A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery?
Intestinal obstruction
Folate deficiency
Malabsorption of fat
Fluid and electrolyte imbalance
The Correct Answer is D
Choice A Reason: This is incorrect because intestinal obstruction is not a common complication of ileostomy surgery. An ileostomy is a surgical opening in the abdomen that connects the end of the small intestine (ileum) to a pouch or bag outside the body. This allows stool to bypass the colon and rectum. Intestinal obstruction can occur if there is a blockage or narrowing in any part of the digestive tract, but it is more likely to affect the colon than the ileum.
Choice B Reason: This is incorrect because folate deficiency is not a common complication of ileostomy surgery. Folate is a vitamin that is essential for DNA synthesis and cell division. Folate is mainly absorbed in the jejunum, which is the middle part of the small intestine. An ileostomy does not affect the jejunum, so it does not interfere with folate absorption.
Choice C Reason: This is incorrect because malabsorption of fat is not a common complication of ileostomy surgery. Fat is digested and absorbed in both the small and large intestine. An ileostomy does not affect fat digestion, but it may reduce fat absorption by decreasing the transit time and surface area of the intestine. However, this is usually not significant enough to cause malabsorption symptoms.
Choice D Reason: This is correct because fluid and electrolyte imbalance is a common complication of ileostomy surgery. Fluid and electrolytes are mainly absorbed in the colon, which is bypassed by an ileostomy. This can result in increased fluid and electrolyte loss through stool, especially sodium and potassium. This can lead to dehydration, hypotension, weakness, cramps, or arrhythmias.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason: "I ate shellfish about 2 weeks ago at a local restaurant." supports the medical diagnosis of hepatitis A, which is an infection of the liver caused by the hepatitis A virus (HAV). HAV is transmitted by fecal-oral route, meaning that it can be contracted by ingesting contaminated food or water, such as raw or undercooked shellfish from polluted waters. The incubation period for hepatitis A is about two to six weeks.
Choice B Reason: "I was an intravenous drug abuser in the past and shared needles." does not support the medical diagnosis of hepatitis A, but may indicate exposure to hepatitis B or C, which are infections of the liver caused by the hepatitis B virus (HBV) or hepatitis C virus (HCV). HBV and HCV are transmitted by blood or body fluids, meaning that they can be contracted by sharing needles, syringes, or other injection equipment with infected people.
Choice C Reason: "I had a blood transfusion in 1980 after major abdominal surgery." does not support the medical diagnosis of hepatitis A, but may indicate exposure to hepatitis B or C, which are infections of the liver caused by the hepatitis B virus (HBV) or hepatitis C virus (HCV). HBV and HCV are transmitted by blood or body fluids, meaning that they can be contracted by receiving blood transfusions or organ transplants from infected donors. However, since 1992, all donated blood in the United States has been screened for HBV and HCV.
Choice D Reason: "I have had unprotected sex with multiple partners." does not support the medical diagnosis of hepatitis A, but may indicate exposure to hepatitis B or C, which are infections of the liver caused by the hepatitis B virus (HBV) or hepatitis C virus (HCV). HBV and HCV are transmitted by blood or body fluids, meaning that they can be contracted by having unprotected sex with infected people. However, sexual transmission of HAV is rare, unless there is contact with fecal matter.
Correct Answer is A
Explanation
Choice A Reason: This is the correct choice because driving a motorcycle is a high-risk activity that can expose the client to head trauma, especially if they do not wear a helmet. Traumatic brain injury (TBI) is a condition where the brain is damaged by an external force, such as a collision, fall, or assault.
Choice B Reason: This is incorrect because having high blood pressure is not a direct risk factor for traumatic brain injury. High blood pressure can increase the risk of stroke, which is a condition where the brain is damaged by an internal cause, such as a blood clot or hemorrhage.
Choice C Reason: This is incorrect because smoking and having a family history of brain cancer are not risk factors for traumatic brain injury. Smoking and genetic factors can increase the risk of developing brain tumors, which are abnormal growths of cells in the brain.
Choice D Reason: This is incorrect because golfing and driving a golf cart are low-risk activities that do not pose a significant threat to the client's head. Golfing and driving a golf cart may cause minor injuries, such as sprains, strains, or bruises, but not traumatic brain injury.

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