A nurse is preparing a preoperative patient for a sigmoid colostomy. What information should the nurse include in the discussion?
The stoma will be located in the lower left abdomen.
The stoma may appear purple.
The colostomy will not produce formed stool.
The end of the stoma may be painful after the procedure.
The Correct Answer is A
Choice A rationale
The stoma for a sigmoid colostomy is typically located in the lower left abdomen. This is because the sigmoid colon is a part of the large intestine that is located in the lower left quadrant of the abdomen.
Choice B rationale
A stoma should appear pink or red and moist. A purple stoma could indicate a lack of blood supply, which is a medical emergency.
Choice C rationale
A sigmoid colostomy will produce formed stool because the sigmoid colon is the last part of the colon, where water is absorbed and stool is formed.
Choice D rationale
The end of the stoma (the part that sticks out from the abdomen) should not be painful after the procedure. If a patient experiences pain, it could indicate a complication such as a blockage or infection.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Donning sterile gloves before inserting the indwelling urinary catheter is a critical step to prevent infection. The urinary tract is normally sterile, and using sterile gloves helps maintain this sterility during the procedure.
Choice B rationale
Applying an oil-based lubricant to the indwelling urinary catheter is not recommended. Oil- based lubricants can damage latex catheters and increase the risk of infection. A water-soluble lubricant is typically used.
Choice C rationale
Using one cotton swab to clean the client’s genitalia is not sufficient. Proper cleaning and disinfection of the area are crucial to prevent introducing bacteria into the urinary tract during catheter insertion.
Choice D rationale
Testing the balloon on the indwelling urinary catheter before insertion is not typically done. The balloon is usually inflated with sterile water once the catheter is in place to ensure that it remains in the bladder.
Correct Answer is C
Explanation
Choice A rationale
Sterile gloves are not necessary when checking a patient’s pulse. They are typically used for procedures that require aseptic technique, such as wound dressing changes or insertion of a central venous catheter.
Choice B rationale
Protective eyewear is used to protect the healthcare provider from splashes or sprays of blood, body fluids, secretions, or excretions. It is not necessary when checking a patient’s pulse.
Choice C rationale
Clean gloves should be worn when touching blood, body fluids, secretions, excretions, mucous membranes, and non-intact skin. This includes when caring for a patient with MRSA in an abdominal wound.
Choice D rationale
An N95 respirator mask is used to protect the healthcare provider from airborne pathogens, such as tuberculosis. It is not necessary when checking a patient’s pulse.
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