A client diagnosed with ulcerative colitis has a new ileostomy. Which statement indicates the client needs more teaching concerning the ileostomy?

"I should clean the stoma site with warm water and mild soap."

"I can continue to participate in physical activities and exercise."

"I should avoid eating high-fiber foods."

"I should change the ostomy bag every day."

Answer and Explanation

The Correct Answer is D

A. Cleaning the stoma site with warm water and mild soap is appropriate and the correct way to maintain stoma hygiene. No harsh chemicals or abrasive materials should be used.
B. It is safe for the client to continue participating in physical activities and exercise, as long as they feel comfortable and take necessary precautions to protect the stoma.
C. Clients with an ileostomy are generally advised to avoid high-fiber foods, especially right after surgery, to reduce the risk of blockages.
D. The ostomy bag should typically be changed every 3 to 7 days, depending on the type of bag used and the amount of output. Changing it every day is unnecessary unless there are signs of leakage or skin irritation.

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Correct Answer is C

Explanation

A. Total loss of gastric enzymes is not a primary cause of dumping syndrome. While gastric enzymes may be reduced following gastric surgery, the syndrome is primarily related to the way food moves through the digestive tract.
B. Excess secretion of digestive enzymes in the intestines does not directly cause dumping syndrome. Although enzyme levels can be affected by surgery, dumping syndrome is more about the timing and volume of food delivery to the intestines.
C. Rapid emptying of stomach contents into the small intestine is the primary cause of dumping syndrome. This occurs because the normal regulatory mechanisms of the stomach are bypassed or disrupted after gastric resection, leading to a quick shift of food into the small intestine, which causes symptoms like nausea, diarrhea, and dizziness.
D. Excess glycogen production by the liver is not related to dumping syndrome. This would be more relevant to conditions affecting glucose metabolism, not gastrointestinal emptying.

A. A patient with a scheduled physical therapy session in 1 hour. B. A patient with a routine follow-up appointment for a non-urgent condition. C. A patient with altered mental status and confusion. D. A patient with moderate pleuritis and requesting pain medication.

Correct Answer is C

Explanation

A. While this patient is scheduled for a physical therapy session, it is not an urgent concern that would require immediate attention.
B. A routine follow-up appointment for a non-urgent condition can be managed at a later time and does not take priority over more acute concerns.
C. A patient with altered mental status and confusion should be assessed first. This could indicate a serious underlying issue such as infection, hypoxia, or a neurological condition. Altered mental status in any patient warrants immediate attention to prevent further complications.
D. Although the patient with pleuritis is in pain, moderate pleuritis is typically not an urgent condition, and pain management can be provided after more pressing concerns are addressed.

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A client diagnosed with ulcerative colitis has a new ileostomy. Which statement indicates the client needs more teaching concerning the ileostomy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

As a result of gastric resection, the client is at risk for developing dumping syndrome. The nurse should prepare a plan of care for this client based on knowledge that this problem stems primarily from which of the following gastrointestinal changes?

Correct Answer is C

Explanation

Which patient should the nurse assess first after receiving a change-of-shift report?

Correct Answer is C

Explanation

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