CHAPTER 39: ELIMINATION

CHAPTER 39: ELIMINATION

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A client has a urinary tract infection and experiences an episode of urinary incontinence. The nurse would classify this type of urinary incontinence as being:

ANS:  A

Acute urinary incontinence is transient and reversible. It can occur during an acute illness. Common causes include urinary tract infection. There are four types of chronic urinary incontinence, two of which are stress and instability. Stress urinary incontinence is the uncontrolled loss of urine caused by physical exertion in the absence of a detrusor muscle contraction. Instability urinary incontinence is the loss of urine by a premature or hyperactive contraction of the detrusor muscle.

PTS:   1                    DIF:    Analysis

REF:   Common Alterations in Elimination: Urinary Elimination

2. The client has severe arthritis and is unable to go upstairs quickly to the bathroom located on the second floor. The client has occasional incontinence. The nurse would classify this type of incontinence as being:

ANS:  B

Functional incontinence is the loss of urine caused by altered mobility, dexterity, access to the toilet, or changes in mentation. Urge incontinence and reflex incontinence are two types within the category of instability incontinence, which is the loss of urine caused by a premature or hyperactive contraction of the detrusor. Urethra hypermobility is a characteristic of stress incontinence, which is the uncontrolled loss of urine caused by physical exertion in the absence of a detrusor muscle contraction.

PTS:   1                    DIF:    Analysis

REF:   Common Alterations in Elimination: Urinary Elimination

3. A client tells the nurse that she wants to be checked for a bowel infection because she has been constipated. The nurse should instruct this client that constipation is NOT caused by:

ANS:  D

Constipation is caused by dehydration, which dries the stool; inadequate dietary bulk; and diverticular disease. Infectious agents would not cause constipation but rather, diarrhea.

PTS:   1                    DIF:    Application    REF:   Bowel Elimination: Constipation

4. A client tells the nurse that he experiences episodes of diarrhea that occur for days and he has no idea why. The nurse realizes that a cause of diarrhea would be:

ANS:  B

Diarrhea is the passage of liquefied stool that occurs frequently. The primary causes of diarrhea include infectious agents, malabsorption disorders, inflammatory bowel disease, short bowel syndrome, side effects of drugs, and laxative or enema misuse. Overhydration and low-fiber diets do not cause constipation. Anticholinergic drugs could cause constipation.

PTS:   1                    DIF:    Analysis         REF:   Diarrhea

5. A client tells the nurse that at times she is incontinent of stool. Which condition is most likely to cause fecal incontinence in a normally continent individual?

ANS:  A

Fecal incontinence is the involuntary loss of stool. Normally, the rectum is able to accommodate 400 mL of feces at low pressure, but if the volume of stool is overwhelming, as with diarrhea, fecal incontinence can occur. Ignoring the initial urge to defecate will not cause fecal incontinence. Sphincter weakness develops over time and would not cause fecal incontinence in a normally continent individual. Eating a large meal quickly is not known to be a cause of fecal incontinence.

PTS:   1                    DIF:    Analysis         REF:   Fecal Incontinence