Chapter 49 Kozier And Erbs Fundamentals of Nursing 10th Edition by Berman Snyder

Chapter 49 Kozier And Erbs Fundamentals of Nursing 10th Edition by Berman Snyder

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Question 1

Type: MCSA

A client asks the RN why it is more difficult to use a bedpan for defecating than sitting on the toilet. Which would be the nurse’s best response?

1. The sitting position decreases the contractions of the muscles of the pelvic floor.
2. The sitting position increases the downward pressure on the rectum, making it easier to pass stool.
3. The sitting position increases the pressure within the abdomen.
4. The sitting position inhibits the urge to urinate, allowing one to defecate.

Correct Answer: 2

Rationale 1: Expulsion of the feces is assisted by contraction of the abdominal muscles and the diaphragm, which increases abdominal pressure, and by contraction of the muscles of the pelvic floor, which moves the feces through the anal canal.

Rationale 2: Normal defecation is facilitated by thigh flexion, which increases the pressure within the abdomen, and a sitting position, which increases the downward pressure on the rectum.

Rationale 3: Thigh flexion increases the pressure within the abdomen.

Rationale 4: The sitting position increases the downward pressure on the rectum.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

QSEN Competencies: I.A. 1.  Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1. Describe the physiology of defecation.

MNL Learning Outcome: 4.9.2. Recognize factors that affect bowel elimination.

Page Number: 1212

Question 2

Type: MCSA

A client asks the nurse why expelled flatus is foul-smelling. What should the nurse respond?

1. The actions of microorganisms within the gastrointestinal tract are responsible for the odor.
2. The client’s emotions are causing the gas formation.
3. The sensory nerves in the rectum are being stimulated.
4. The client has swallowed too much air while eating.

Correct Answer: 1

Rationale 1: The actions of the microorganisms are responsible for the odor produced and also the color of the feces.

Rationale 2: Extreme stimulation of the client’s emotions would result in large amounts of mucus being secreted.

Rationale 3: The sensory nerves, when stimulated, give one the desire to defecate, not form gas.

Rationale 4: Eating too fast or talking while eating does cause the formation of gas but does not contribute to the odor.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Basic Care and Comfort

QSEN Competencies: I.A. 1.  Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1. Describe the physiology of defecation.

MNL Learning Outcome: 4.9.2. Recognize factors that affect bowel elimination.

Page Number: 1212

Question 3

Type: MCSA

The home care nurse is reviewing a list of clients prior to making visits. For which client should the nurse plan interventions to decrease the risk of developing constipation?

1. An adult who is on bed rest
2. An infant who is breast-fed
3. A school-age child at recess
4. A toddler who is now walking

Correct Answer: 1

Rationale 1: Adults who are on bed rest are at greatest risk for developing constipation.

Rationale 2: Infants who are breast-fed pass stools frequently, usually after each feeding, because the intestine is immature and water is not well absorbed.

Rationale 3: School-age children may delay defecation because of play, but their activity still promotes regular bowel movements.

Rationale 4: A toddler who is now walking has some control of defecation, and the nervous and muscular systems are sufficiently well developed to permit bowel control.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1.  Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4. Identify common causes and effects of selected fecal elimination problems.

MNL Learning Outcome: 4.9.2. Recognize factors that affect bowel elimination.

Page Number: 1215