A patient has undergone a single-barrel descending colon colostomy for the palliative treatment of stage IV colon cancer. The nurse assesses the colostomy stoma to ensure that it is:
Beefy red and moist
Dusky maroon colored
Pale and pink
Pink and dry
The Correct Answer is A
Choice A reason: A healthy stoma should be beefy red and moist, indicating good blood supply and hydration.
Choice B reason: A dusky maroon color could indicate compromised blood supply or ischemia.
Choice C reason: A pale and pink stoma may suggest anemia or reduced blood flow.
Choice D reason: A stoma that is pink and dry could be dehydrated, which is not ideal.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: The annual pneumococcal vaccine is recommended for preventing pneumococcal disease, which can be a complication of COPD, but it is not a primary prevention method for COPD itself.
Choice B reason: Maintaining ideal weight is important for overall health but is not directly related to the prevention of COPD.
Choice C reason: The annual influenza vaccine can help prevent flu-related complications in individuals with COPD but is not a primary prevention method for COPD.
Choice D reason: Stopping or cutting back on smoking is the most effective way to prevent COPD, as smoking is the leading cause of the disease.
Correct Answer is D
Explanation
Choice A reason: Placing suction equipment at the bedside is a preparatory measure but not a preventive intervention for pulmonary complications.
Choice B reason: Performing ROM exercises is beneficial for overall mobility but does not directly prevent pulmonary complications.
Choice C reason: Administering an expectorant may help clear secretions but is not the primary preventive measure for pulmonary complications.
Choice D reason: Encouraging the use of incentive spirometry is a proven intervention to prevent pulmonary complications by promoting lung expansion and preventing atelectasis, especially in patients with a history of smoking.
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