ra ra ra ra ra ra ra ra ra ra ra ra ra
e same day is stressful. Ignoring the urge to defecate, depression, and agerelated changes of the ol
ar ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
der adult (80-yearold man) are causes of constipation, which is from slowed peristalsis.
ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Apply (application) ra
OBJ:Discuss how psychological and physiological factors may alter the elimination process. T
ra ra ra ra ra ra ra ra ra ra ar
OP:Assessment MSC: Psychosocial Integrity ra ra
ra ra ra
MULTIPLE CHOICE ra
1. The nursing attendant is teaching a health class about the gastrointestinal tract. The nursin
ra ra ra ra ra ra ra ra ra ra ra ra ra
g attendant will explain that which portion of the digestive tract absorbs most of the nutrie
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
nts?
a. Ileum
b. Cecum
c. Stomach
d. Duodenum
ACCURATE ar
ANSWER:-D
The duodenum and jejunum absorb most nutrients and electrolytes in the small intestine. Th
ra ra ra ra ra ra ra ra ra ra ra ra ra
e ileum absorbs certain vitamins, iron, and bile salts. Food is broken down in the stomach. Th
ar ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
e cecum is the beginning of the large intestine.
ar ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
OBJ:Discuss the role of gastrointestinal organs and their physiological function in digestion and
ra ra ra ra ra ra ra ra ra ra ra ra ar
elimination. TOP:Teaching/Learning
MSC: Health Promotion and Maintenance
ra ra ra ra
2. The nursing attendant is caring for hospital client s with ostomies. In which ostomy location
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
will the nursing attendant expect very liquid stool to be present?
ra ra ra ra ra ra ra ra ra ra
a. Sigmoid
b. Transverse
c. Ascending
d. Descending
ACCURATE ar
ANSWER:-C
The path of digestion goes from the ascending, across the transverse, to the descending and finall
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
y passing into the sigmoid; therefore, the least formed stool (very liquid) would be in the ascending
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
.
DIF:Apply (application) ra
OBJ:Discuss how psychological and physiological factors may alter the elimination process. T
ra ra ra ra ra ra ra ra ra ra ar
OP:Assessment MSC: Physiological Adaptation ra ra
3. A nursing attendant is teaching a hospital client about the large intestine in elimination. I
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
n which order will the nursing attendant list the structures, starting with the first portion? a.
ar ra ra ra ra ra ra ra ra ra ra ra ra ra
Cecum, ascending, transverse, descending, sigmoid, and rectum
ra ra ra ra ra ra
b. Ascending, transverse, descending, sigmoid, rectum, and cecum ra ra ra ra ra ra
c. Cecum, sigmoid, ascending, transverse, descending, and rectum
ra ra ra ra ra ra
d. Ascending, transverse, descending, rectum, sigmoid, and cecum ra ra ra ra ra ra
ACCURATE ANSWER:-A ra
, The large intestine is divided into the cecum, ascending colon, transverse colon, descending col
ra ra ra ra ra ra ra ra ra ra ra ra ar
on, sigmoid colon, and rectum. The large intestine is the primary organ of bowel elimination.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
OBJ:Discuss the role of gastrointestinal organs and their physiological function in digestion and
ra ra ra ra ra ra ra ra ra ra ra ra ar
elimination. TOP:Teaching/Learning
MSC: Health Promotion and Maintenance
ra ra ra ra
4. The nursing attendant is planning care for a group of hospital client s. Which task will
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
the nursing attendant assign to the nursing assistive personnel (AP)? a.
ra ra ra ra ra ra ra ra ra
Performing the first postoperative pouch change ra ra ra ra ra
b. Maintaining a nasogastric tube ra ra ra
c. Administering an enema ra ra
d. Digitally removing stool ra ra
ACCURATE ANSWER:-C ra
The skill of administering an enema can be delegated to an AP. The skill of inserting and main
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
taining a nasogastric (NG) tube cannot be delegated to an AP. The nursing attendant should
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
do the first postoperative pouch change. Digitally removing stool cannot be delegated to nursi
ra ra ra ra ra ra ra ra ra ra ra ar ra
ng assistive personnel.
ra ra
DIF:Apply (application) ra
OBJ:Use critical thinking and clinical decision making when providing care to hospital client s with alter
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
at ions in bowel elimination. TOP:Planning MSC: Management of Care
ra ra ra ra ra ra ra ra
5. A nursing attendant is assisting a hospital client in making dietary choices that
ra ra ra ra ra ra ra ra ra ra ra ra ar
promote healthy bowel elimination. Which menu option should the nursing a
ra ra ra ra ra ra ra ra ra ra
ttendant recommend? ra
a. Broccoli and cheese soup with potato bread ra ra ra ra ra ra
b. Turkey and mashed potatoes with brown gravy ra ra ra ra ra ra
c. Grape and walnut chicken salad sandwich on whole wheat bread
ra ra ra ra ra ra ra ra ra
d. Dinner salad topped with hard-boiled eggs, cheese, and fat-free dressing
ra ra ra ra ra ra ra ra ra
ACCURATE ANSWER:-C ra
Grapes and whole wheat bread are high fiber and should be chosen. Cheese, eggs, potato brea
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
d, and mashed potatoes do not contain as much fiber as whole wheat bread. A healthy diet for t
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra
he bowel should include foods high in bulkforming fiber. Whole grains, fresh fruit, and fresh veg
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
etables are excellent sources. Foods wit ra ra ra ra ra
hout much fiber and with high levels of fat can slow down peristalsis, causing constipation.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Apply (application) ra
OBJ:Select individualized nursing interventions using your clinical judgment that promote norm
ra ra ra ra ra ra ra ra ra ra
al elimination in your hospital client s. TOP:Implementation MSC:
ar ra ra ra ra ra ra
Health Promotion and Maintenance ra ra ra
6. A hospital client is using laxatives 3 times daily to lose weight. After stopping laxative use, t
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
he hospital client has difficulty with constipation and wonders if laxatives should be taken
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
again. Which information will the nursing attendant share with the hospital client ? a. Long-
ra ra ra ra ra ra ra ra ra ra ra ra
term laxative use causes the bowel to become less responsive to stimuli, and consti
ra ra ra ra ra ra ra ra ra ra ra ra ar
pation may occur. ra ra
b. Laxatives can cause trauma to the intestinal lining and scarring may result, leading ra ra ra ra ra ra ra ra ra ra ra ra ar
to decreased peristalsis. ra ra
, c. Long-
term use of emollient laxatives is effective for treatment of chronic constip
ar ra ra ra ra ra ra ra ra ra ar
ation and may be useful in certain situations.
ra ra ra ra ra ra ra
d. Laxatives cause the body to become malnourished, so when the hospital client
ra ra ra ra ra ra ra ra ra ra ra ra
begins eating again, the body absorbs all of the food, and no waste products are produced.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
ACCURATE ANSWER:-A ra
Teach hospital client s about the potential harmful effects of overuse of laxatives, such as imp
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
aired bowel motility and decreased response to sensory stimulus. Make sure the hospital clie
ra ra ra ra ra ra ra ra ra ra ra ra ra
nt understands that laxatives are not to be used long term for maintenance of bowel function.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
Increasing fluid and fiber intake can help with this problem. Laxatives do not cause scarring.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra
Even if malnourished, the body will produce waste if any substance is consumed.
ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
OBJ:Discuss how psychological and physiological factors may alter the elimination process. T
ra ra ra ra ra ra ra ra ra ra ar
OP:Teaching/Learning MSC: Health Promotion and Maintenance ra ra ra ra
7. A hospital client recovering from a hip fracture is having difficulty defecating into a bedpa
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
n while lying in bed. Which action by the nursing attendant will assist the hospital client i
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
n having a successful bowel movement?
ra ra ra ra ra
a. Preparing to administer a barium enema ra ra ra ra ra
b. Withholding narcotic pain medication ra ra ra
c. Administering laxatives to the hospital client ra ra ra ra ra
d. Raising the head of the bed ra ra ra ra ra
ACCURATE ANSWER:-D ra
Lying in bed is an unnatural position; raising the head of the bed assists the hospital client int
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
o a more normal position that allows proper contraction of muscles for elimination.
ra ra ra ra ra ra ra ra ra ra ra ra
Laxatives would not give the hospital client control over bowel movements. A barium ene
ra ra ra ra ra ra ra ra ra ra ra ra ra
ma is a diagnostic test, not an intervention to promote defecation. Painrelief measures should be
ra ra ra ra ra ra ra ra ra ra ra ra ar ra ra
given; however, preventative action should be taken to prevent co nstipation.
ra ra ra ra ra ra ra ra ra
DIF:Apply (application) ra
OBJ:Discuss how psychological and physiological factors may alter the elimination process.
ra ra ra ra ra ra ra ra ra ra
TOP:Implementation MSC: Basic Care and Comfort ra ra ra
8. Which hospital client is most at risk for increased peristalsis?
ra ra ra ra ra ra ra ra ra
a. A 5-year-old child who ignores the urge to defecate owing to embarrassment
ra ra ra ra ra ra ra ra ra ra ra
b. A 21-year-old female with three final examinations on the same day
ra ra ra ra ra ra ra ra ra ra
c. A 40-year-old female with major depressive disorder
ra ra ra ra ra ra
d. An 80-year-old male in an assisted-living environment
ra ra ra ra ra ra
ACCURATE ANSWER:-B ra
Stress can stimulate digestion and increase peristalsis, resulting in diarrhea; three finals on th
ra ra ra ra ra ra ra ra ra ra ra ra ra
e same day is stressful. Ignoring the urge to defecate, depression, and agerelated changes of the ol
ar ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
der adult (80-yearold man) are causes of constipation, which is from slowed peristalsis.
ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Apply (application) ra
OBJ:Discuss how psychological and physiological factors may alter the elimination process. T
ra ra ra ra ra ra ra ra ra ra ar
OP:Assessment MSC: Psychosocial Integrity ra ra
