A client has a sigmoid colostomy. When the bowel has recovered, the nurse expects the stool to be:

Formed, like a normal bowel movement

Liquid and continuous throughout the day

Mushy and semi-liquid most of the time

Watery and rich in digestive enzymes

Nutrition, tube feeding, intake and output and elimination

52 NCLEX-RN practice questions on Nutrition, tube feeding, intake and output and elimination, part of Basic Care and Comfort. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
During a 0700-1500 shift a client receives IV fluid at 75 mL/h for the whole shift. The client drinks 180 mL of coffee and 120 mL of juice at breakfast, 240 mL of milk at lunch, and eats 300 mL of ice chips. Vomitus totals 150 mL. The client's total intake for the shift is:
1. A1,140 mL
2. B1,290 mL
3. C690 mL
4. D1,440 mL
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Answer: B · 1,290 mL
The IV gives 75 mL/h x 8 h = 600 mL. Oral fluids are 180 + 120 + 240 = 540 mL, and ice chips count as about half their volume, 150 mL. The total is 600 + 540 + 150 = 1,290 mL; vomitus is output and is not subtracted from intake. The item tests recognising and analysing cues in a calculation.
- A: 1,140 mL leaves out the ice chips, or subtracts the vomitus.
- C: 690 mL leaves out the IV fluid.
- D: 1,440 mL counts the ice chips at their full volume.
Question 2 · Easy
On the second day after a colostomy is created, the nurse notes the expected appearance of a healthy stoma:
1. AMoist and red to pink
2. BDry and pale pink
3. CDark purple and dry
4. DDusky blue and moist
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Answer: A · Moist and red to pink
A healthy stoma is moist and red to pink, much like the inside of the mouth, because it is well-perfused bowel mucosa. Mild oedema is expected for the first weeks. Pallor, a dusky or purple colour, or a dry surface suggest poor blood supply and must be reported at once. The item tests recognising normal versus abnormal cues.
- B: A pale, dry stoma suggests poor perfusion or anaemia, not normal healing.
- C: Dark purple and dry suggests necrosis and needs urgent reporting.
- D: A dusky blue colour indicates early ischaemia.
Question 3 · Medium
A client has a sigmoid colostomy. When the bowel has recovered, the nurse expects the stool to be:
1. AFormed, like a normal bowel movement
2. BLiquid and continuous throughout the day
3. CMushy and semi-liquid most of the time
4. DWatery and rich in digestive enzymes
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Answer: A · Formed, like a normal bowel movement
The further along the colon the stoma lies, the more water has been absorbed, so a sigmoid colostomy passes formed stool. A transverse colostomy produces mushy stool, and an ileostomy or ascending colostomy produces liquid, enzyme-rich output. Knowing the expected output lets the nurse spot abnormal changes. The item tests recognising cues.
- B: Continuous liquid output is typical of an ileostomy.
- C: Mushy stool is typical of a transverse colostomy.
- D: Watery, enzyme-rich output comes from an ileostomy and is irritating to skin.
Question 4 · Medium
An 84-year-old resident has had no formed stool for 6 days and now has small amounts of liquid stool seeping several times a day. The nurse should first suspect:
1. ALactose intolerance
2. BViral gastroenteritis
3. CFecal impaction with overflow
4. DLaxative-induced diarrhoea
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Answer: C · Fecal impaction with overflow
Liquid stool can leak around a hard mass of retained stool in the rectum. In an older adult with no formed stool for days, seepage of liquid stool is a classic cue of impaction rather than true diarrhoea. The nurse checks for impaction before giving any antidiarrhoeal, which would make it worse. The item tests prioritising hypotheses.
- A: Lactose intolerance gives diarrhoea after dairy, not prolonged retention.
- B: Gastroenteritis would follow a normal stool pattern, not 6 days without stool.
- D: Nothing in the history points to laxative use.
Question 5 · Medium
A severely malnourished client started enteral feeding yesterday. To detect refeeding syndrome, the result the nurse should monitor most closely is:
1. ASerum albumin
2. BSerum creatinine
3. CSerum amylase
4. DSerum phosphorus
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Answer: D · Serum phosphorus
When feeding restarts after starvation, insulin release drives phosphorus, potassium and magnesium into cells, and serum levels can fall sharply in the first days. Hypophosphataemia is the hallmark and can cause muscle weakness, respiratory failure and heart failure. Feeds are started slowly and electrolytes are checked daily. The item tests recognising cues.
- A: Albumin changes too slowly to signal refeeding syndrome.
- B: Creatinine reflects kidney function and is not the key marker.
- C: Amylase reflects pancreatic injury, not refeeding.
Question 6 · Hard
Day 4 after ileostomy creation. Nurses' notes: output 2,600 mL of watery effluent in 24 hours, client dizzy on standing. BP lying 118/72 mm Hg, standing 94/60 mm Hg; pulse 112/min; urine 20 mL/h, dark amber. Which problem should the nurse address first?
1. AFluid volume deficit from high stoma output
2. BParalytic ileus after bowel surgery
3. CInfection of the peristomal skin
4. DSmall bowel obstruction behind the stoma
Answer and explanation in LearnFree account
Question 7 · Hard
A client with a high thoracic cord injury develops autonomic dysreflexia. The nurse has already raised the head of the bed and loosened the leg straps; BP is still 204/116 mm Hg. The catheter bag holds 40 mL, the same as at 1000. What should the nurse do next?
1. AInspect the catheter and tubing for a kink or blockage
2. BGive the PRN antihypertensive before anything else
3. CPerform a digital rectal check for impacted stool
4. DLower the head of the bed to lie the client flat
Answer and explanation in LearnFree account
Question 8 · Medium
A client who had a partial gastrectomy is taught how to prevent dumping syndrome. Which statement indicates a need for further teaching?
1. AI will choose protein foods and limit sweets and sugar.
2. BI will eat six small meals a day instead of three.
3. CI will lie down for about 30 minutes after I eat.
4. DI will drink a large glass of water with each meal.
Answer and explanation in LearnFree account
Question 9 · Hard
After a transurethral resection of the prostate, a client has continuous bladder irrigation. During the shift 3,000 mL of irrigant is instilled, and the drainage bag holds 3,850 mL at the end of the shift. The client's actual urine output is:
1. A3,850 mL
2. B3,000 mL
3. C6,850 mL
4. D850 mL
Answer and explanation in LearnFree account
Question 10 · Medium
A client receives continuous nasogastric feeding at 60 mL/h. At 0800 the nurse aspirates a gastric residual of 180 mL; the abdomen is soft and the client denies nausea. Facility protocol holds feeding only for a residual over 500 mL. What should the nurse do?
1. AStop the feeding and notify the health care provider
2. BReduce the rate to 30 mL/h and recheck in 4 hours
3. CReturn the aspirate and continue the feeding at 60 mL/h
4. DDiscard the aspirate and hold the feeding for 1 hour
Answer and explanation in LearnFree account
Question 11 · Medium
A client with dysphagia after a stroke is prescribed nectar-thick liquids. Which action by the assistive personnel requires the nurse to intervene?
1. AOffering the thickened juice through a drinking straw
2. BReminding the client to tuck the chin when swallowing
3. CPlacing food on the unaffected side of the mouth
4. DSeating the client fully upright for the meal
Answer and explanation in LearnFree account
Question 12 · Medium
A client with urge urinary incontinence starts bladder training. The nurse's instructions should include the advice to:
1. AWear absorbent pads so that a voiding schedule is not needed
2. BDrink little or no fluid during the day to reduce the urges
3. CVoid whenever the urge comes, even if that is every 30 minutes
4. DVoid on a set schedule and slowly lengthen the time between voids
Answer and explanation in LearnFree account
Question 13 · Medium
The nurse observes an assistive personnel caring for a client with an indwelling urinary catheter. Which action requires the nurse to intervene?
1. ASecuring the catheter tubing to the client's upper thigh
2. BEmptying the bag into a container used only for that client
3. CPlacing the drainage bag on the floor beside the bed
4. DCleaning the urinary meatus with soap and water
Answer and explanation in LearnFree account
Question 14 · Easy
The nurse teaches pelvic floor (Kegel) exercises to a client with stress urinary incontinence. Which statement shows the teaching was understood?
1. AI tighten my buttocks and thigh muscles together
2. BI bear down as if I am having a bowel movement
3. CI practise by stopping my urine stream every time I void
4. DI squeeze the muscles I would use to stop passing urine
Answer and explanation in LearnFree account
Question 15 · Hard
Four clients on a surgical unit have bowel or urinary needs this morning. Which client should the nurse assess first?
1. AA client with a new urinary catheter who reports an urge to void
2. BA client 1 day after colostomy creation whose stoma is now dark purple
3. CA client with a 5-day-old ileostomy who has 900 mL of output in 24 hours
4. DA client with a gastrostomy tube that has a small leak of clear fluid at the site
Answer and explanation in LearnFree account
Question 16 · Hard
A client with cirrhosis and hepatic encephalopathy receives oral lactulose. Two days ago the client was confused with asterixis. Which finding today best shows that the therapy is working?
1. ATwo or three soft stools a day and clearer thinking
2. BNo stool for 2 days and a soft, non-tender abdomen
3. COne formed stool every second day and no cramping
4. DSix watery stools a day and a drop in blood pressure
Answer and explanation in LearnFree account
Question 17 · Medium
A client with chronic kidney disease has a serum potassium of 5.8 mEq/L (reference 3.5-5.0). The best snack choice for this client is:
1. AA banana
2. BA baked potato
3. CAn orange
4. DApple slices
Answer and explanation in LearnFree account
Question 18 · Medium
A client weighing 70 kg is 6 hours after abdominal surgery. Which finding on the intake and output record should the nurse report to the health care provider?
1. AIntake of 1,900 mL and output of 1,650 mL since surgery
2. BUrine output of 75 mL over the past 4 hours
3. CDark yellow urine with an output of 45 mL in the last hour
4. DNasogastric drainage of 200 mL of green fluid in 8 hours
Answer and explanation in LearnFree account
Question 19 · Easy
A client with heart failure is on a 2-g sodium diet. The lunch choice from the menu that fits this diet best is:
1. ACanned chicken noodle soup with crackers
2. BHam and cheese sandwich on white bread
3. CRoasted chicken breast with steamed rice
4. DFrozen pepperoni pizza with a side salad
Answer and explanation in LearnFree account
Question 20 · Medium
A client starts scheduled oral morphine for cancer pain. The most appropriate regimen to prevent constipation is:
1. AA soapsuds enema every morning
2. BMineral oil at bedtime every night
3. CA daily stimulant laxative with a stool softener
4. DPsyllium only when no stool for 3 days
Answer and explanation in LearnFree account
Question 21 · Hard
A client's urine output from an indwelling catheter was 50-60 mL/h but has been 0 mL for the past 2 hours. The client reports suprapubic discomfort. What should the nurse do first?
1. ANotify the provider of possible acute kidney injury
2. BReplace the catheter with a new sterile catheter
3. CIrrigate the catheter with 60 mL of sterile saline
4. DCheck the tubing for kinks and the bag position
Answer and explanation in LearnFree account
Question 22 · Medium
A client with a spinal cord injury begins a bowel training programme. The nurse should plan the daily bowel routine for:
1. AEvery other day before lunch
2. BAbout 30 minutes after breakfast
3. CJust before the client goes to sleep
4. DWhenever the client feels the urge
Answer and explanation in LearnFree account
Question 23 · Medium
A client newly diagnosed with celiac disease asks what she can eat for dinner. The meal the nurse should recommend is:
1. AChicken pasta with a creamy sauce
2. BBeef and barley soup with a bread roll
3. CGrilled fish with rice and steamed carrots
4. DRye toast with scrambled eggs
Answer and explanation in LearnFree account
Question 24 · Hard
A client with a 2-week-old colostomy reports burning skin around the stoma. The peristomal skin is red and weeping in a ring that matches the barrier opening, which the client cuts to 1/2 inch wider than the stoma. What should the nurse do?
1. AAsk the provider for an oral antibiotic for the infection
2. BLeave the pouch off for a day so the skin can air dry
3. CApply a thick layer of petroleum jelly under the barrier
4. DRemeasure the stoma and cut the barrier 1/8 inch wider
Answer and explanation in LearnFree account
Question 25 · Hard
A client needs 1,800 kcal a day from a formula that provides 1.5 kcal/mL. The feeding runs continuously for 20 hours each day and is held for 4 hours for therapy. The nurse should set the pump to run at:
1. A75 mL/h
2. B50 mL/h
3. C60 mL/h
4. D90 mL/h
Answer and explanation in LearnFree account

27 more Nutrition, tube feeding, intake and output and elimination questions

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Nutrition, tube feeding, intake and output and elimination

During a 0700-1500 shift a client receives IV fluid at 75 mL/h for the whole shift. The client drinks 180 mL of coffee and 120 mL of juice at breakfast, 240 mL of milk at lunch, and eats 300 mL of ice chips. Vomitus totals 150 mL. The client's total intake for the shift is:

On the second day after a colostomy is created, the nurse notes the expected appearance of a healthy stoma:

A client has a sigmoid colostomy. When the bowel has recovered, the nurse expects the stool to be:

An 84-year-old resident has had no formed stool for 6 days and now has small amounts of liquid stool seeping several times a day. The nurse should first suspect:

A severely malnourished client started enteral feeding yesterday. To detect refeeding syndrome, the result the nurse should monitor most closely is:

Day 4 after ileostomy creation. Nurses' notes: output 2,600 mL of watery effluent in 24 hours, client dizzy on standing. BP lying 118/72 mm Hg, standing 94/60 mm Hg; pulse 112/min; urine 20 mL/h, dark amber. Which problem should the nurse address first?

A client with a high thoracic cord injury develops autonomic dysreflexia. The nurse has already raised the head of the bed and loosened the leg straps; BP is still 204/116 mm Hg. The catheter bag holds 40 mL, the same as at 1000. What should the nurse do next?

A client who had a partial gastrectomy is taught how to prevent dumping syndrome. Which statement indicates a need for further teaching?

After a transurethral resection of the prostate, a client has continuous bladder irrigation. During the shift 3,000 mL of irrigant is instilled, and the drainage bag holds 3,850 mL at the end of the shift. The client's actual urine output is:

A client receives continuous nasogastric feeding at 60 mL/h. At 0800 the nurse aspirates a gastric residual of 180 mL; the abdomen is soft and the client denies nausea. Facility protocol holds feeding only for a residual over 500 mL. What should the nurse do?

A client with dysphagia after a stroke is prescribed nectar-thick liquids. Which action by the assistive personnel requires the nurse to intervene?

A client with urge urinary incontinence starts bladder training. The nurse's instructions should include the advice to:

The nurse observes an assistive personnel caring for a client with an indwelling urinary catheter. Which action requires the nurse to intervene?

The nurse teaches pelvic floor (Kegel) exercises to a client with stress urinary incontinence. Which statement shows the teaching was understood?

Four clients on a surgical unit have bowel or urinary needs this morning. Which client should the nurse assess first?

A client with cirrhosis and hepatic encephalopathy receives oral lactulose. Two days ago the client was confused with asterixis. Which finding today best shows that the therapy is working?

A client with chronic kidney disease has a serum potassium of 5.8 mEq/L (reference 3.5-5.0). The best snack choice for this client is:

A client weighing 70 kg is 6 hours after abdominal surgery. Which finding on the intake and output record should the nurse report to the health care provider?

A client with heart failure is on a 2-g sodium diet. The lunch choice from the menu that fits this diet best is:

A client starts scheduled oral morphine for cancer pain. The most appropriate regimen to prevent constipation is:

A client's urine output from an indwelling catheter was 50-60 mL/h but has been 0 mL for the past 2 hours. The client reports suprapubic discomfort. What should the nurse do first?

A client with a spinal cord injury begins a bowel training programme. The nurse should plan the daily bowel routine for:

A client newly diagnosed with celiac disease asks what she can eat for dinner. The meal the nurse should recommend is:

A client with a 2-week-old colostomy reports burning skin around the stoma. The peristomal skin is red and weeping in a ring that matches the barrier opening, which the client cuts to 1/2 inch wider than the stoma. What should the nurse do?

A client needs 1,800 kcal a day from a formula that provides 1.5 kcal/mL. The feeding runs continuously for 20 hours each day and is held for 4 hours for therapy. The nurse should set the pump to run at: