Exam #3 (Week 7) NURS 2821

1. What does the large intestine do and how does transit affect stool?

Absorbs water and forms feces → slow transit causes constipation

2. Which foods help constipation?

Fruits, high-fiber foods, vegetables, and bran-rich foods.

3. Which foods and medications cause constipation?

Cheese, Lean meat, Eggs, Pasta, Opioids, and Antacids

4. Which foods and medications may cause diarrhea?

Antibiotics, Laxative foods, alcohol, coffee, magnesium, and metformin

5. Which foods produce gas?

Beans, onions, cabbage, and cauliflower

6. Why can fiber worsen constipation?

Fiber without enough fluid increases bulk and hardens stool

7. Which patients are at high risk for constipation?

Limited mobility, constipating medications, low fluid or fiber intake, depression, painful defecation from CNS disease or lesions.

8. What bowel history should the nurse obtain?

Usual pattern, meaning the patient’s unique baseline frequency, consistency, and comfort.

9. Why auscultate bowel sounds before palpation?

Touching the abdomen can alter bowel sounds

10. What is normal adult stool?

Brown, soft, and formed.

11. What do hard dry stools indicate?

Constipation from slow intestinal transit.

12. What do liquid stools indicate?

Diarrhea and rapid transit → Bristol types 6–7

13. What can black tarry stool indicate?

Upper Gastrointestinal bleeding or iron supplements.

14. What can red stool indicate?

Lower GI bleeding

15. What can pale clay-colored stool indicate?

Absence of bile

16. What can pencil-shaped stool suggest?

Obstruction or rapid peristalsis

17. What can mucus in stool indicate?

Intestinal inflammation or irritation

18. What finding suggests fecal impaction?

Hardened stool mass + distention + liquid stool leaking around it

19. Why hold antidiarrheals when impaction is possible?

Liquid stool may be leaking around a hard impaction, and the medication can worsen the blockage.

20. What signs may indicate colorectal cancer?

Rectal bleeding, blood in the stool, and persistent changes in bowel habits or stool consistency.

21. What does a fecal occult blood test detect?

Hidden blood in stool

22. How should a stool specimen be collected?

Using medical asepsis

23. Which test examines the esophagus, stomach, and duodenum?

The esophagogastroduodenoscopy (EGD) examines the esophagus, stomach, and duodenum.

24. Which test examines the rectum, colon, and distal small bowel?

Colonoscopy

25. Which test examines the distal sigmoid colon?

Sigmoidoscopy

26. What is the difference between direct and indirect GI testing?

Direct = scope visualization; indirect = imaging such as x-ray

27. What is constipation?

Constipation is hard, dry stool with straining and fewer bowel movements than usual

28. What is bowel incontinence?

Loss of voluntary control of stool or gas

29. What is the priority for a patient with diarrhea?

Maintaining fluids and electrolytes balance to prevent dehydration + protect perianal skin

30. What interventions promote regular bowel elimination?

Encouraging going to the toilet after meals and exercise.

31. Why is toileting after meals helpful?

The gastrocolic reflex stimulates colon movement after eating

32. What is the best position for an enema?

Left side-lying Sims position → follows the natural rectosigmoid curve

33. What is the purpose of a cleansing enema?

Distends the colon → stimulates peristalsis and evacuation of stools

34. What is the purpose of a hypertonic enema?

Draws fluid into the bowel (the intestines)→ softens stool

35. What is the purpose of an oil-retention enema?

Lubricates stool and intestinal mucosa

36. What is the purpose of a carminative enema?

Helps expel flatus (gas expelled through the anus).

37. What enema treats intestinal parasites?

Anthelmintic enema

38. What is the goal of bowel training?

To produce soft, formed stool at regular intervals without laxatives.

39. What is the expected output from a sigmoid or descending colostomy?

More formed stool that may become regulated

40. What is the expected output from a transverse or ascending colostomy?

Mushy to semi-liquid stool

41. What is the expected output from an ileostomy?

Liquid, continuous output that contains enzymes and can irritate the skin.

42. What does a healthy bowel stoma look like?

Moist and dark pink to red

43. What does a pale or dusky stoma indicate?

A pale stoma may indicate anemia, while a dusky stoma may indicate poor blood supply.

44. What diet is recommended after a new colostomy?

Low fiber for the first 6–8 weeks + adequate fluids

45. How much fluid should a colostomy patient generally drink daily?

At least 2.5 quarts unless restricted

46. Which foods may cause ostomy blockage?

Nuts, corn, popcorn, coconut, and mushrooms.

47. Which foods can thicken ostomy output?

Bananas, rice, yogurt, and applesauce

48. What is the purpose of an ileoanal pouch?

It allows stool to pass through the anus after the colon and rectum are removed by creating a J-pouch from the ileum

49. What is the main function of the kidneys?

Filter blood to form urine and regulate fluid.

50. Why are females at higher risk for UTIs?

The female urethra is shorter → bacteria reach the bladder more easily

51. What is normal adult urine output?

About 1,400 mL per day

52. What is oliguria?

Urine output less than about 400 mL/day

53. What is anuria?

Little to no urine production → possible severe kidney dysfunction → Urine output less than 50mL in 24 hours.

54. What do dysuria, urine urgency, and urine frequency indicate?

It may indicate a Urinary Tract Infection (UTI).

55. What is urinary retention?

Incomplete bladder emptying → hesitancy, distention, frequent small voids.

56. Which finding best supports urinary retention?

Small amounts of urine every few hours + bladder fullness or distention

57. What confirms suspected urinary retention?

Bladder palpation or bladder scan for residual urine

58. What is stress incontinence?

It is pressure such as coughing, sneezing, laughing, or lifting that causes urine leakage.

59. What is urge incontinence?

Sudden urgency followed by involuntary urine loss

60. What is overflow incontinence?

Dribbling from an overdistended bladder due to incomplete emptying

61. What is functional incontinence?

The patient cannot reach or use the toilet because of immobility

62. What is reflex incontinence?

The bladder empties without awareness → often caused by neurologic injury

63. What atypical UTI signs may occur in older adults?

New confusion

64. What promotes normal urination?

Privacy, a comfortable position, adequate fluids, and enough time to void.

65. What fluid intake is generally encouraged for urinary health?

About 2,000 to 3,000 mL of fluid daily unless restricted

66. How do Kegel exercises help?

Strengthen pelvic floor muscles → improve urethral closure → reduce stress incontinence

67. What is bladder training?

Gradually lengthening time between voids → increases bladder capacity and reduces urgency

68. What is timed or prompted voiding?

Toileting on a schedule every 2–4 hours → helpful for cognitive impairment

69. How should incontinence-associated skin damage be prevented?

Clean promptly with a pH-balanced cleanser and apply a moisture barrier.

70. What is the purpose of intermittent catheterization?

Temporarily empties the bladder, especially with urinary retention, while lowering infection risk.

71. What is the purpose of an indwelling Foley catheter?

Continuous drainage using a balloon to keep the catheter in the bladder

72. What is a triple-lumen catheter used for?

Continuous bladder irrigation through an extra port

73. What is the most effective CAUTI-prevention action?

Assess the need daily → remove the catheter as soon as possible

74. How should the catheter drainage bag be positioned?

Below bladder level and off the floor → prevents backflow and contamination

75. Why must the catheter drainage system remain closed?

Opening it introduces bacteria → increases CAUTI risk

76. How should catheter tubing be positioned?

Free of kinks and dependent loops → maintains urine flow

77. Why secure an indwelling catheter?

Prevents tension, pulling, and urethral trauma.

78. How should a urine culture be collected from an indwelling catheter?

Clean the sampling port → aspirate fresh urine with a sterile syringe

79. Why should urine not be collected from the drainage bag?

Bag urine may be stale or contaminated → inaccurate results

80. What does an ileal conduit do?

Diverts urine through intestine into an external pouch → continuous drainage

81. What is expected in ileal conduit urine?

Some mucus because the conduit is made from intestine

82. How full should a urinary diversion pouch be before emptying?

Empty at one-third to one-half full

84. What do decreased urine output and edema indicate?

Impaired Kidney function

85. What is a critical lab value?

A life-threatening abnormal result requiring prompt action and documentation

86. What should the nurse do after receiving a critical lab value?

Assess the patient → notify the provider using SBAR → read back and document

87. What do low hemoglobin and hematocrit suggest?

Anemia → decreased oxygen-carrying capacity and hypoxia risk

88. What do abnormal WBC and platelet counts suggest?

High WBC = infection or inflammation; low platelets = bleeding risk; high platelets = thrombosis risk

89. What are the normal sodium and potassium ranges?

Sodium 135–145 mEq/L; potassium 3.5–5.0 mEq/L

90. Why are severe sodium and potassium abnormalities dangerous?

Na⁺ <120 → seizures; K⁺ >6.5 → dysrhythmias and cardiac arrest

91. What do elevated BUN and creatinine suggest?

Reduced kidney filtration or impaired renal function

92. What do elevated ALT and AST suggest?

Hepatocellular injury

93. What do elevated alkaline phosphatase and bilirubin suggest?

Cholestasis

94. What does low albumin suggest?

Malnutrition or liver disease

95. What is the therapeutic INR range for many patients taking warfarin?

About 2.0–3.0

96. What does an INR greater than 5 indicate?

High bleeding risk → assess for bleeding and notify the provider

97. What does a very high aPTT in a patient receiving heparin suggest?

Excess anticoagulation → bleeding risk

98. What do protein and WBCs in the urine indicate?

Protein may indicate kidney disease, while WBCs may indicate a urinary tract infection or inflammation.

99. What are common signs of medication toxicity?

Digoxin → dysrhythmias or visual changes; phenytoin → nystagmus or ataxia; theophylline → seizures or dysrhythmias

100. What is the safest way to interpret laboratory results?

Compare reference ranges → assess trends → correlate with the patient → report critical values promptly