11/16/2024 10:16 AM
NSG203 Exam 3 Questions With Correct
Answers
A nurse who is administering a return-flow enema to a patient should instill 100 mL of enema
fluid and then....
A. instruct the patient to retain the fluid
B. lower the container to allow the solution to flow back out
C. help the patient to the toilet or beside commode
D. wait 5 min and instill another 100 mL of fluid - answer✔B. lower the container to allow the
solution to flow back out
A nurse is administering an enema medication with sodium polystyrene sulfonate (Kayexalate)
to an older adult patient who has hyperkalemia. The nurse should insert the tip of the rectal
tube...
A. 2.5-3.75 cm (1-1.5 in)
B. 5-7.5 cm (2-3 in)
C. 7.5-10 cm (3-4 in)
D. 10-12.5 cm (4-5 in) - answer✔C. 7.5-10 cm (3-4 in)
A nurse is preparing to administer a cleansing enema to a patient who is prone to fecal
incontinence due to poor sphincter control and is unlikely to retain the enema solution. Which
of the following interventions is appropriate for this patient?
A. Place the patient in the dorsal recumbent position on a bedpan
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B. Administer the enema while the patient sits on the toilet
C. Administer an antidiarrheal mediation 3hr prior to the enema
D. Instill 200mL of fluid at 15-minu intervals times four - answer✔A. Place the patient in the
dorsal recumbent position on a bedpan
A nurse is preparing to administer an oil-retention enema to a patient who has constipation.
The nurse explains that the patient should try to retain the instilled oil for
A. as long as it takes to complete the procedure
B. about 10-15 minutes
C. until the next time he feels the urge to defecate
D. at least 30 min, but preferably as long as he can - answer✔D. at least 30 min, but preferably
as long as he can
While a nurse is administering a cleansing enema, the patient reports abdominal cramping.
Which of the following is the appropriate intervention?
A. measure the patient's vital signs
B. notify the PCP
C. lower the enema fluid container
D. stop the enema instillation - answer✔C. lower the enema fluid container
A patient who is Post Op is experiencing abdominal distention and is having difficulty expelling
flatus. The nurse should anticipate receiving and order from the provider for which of the
following types of enemas?
A. Cleansing
B. Return-flow
C. Medicated
D. Oil-retention - answer✔B. Return-flow
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A nurse is preparing to administer the first of two large-volume, cleansing enemas prescribed
for a patient in preparation for a diagnostic procedure. Which of the following is an appropriate
step in the procedure?
A. warm the enema solution prior to instillation
B. prepare 1500 mL of enema fluid
C. use tap water as the enema fluid
D. hang the enema container 24 inches above the anus - answer✔A. warm the enema solution
prior to instillation
A nurse is preparing an older adult patient for an enema. The nurse should assist the patient to
which of the following positions?
A. prone
B. dorsal recumbent
C. right lateral with both knees at chest
D. left lateral with the right leg flexed - answer✔D. left lateral with the right leg flexed
A nurse is applying a condom catheter for an older adult patient who is uncircumcised. Which
of the following is an appropriate step in this procedure?
A. stretching the catheter along the length of the penis
B. Securing the catheter with adhesive tape
C. Leaving a space between the penis and catheter's tip
D. repositioning the foreskin after application - answer✔C. Leaving a space between the penis
and catheter's tip
A nurse is likely to receive an order for urinary catheterization of a newly admitted patient
who...
A. has a persistent UTI
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