A client with bladder cancer had surgical placement of a ureteroileostomy (ileal conduit) yesterday. Which postoperative assessment finding should the nurse report to the healthcare provider immediately?

Liquid brown drainage from stoma.

Stomal output of 40 mL in the last hour.

Red edematous stomal appearance.

Mucous strings floating in the drainage.

Answer and Explanation

The Correct Answer is A

A. Liquid brown drainage from the stoma is abnormal and could indicate bowel content leakage, suggesting a potential connection between the bowel and the conduit or possible infection. This is a critical finding and should be reported immediately.

- B: A stomal output of 40 mL in the last hour is within normal limits postoperatively, as urine production can vary and this amount does not suggest acute complications.

C. A red and edematous stomal appearance is normal in the immediate postoperative period and indicates adequate blood supply to the stoma.

- D: Mucous strings in the drainage are normal because mucus is produced by the intestinal lining, which is now part of the urinary diversion. This is an expected finding and not a cause for immediate concern.

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Correct Answer is D

Explanation

- A) Any level of fever is not necessarily serious after vaccination. Mild fever is a common side effect and can be monitored at home unless it exceeds 101 degrees Fahrenheit or persists beyond 48 hours.
- B) Keeping the child home from daycare is not necessary unless the child develops symptoms that warrant closer observation or care, such as a high fever or behavioral changes.
- C) Aspirin should not be given to children due to the risk of Reye's syndrome, a rare but serious condition that can cause swelling in the liver and brain.
- D) Applying a cool pack to the injection site is a safe and effective way to reduce discomfort and swelling that may occur after the vaccination.

A. Determine the last time the client had a bowel movement. B. Inquire if the client has taken regularly scheduled medications. C. Ask if the client has an allergy to shellfish. D. Find out if the client can lie prone for the x-ray.

Correct Answer is C

Explanation

A. Determine the last time the client had a bowel movement: While bowel movements may affect imaging studies of the abdomen, knowing the timing of the last bowel movement is not directly related to the safety or effectiveness of an IV pyelogram.
B. Inquire if the client has taken regularly scheduled medications: While it's important to know about medications, especially if they might interfere with the test or need to be temporarily
discontinued, the presence of an allergy to shellfish is more critical for IV pyelogram preparation.
C. Ask if the client has an allergy to shellfish: IV pyelogram contrast dye contains iodine, and some clients may be allergic to iodine-containing substances, including shellfish. An allergic reaction to the contrast dye could lead to serious complications.
D. Find out if the client can lie prone for the x-ray: While positioning is important for imaging studies, it's not as critical as ensuring the client does not have an allergy to the contrast dye.

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A client with bladder cancer had surgical placement of a ureteroileostomy (ileal conduit) yesterday. Which postoperative assessment finding should the nurse report to the healthcare provider immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A parent asked the nurse how to care for their 4-year-old child after receiving the Haemophilus influenzae type b (Hib) conjugate vaccine. Which instruction should the nurse provide?

Correct Answer is D

Explanation

A client is scheduled for an IV pyelogram today. The nurse instructs the client that the x-ray visualizes the kidneys, ureters, and bladder. Which information is most important for the nurse to gather before the client goes for the x-ray?

Correct Answer is C

Explanation

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