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 A
Explanation
Choice A reason : A renal biopsy is an invasive procedure that can directly assess the extent of glomerular damage and is considered the gold standard for diagnosing the cause of abnormal GFR.
Choice B reason : Routine urinalysis can detect abnormalities in the urine but cannot quantify GFR or directly assess glomerular damage.
Choice C reason : A renal scan can evaluate renal perfusion and function but is less specific for glomerular damage compared to a biopsy.
Choice D reason : Creatinine clearance can estimate GFR but does not provide information on the specific cause of glomerular damage.
Correct Answer is A
Explanation
Choice A reason: Pin site care is essential for a client with skeletal traction to prevent infection and ensure proper healing.
Choice B reason: A five-pound weight lifting restriction is not related to the care of a client with skeletal traction.
Choice C reason: Prone positioning is not typically recommended for clients with skeletal traction as it may interfere with the traction setup.
Choice D reason: Intermitent weights are not a standard intervention for skeletal traction, which requires consistent and controlled application of force.
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