A nurse is evaluating a client's acceptance of having a new ileostomy.
Which of the following statements by the client indicates acceptance?

"I will attend a support group to help me handle difficulties when they occur.”

"I have my partner empty the bag for me, so I don't have to look at it.”

"I look forward to having normal bowel movements again.”

"I wish my sexual relationship with my partner was like it was before.”

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Attending a support group to seek help and guidance for handling difficulties indicates the client's acceptance of having a new ileostomy. It demonstrates a proactive approach to coping with the challenges associated with living with an ileostomy.

Choice B rationale:

Having a partner empty the bag for the client to avoid looking at it may indicate avoidance or denial rather than acceptance. While support from a partner is essential, it's also important for the client to actively participate in self-care and adaptation.

Choice C rationale:

Looking forward to having normal bowel movements again may indicate a lack of acceptance or unrealistic expectations since having an ileostomy means a change in bowel function. The client should be educated about the permanence of the ileostomy.

Choice D rationale:

Wishing for a return to the pre-ileostomy sexual relationship may indicate difficulty accepting the changes in body image and function that come with an ileostomy. It may also suggest unrealistic expectations. The client should be encouraged to seek support and counseling for body image issues and sexual concerns.

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Correct Answer is B

Explanation

Choice A rationale:

Severe nausea and vomiting are not typically associated with an ectopic pregnancy at 8 weeks of gestation. Instead, nausea and vomiting are common symptoms of a normal intrauterine pregnancy due to hormonal changes. Ectopic pregnancies often present with different symptoms, such as pelvic pain and vaginal bleeding.

Choice B rationale:

Pelvic pain is a common and concerning symptom of an ectopic pregnancy. It occurs because the fertilized egg implants outside the uterus, usually in the fallopian tube, which can lead to pain and discomfort as the pregnancy progresses.

Choice C rationale:

Uterine enlargement greater than expected for gestational age is not a typical finding in an ectopic pregnancy. In an ectopic pregnancy, the fertilized egg implants outside the uterus, so uterine enlargement is usually not evident or is less than expected for the gestational age.

Choice D rationale:

Copious vaginal bleeding is a possible but not specific finding in an ectopic pregnancy. While vaginal bleeding can occur, it is often not as heavy as the bleeding associated with a miscarriage or a normal intrauterine pregnancy. Pelvic pain is usually the more prominent symptom.

A. Call the supervisor to ask for another nurse. B. Document objective findings about the situation. C. Remove the nurse from the client care area. D. Assign clients to the remaining staff.

Correct Answer is C

Explanation

Choice A rationale:

Calling the supervisor to ask for another nurse is not the first action the charge nurse should take when noticing the smell of alcohol on a nurse's breath. While it's important to involve the supervisor, immediate action to ensure patient safety is required.

Choice B rationale:

Documenting objective findings about the situation is a valid step in the process, but it should not be the first action. The charge nurse's primary responsibility is to address the immediate safety concerns.

Choice C rationale:

Removing the nurse from the client care area is the first action the charge nurse should take when smelling alcohol on a nurse's breath. This action ensures patient safety and prevents potential harm caused by impaired nursing care.

Choice D rationale:

Assigning clients to the remaining staff is not the first action to take when there is suspicion of alcohol impairment in a nurse. Patient safety and addressing the situation involving the impaired nurse take precedence.

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A nurse is evaluating a client's acceptance of having a new ileostomy.Which of the following statements by the client indicates acceptance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client in the prenatal clinic who has a possible ectopic pregnancy at 8 weeks of gestation.Which of the following findings should the nurse expect?

Correct Answer is B

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Correct Answer is C

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A nurse is evaluating a client's acceptance of having a new ileostomy.
Which of the following statements by the client indicates acceptance?