Chapter 35: Bowel Elimination

Chapter 35: Bowel Elimination

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A student nurse is caring for a patient who has dehydration as a result of diarrhea. Diarrhea is a result of abnormally fast peristalsis in what organ?

ANS:   D

The large intestine is the primary organ of bowel elimination. If peristalsis is abnormally fast in the colon, there is less time for water to be absorbed and the stool will be watery. The stomach is part of the upper GI system. The duodenum and jejunum are part of the small intestines.

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    994

OBJ:    Explain the physiology of digestion, absorption, and bowel elimination.

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Physiological Integrity

2. The labor/delivery nurse is caring for a 33-year-old who is in labor with her first child. The patient complained to the nurse about the hemorrhoids that she has experienced during the last month of her pregnancy. She asks, “what can I do to prevent future problems with hemorrhoids?” What is the nurse’s best response?

ANS:   B

Hemorrhoids are dilated, engorged veins in the lining of the rectum. Increased venous pressure resulting from straining at defecation, pregnancy, and chronic illnesses, such as congestive heart failure and chronic liver disease, are causative factors. A hemorrhoid forms either within the anal canal (internal) or through the opening of the anus (external). Passage of hard stool causes hemorrhoid tissue to stretch and bleed. Hemorrhoid tissue becomes inflamed and tender, and patients complain of itching and burning. Because pain worsens during defecation, the patient sometimes ignores the urge to defecate, resulting in constipation.

PTS:    1                      DIF:    Cognitive Level: Applying (Application)

REF:    997 | 1013

OBJ:    List nursing measures aimed at promoting normal elimination and defecation.

TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

3. The nurse caring for several patients on the surgical unit of the hospital. The nurse knows that constipation can be a significant health hazard and encourages the postoperative patients to drink fluids. Which one of the following patients is most at risk from complications related to constipation?

ANS:   B

Constipation is a significant health hazard. Straining during defecation causes problems for patients with recent abdominal, gynecological, or rectal surgery. An effort to pass a stool can cause sutures to separate, reopening a wound. In addition, patients with cardiovascular disease, diseases causing elevated intraocular pressure (glaucoma), and increased intracranial pressure need to prevent constipation and avoid using the Valsalva maneuver. Constipation is most often caused by changes in diet, medications, mobility, inflammation, environmental factors (e.g., unavailability of toilet facilities or lack of privacy), and lack of knowledge about regular bowel habits.

PTS:    1                      DIF:    Cognitive Level: Analyzing (Analysis)

REF:    994 | 996

OBJ:    List nursing measures aimed at promoting normal elimination and defecation.

TOP:    Nursing Process: Implementation      MSC:   Client Needs: Physiological Integrity

4. A patient will be undergoing abdominal surgeries, which will most likely result in an ostomy. The patient asks the nurse, “What will the stool from my ostomy look like?” What is the best answer?

ANS:   D

The location of an ostomy determines stool consistency. The more intestine remaining, the more formed and normal the stool. For example, an ileostomy bypasses the entire large intestine, creating frequent, liquid stools. A person with a sigmoid colostomy will have a more formed stool.

PTS:    1                      DIF:    Cognitive Level: Applying (Application)

REF:    997 | 998

OBJ:    Describe nursing care required to maintain structure and function of a bowel diversion.     TOP:            Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance