A nurse is caring for a client who has a newly created colostomy. The client's partner tells the nurse that the client refuses to look at the stoma. Which of the following actions should the nurse take?

Encourage the client and partner to avoid expressing negative feelings about the colostomy.

Suggest the client join a support group for people who have colostomies.

Instruct the client's partner to assume care of the colostomy for the client.

Transfer the client to a rehabilitation facility for instruction about self-management of the colostomy.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Encourage the client and partner to avoid expressing negative feelings about the colostomy: Suppressing negative emotions can hinder psychological adjustment. Clients should be encouraged to express their feelings openly as part of the adaptation and coping process.

B. Suggest the client join a support group for people who have colostomies: Support groups can provide emotional reassurance, shared experiences, and practical coping strategies. Seeing others manage their stomas successfully can promote acceptance and self-confidence.

C. Instruct the client's partner to assume care of the colostomy for the client: While partner support is important, encouraging dependence may delay the client’s adjustment and self-care ability. The goal should be to promote independence and acceptance at the client’s pace.

D. Transfer the client to a rehabilitation facility for instruction about self-management of the colostomy: A transfer is not necessary unless the client has complex needs. Initial support, education, and emotional guidance should be provided in the current care setting.

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Correct Answer is A

Explanation

Rationale:

A. Frequent swallowing: Frequent swallowing, especially of small amounts, can indicate that the child is swallowing blood from postoperative bleeding. This is a common early sign of hemorrhage following a tonsillectomy and requires immediate evaluation.

B. Increased drowsiness: Drowsiness can result from anesthesia, pain medication, or fatigue after surgery. While it should be monitored, it is not a specific indicator of postoperative hemorrhage in a child following tonsillectomy.

C. Elevated pain level: Pain is expected after tonsillectomy and does not necessarily signal bleeding. Sudden severe pain might warrant reassessment, but elevated pain alone is not a definitive sign of hemorrhage.

D. Diminished breath sounds: Diminished breath sounds are not typically associated with post-tonsillectomy hemorrhage. This finding may indicate a respiratory issue, but not specifically bleeding from the surgical site.

A. Limit teaching sessions about the procedure to 20 min. B. Explain in simple terms how the procedure will affect the child. C. Ask the parents to wait outside the room during the procedure. D. Instruct the child in deep-breathing methods prior to the procedure.

Correct Answer is B

Explanation

Rationale:

A. Limit teaching sessions about the procedure to 20 min: Preschoolers have short attention spans, but 20 minutes is still too long for teaching at this developmental stage. Teaching should be concise and focused, ideally lasting only a few minutes just before the procedure.

B. Explain in simple terms how the procedure will affect the child: Preschoolers benefit from clear, age-appropriate explanations that help them understand what to expect. Using simple language and concrete terms reduces fear and builds trust with the nurse.

C. Ask the parents to wait outside the room during the procedure: Parents often provide comfort and reassurance during stressful experiences. Unless they are interfering or the child requests otherwise, their presence can help reduce the child’s anxiety.

D. Instruct the child in deep-breathing methods prior to the procedure: While relaxation techniques are helpful for older children, preschoolers may have difficulty understanding and following deep-breathing instructions. Simple distraction methods are often more effective.

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A nurse is caring for a client who has a newly created colostomy. The client's partner tells the nurse that the client refuses to look at the stoma. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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