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Your patient, Christopher, has a diagnosis of ulcerative colitis and has severe abdominal pain aggravated by movement, rebound tenderness, fever, nausea, and decreased urine output. This may indicate which complication?
- A. Fistula.
- B. Bowel perforation.
- C. Bowel obstruction.
- D. Abscess.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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When planning care for a client with ulcerative colitis who is experiencing symptoms, which client care activities can the nurse appropriately delegate to a unlicensed assistant?
- A. Assessing the client's bowel sounds
- B. Providing skin care following bowel movements
- C. Evaluating the client's response to antidiarrheal medications
- D. administration of pain medication every 4 hours
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
You're preparing a patient with a malignant tumor for colorectal surgery and subsequent colostomy. The patient tells you he's anxious. What should your initial step be in working with this patient?
- A. Determine what the patient already knows about colostomies.
- B. Show the patient some pictures of colostomies.
- C. Arrange for someone who has a colostomy to visit the patient.
- D. Provide the patient with written material about colostomy care.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse evaluates the client's stoma during the initial post-op period. Which of the following observations should be reported immediately to the physician?
- A. The stoma is slightly edematous
- B. The stoma is dark red to purple
- C. The stoma oozes a small amount of blood
- D. The stoma does not expel stool
Correct Answer: B
Rationale: A dark red to purple stoma may indicate compromised blood flow or ischemia, which requires immediate medical attention. This color change could be a sign of inadequate blood supply to the stoma tissue, leading to tissue damage or necrosis. Reporting this observation promptly is crucial to prevent further complications. Choices A, C, and D are not indicative of immediate medical concern. A slightly edematous stoma, oozing a small amount of blood, or not expelling stool may not be uncommon findings during the initial post-op period and can be managed without urgent intervention.
A patient who underwent abdominal surgery now has a gaping incision due to delayed wound healing. Which method is correct when you irrigate a gaping abdominal incision with sterile normal saline solution, using a piston syringe?
- A. Rapidly instill a stream of irrigating solution into the wound.
- B. Apply a wet-to-dry dressing to the wound after the irrigation.
- C. Moisten the area around the wound with normal saline solution after the irrigation.
- D. Irrigate continuously until the solution becomes clear or all of the solution is used.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Annebell is being discharged with a colostomy, and you're teaching her about colostomy care. Which statement correctly describes a healthy stoma?
- A. At first, the stoma may bleed slightly when touched.
- B. The stoma should appear dark and have a bluish hue.
- C. A burning sensation under the stoma faceplate is normal.
- D. The stoma should remain swollen away from the abdomen.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.