A nurse is assisting with evaluating a newly licensed nurse who is draining an ileostomy bag for a client. Which of the
following actions by the newly licensed nurse indicates an understanding of the procedure?
Wears sterile gloves to drain the ileostomy bag
Washes the skin surrounding the client's ileostomy with hot water
Cleans the end of the ileostomy pouch before clamping
Empties the ileostomy bag when it is three-fourths full
The Correct Answer is C
Choice A reason: Wearing sterile gloves is not necessary when draining an ileostomy bag as this is not a sterile procedure. Clean gloves are typically used.
Choice B reason: Washing the skin surrounding the ileostomy with hot water is not recommended as it can cause
irritation. Lukewarm water should be used, and the area should be patted dry.
Choice C reason: Cleaning the end of the ileostomy pouch before clamping is important to maintain hygiene and
prevent contamination when draining the bag.
Choice D reason: The ileostomy bag should be emptied when it is one-third to one-half full to prevent leakage and ensure comfort for the client.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: While it is important to save the specimen in a clean container, this is not a preparatory action for
obtaining the specimen.
Choice B reason: Rinsing the client's mouth before collecting the specimen is the correct answer because it helps to remove food particles and bacteria that could contaminate the sample.
Choice C reason: Collecting a sputum specimen after a meal is not recommended as it may be contaminated by food particles.
Choice D reason: The time of day is less important than the preparation of the client; however, early morning is usually preferred for collecting a sputum specimen as it tends to be more concentrated after a night's rest.
Correct Answer is D
Explanation
Choice A reason: While bananas are well-known for their potassium content, with one medium banana containing about 451 mg of potassium, they are not the highest source among the options given.
Choice B reason: Spinach is also a good source of potassium, with 1 cup of cooked spinach offering about 830 mg. However, it still does not surpass the potassium content of a baked potato.
Choice C reason: Avocados contain potassium, with one-half cup providing 364 mg. Despite their health benefits,
they have less potassium compared to a baked potato.
Choice D reason: Baked potatoes contain the highest amount of potassium among the options listed. One medium baked potato has 929 mg of potassium, making it the best choice for someone at risk for hypokalemia.
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