A nurse is collecting data from a client who is postoperative following placement of a colostomy in the ascending colon. In which of the following locations should the nurse expect to find the stoma?
A
B
C
The Correct Answer is A
A. Right upper quadrant is correct. A colostomy placed in the ascending colon is typically located in the right upper quadrant of the abdomen. The ascending colon runs along the right side of the abdomen, so the stoma will be located in that region.
B. Left lower quadrant is incorrect. The left lower quadrant is typically where the descending colon or sigmoid colon are located, so a colostomy placed here would be for those regions, not the ascending colon.
C. Left upper quadrant is incorrect. The left upper quadrant contains parts of the stomach, spleen, and pancreas, but not the ascending colon. A colostomy in the ascending colon would not be located here.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Measure the client's abdominal girth daily is correct. Ascites is characterized by fluid accumulation in the abdomen. Measuring abdominal girth regularly is important for monitoring changes in the amount of fluid retention and for assessing the progression of ascites. It is a standard nursing intervention for clients with this condition.
B. Keep the client's daily protein intake below 0.8 g/kg is incorrect. Protein intake should not be restricted to this extent. In fact, adequate protein is important for liver health and to prevent muscle wasting in clients with cirrhosis, unless there are complications such as hepatic encephalopathy.
C. Restrict the client's sodium intake to 3 g per day is incorrect. Sodium intake is typically restricted more severely for clients with ascites. The general recommendation is often less than 2 g per day to help prevent fluid retention and reduce the burden on the heart and kidneys.
D. Position the client supine with legs elevated is incorrect. While elevating the legs can help reduce edema in the legs, positioning the client supine does not provide the same benefit for ascites. Side-lying with legs elevated or sitting with the legs elevated may be more beneficial.
Correct Answer is D
Explanation
A. Tinnitus with ear pain: While tinnitus can be a side effect of some medications, it is not associated with Stevens-Johnson syndrome (SJS). This symptom is more common with other medications or conditions, like aspirin or certain antibiotics, but not allopurinol.
B. Diplopia: Diplopia (double vision) is not a common sign of Stevens-Johnson syndrome. This symptom could be related to other conditions but is not characteristic of SJS.
C. Hyperreflexia: Hyperreflexia is not a typical manifestation of Stevens-Johnson syndrome. While neurological symptoms may sometimes occur, they are not central to the diagnosis of SJS.
D. Skin rash with fever: A skin rash with fever is a classic early sign of Stevens-Johnson syndrome. It is a potentially life-threatening reaction to certain medications, including allopurinol, and requires immediate medical attention. The rash often begins with a mild erythema, which may progress to blistering and sloughing of the skin.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today