The nurse is caring for a client with a wound from a biking accident. She assesses the wound and notices that the surrounding skin is very red and warm. The wound looks swollen and is draining a green like drainage. The nurse would recognize these symptoms would be a sign of what?

Anemia

Infection

Wound healing

Necrosis

Answer and Explanation

The Correct Answer is B

Choice A rationale: Redness, warmth, swelling, and green drainage are not typically signs of anemia.
Choice B rationale: These symptoms are indicative of infection. Infections can cause localized redness, warmth, swelling, and the drainage of discolored material.
Choice C rationale: While wound healing may involve some inflammation, the described symptoms are more consistent with infection than normal wound healing.
Choice D rationale: Necrosis involves tissue death and is not typically associated with redness, warmth, and swelling.

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Correct Answer is A

Explanation

Choice A rationale: A purplish-colored stoma may indicate compromised blood supply and should be reported to the provider.
Choice B rationale: A shiny, moist stoma is a healthy characteristic of a colostomy. Choice C rationale: Stoma oozing red drainage is a normal finding after colostomy surgery.
Choice D rationale: "Budded" stoma is not a recognized term related to colostomy assessment.

A. Increase dietary intake of raw vegetables. B. Limit activity. C. Drink four to five glasses of water daily. D. Bear down hard when defecating.

Correct Answer is C

Explanation

Choice A rationale: While dietary fiber is important for bowel health, raw vegetables can be harder to digest. Cooking or steaming vegetables may be a more suitable option for some individuals with constipation.
Choice B rationale: Limiting activity can contribute to constipation, as physical activity helps stimulate bowel movements.
Choice C rationale: Drinking four to five glasses of water daily is important for maintaining hydration and supporting normal bowel function. Dehydration can contribute to constipation.
Choice D rationale: Bearing down hard when defecating may increase the risk of complications and is not a recommended strategy for relieving constipation.

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The nurse is caring for a client with a wound from a biking accident. She assesses the wound and notices that the surrounding skin is very red and warm. The wound looks swollen and is draining a green like drainage. The nurse would recognize these symptoms would be a sign of what?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a PACU is assessing a client who has a newly created colostomy. Which of the following findings should the nurse report to the provider?

Correct Answer is A

Explanation

A nurse is providing education for an older adult client who reports constipation. Which of the following instructions should the nurse include in the teaching?

Correct Answer is C

Explanation

Upon assessment of the urine in a client's indwelling urinary catheter drain bag, the nurse notes the urine to be dark yellow. Which next step should the nurse implement?

A client tells the nurse that he takes laxatives every day but is still constipated. The nurse's response is based on which reasoning?

The nurse uses gait belts when assisting clients to ambulate. Which client would be a likely candidate for this assistive device?

The nurse is caring for a client with a wound from a biking accident. She assesses the wound and notices that the surrounding skin is very red and warm. The wound looks swollen and is draining a green like drainage. The nurse would recognize these symptoms would be a sign of what?

A medical-surgical nurse is assisting a wound care nurse with the debridement of a client's coccyx wound. What is the primary goal of this action?

A nurse is completing her physical assessment on her newly admitted patient. She is assessing the patient's skin and documenting her findings. How should she document the following wound?

A client comes to the emergency department with severe abdominal cramping and frequent bloody stools. Food poisoning is suspected. Which assessment techniques and diagnostic studies should the nurse use?

A nurse is caring for a client who has urinary incontinence. Which of the following actions should the nurse implement to prevent the development of skin breakdown?