NURS 325 Exam 3 Review Questions With Complete
Solutions
. A nurse is collecting a bowel elimination history from a newly
admitted patient with a medical diagnosis of possible bowel
obstruction. Which question takes
priority ?
1. "Do you use anything to help you move your bowels?"
2. "When was the last time you moved your bowels?"
3. "What color are your usual bowel movements?"
4. "How often do you have a bowel movement?" Correct
Answers "How often do you have a bowel movement?"
. A primary health-care provider orders a return-flow enema
(Harris flush/drip) for an adult patient with flatulence. When
preparing to administer this enema the nurse compares the steps
of a return-flow enema with cleansing enemas. Which nursing
intervention is unique to a return-flow enema?
1. Lubricate the last 2 inches of the rectal tube.
2. Insert the rectal tube about 4 inches into the anus.
3. Raise the solution container about 12 inches above the anus.
4. Lower the solution container after instilling about 150 mL of
solution. Correct Answers Lower the solution container after
instilling about 150 ml of solution
. Which statements by a patient with diverticulosis alert the
nurse that the patient
needs additional health teaching? Select all that apply.
,1. _____" I should avoid eating high-fiber cereal."
2. _____" I sit on the toilet for 10 minutes after breakfast every
day."
3. _____" I am going to drink 8 glasses of water a day when I
get home."
4. _____" I should hold my breath and bear down when having a
bowel movement."
5. _____ "I like to massage my lower abdomen when I'm trying
to have a bowel
movement." Correct Answers 1. " I should avoid eating high-
fiber cereal."
4. "I should hold my breath and bear down when having a bowel
movement"
.The nurse teaches a patient how to use an incentive spirometer.
What patient outcome will support the conclusion that the use of
the incentive spirometer was effective?
1. Supplemental oxygen use will be reduced
2. Inspiratory volume will be increased
3. Sputum will be expectorated
4. Coughing will be stimulated Correct Answers Inspiratory
volume will be increased
16. A nurse is caring for a patient who has a chest tube after
thoracic surgery. What should the nurse do when caring for this
patient?
1. Encourage the patient to cough and deep breathe at regular
intervals
2. Clamp the tube when providing for activities of daily living
,3. Position the collection device at the same level as the chest
4. Maintain an airtight dressing over the puncture wound
5. Empty chest tube drainage every shift Correct Answers 1.
Encourage the patient to cough and deep breathe at regular
intervals
4. Maintain an airtight dressing over the puncture wound
A hospitalized patient who has been receiving medications via a
variety of routes for several days is scheduled for surgery at
10:00am. What should the nurse plan to do on the day of
surgery?
1. Use an alternative route for oral medications
2. Withhold all the previously prescribed medications
3. Withhold the oral medications and administer the other drugs
4. Obtain directions from the practitioner regarding the
medications Correct Answers Obtain directions from the
practitioner regarding the medications
A meal tray arrives for a patient who is receiving 24% oxygen
via a Venturi mask. What should the nurse do to meet this
patient's needs?
1. Request an order to use a nasal cannula during meals
2. Discontinue the oxygen when the patient is eating meals
3. Obtain an order to change the mask to a nonrebreather mask
during meals
4. Arrange for liquid supplements that can be administered via a
straw through a valve in the mask Correct Answers Request an
order to use a nasal cannula during meals
, A nurse caring for a patient who had an abdominal
hysterectomy. Which intervention best prevents postoperative
thrombophlebitis?
1. Utilization of compression stocking at night
2. Deep breathing and coughing exercises daily
3. Leg exercises 10 times per hour when awake
4. Elevation of the legs on 2 pillows Correct Answers Leg
exercises 10 times per hour when awake
A nurse determines that the teaching about a guaiac test of stool
is understood when the patient states that it identifies the
presence of which of the following?
1. Ova and parasites
2. Hidden blood
3. Bacteria
4. Bile Correct Answers hidden blood
A nurse discourages a patient from straining excessively when
attempting to have a bowel movement. Which undesirable
physiological response is the primary reason why straining on
defecation should be avoided?
1. Dysrhythmia
2. Incontinence
3. Fecal impaction
4. Rectal hemorrhoid Correct Answers dysrhythmia
Solutions
. A nurse is collecting a bowel elimination history from a newly
admitted patient with a medical diagnosis of possible bowel
obstruction. Which question takes
priority ?
1. "Do you use anything to help you move your bowels?"
2. "When was the last time you moved your bowels?"
3. "What color are your usual bowel movements?"
4. "How often do you have a bowel movement?" Correct
Answers "How often do you have a bowel movement?"
. A primary health-care provider orders a return-flow enema
(Harris flush/drip) for an adult patient with flatulence. When
preparing to administer this enema the nurse compares the steps
of a return-flow enema with cleansing enemas. Which nursing
intervention is unique to a return-flow enema?
1. Lubricate the last 2 inches of the rectal tube.
2. Insert the rectal tube about 4 inches into the anus.
3. Raise the solution container about 12 inches above the anus.
4. Lower the solution container after instilling about 150 mL of
solution. Correct Answers Lower the solution container after
instilling about 150 ml of solution
. Which statements by a patient with diverticulosis alert the
nurse that the patient
needs additional health teaching? Select all that apply.
,1. _____" I should avoid eating high-fiber cereal."
2. _____" I sit on the toilet for 10 minutes after breakfast every
day."
3. _____" I am going to drink 8 glasses of water a day when I
get home."
4. _____" I should hold my breath and bear down when having a
bowel movement."
5. _____ "I like to massage my lower abdomen when I'm trying
to have a bowel
movement." Correct Answers 1. " I should avoid eating high-
fiber cereal."
4. "I should hold my breath and bear down when having a bowel
movement"
.The nurse teaches a patient how to use an incentive spirometer.
What patient outcome will support the conclusion that the use of
the incentive spirometer was effective?
1. Supplemental oxygen use will be reduced
2. Inspiratory volume will be increased
3. Sputum will be expectorated
4. Coughing will be stimulated Correct Answers Inspiratory
volume will be increased
16. A nurse is caring for a patient who has a chest tube after
thoracic surgery. What should the nurse do when caring for this
patient?
1. Encourage the patient to cough and deep breathe at regular
intervals
2. Clamp the tube when providing for activities of daily living
,3. Position the collection device at the same level as the chest
4. Maintain an airtight dressing over the puncture wound
5. Empty chest tube drainage every shift Correct Answers 1.
Encourage the patient to cough and deep breathe at regular
intervals
4. Maintain an airtight dressing over the puncture wound
A hospitalized patient who has been receiving medications via a
variety of routes for several days is scheduled for surgery at
10:00am. What should the nurse plan to do on the day of
surgery?
1. Use an alternative route for oral medications
2. Withhold all the previously prescribed medications
3. Withhold the oral medications and administer the other drugs
4. Obtain directions from the practitioner regarding the
medications Correct Answers Obtain directions from the
practitioner regarding the medications
A meal tray arrives for a patient who is receiving 24% oxygen
via a Venturi mask. What should the nurse do to meet this
patient's needs?
1. Request an order to use a nasal cannula during meals
2. Discontinue the oxygen when the patient is eating meals
3. Obtain an order to change the mask to a nonrebreather mask
during meals
4. Arrange for liquid supplements that can be administered via a
straw through a valve in the mask Correct Answers Request an
order to use a nasal cannula during meals
, A nurse caring for a patient who had an abdominal
hysterectomy. Which intervention best prevents postoperative
thrombophlebitis?
1. Utilization of compression stocking at night
2. Deep breathing and coughing exercises daily
3. Leg exercises 10 times per hour when awake
4. Elevation of the legs on 2 pillows Correct Answers Leg
exercises 10 times per hour when awake
A nurse determines that the teaching about a guaiac test of stool
is understood when the patient states that it identifies the
presence of which of the following?
1. Ova and parasites
2. Hidden blood
3. Bacteria
4. Bile Correct Answers hidden blood
A nurse discourages a patient from straining excessively when
attempting to have a bowel movement. Which undesirable
physiological response is the primary reason why straining on
defecation should be avoided?
1. Dysrhythmia
2. Incontinence
3. Fecal impaction
4. Rectal hemorrhoid Correct Answers dysrhythmia
