The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care.

What is the nurse's most appropriate response to this observation?

Remind the patient that they will be responsible for caring for the ileostomy after discharge.

Reassure the patient that this procedure will be reversed in a few months.

Acknowledge the patient's reluctance and initiate discussion to explore their feelings.

Discuss with the medical team during interdisciplinary rounds the need for a psychiatric referral.

Answer and Explanation

The Correct Answer is C

Choice A reason: Reminding the patient that they will be responsible for caring for the ileostomy after discharge may increase their anxiety and reluctance. It does not address the underlying concerns or feelings.

Choice B reason: Reassuring the patient that the procedure will be reversed in a few months is not always accurate and may provide false hope. Each patient's situation is unique, and not all ileostomies are temporary.

Choice C reason: Acknowledging the patient's reluctance and initiating a discussion to explore their feelings is the most appropriate response. This approach allows the nurse to understand the patient's concerns, provide emotional support, and offer practical solutions to help the patient feel more comfortable with ostomy care.

Choice D reason: Discussing the need for a psychiatric referral during interdisciplinary rounds is not the immediate step. The nurse should first address the patient's feelings and concerns directly and provide support.

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Correct Answer is ["A","C","E"]

Explanation

Choice A reason: Ulcers in the descending colon are indicative of Crohn's disease, which affects any part of the gastrointestinal tract.

Choice B reason: Absence of narrowing of the colon and mucosal edema is more indicative of ulcerative colitis rather than Crohn's disease.

Choice C reason: Fistulas and perianal involvement are common complications of Crohn's disease due to the transmural inflammation.

Choice D reason: Mild bleeding and an abdominal mass can be associated with both Crohn's disease and other gastrointestinal disorders, making it less specific.

Choice E reason: Regional, discontinuous skip lesions are a hallmark of Crohn's disease, seen on barium studies, indicating areas of inflammation separated by normal tissue.

A. Acute hemolytic B. Allergic C. Anaphylactic D. Circulatory overload

Correct Answer is B

Explanation

Choice A reason: Acute hemolytic reactions are severe and typically present with symptoms such as fever, chills, flank pain, hemoglobinuria, and shock. The patient's mild symptoms of itching and a localized rash do not match the severe presentation of an acute hemolytic reaction.

Choice B reason: Allergic reactions to blood transfusions are common and usually present with symptoms such as itching, hives, and localized rash. The patient's vital signs and physical assessment showing mild itching and a rash on the arms are consistent with an allergic reaction.

Choice C reason: Anaphylactic reactions are severe allergic reactions that involve respiratory distress, hypotension, and shock. The patient's mild symptoms do not indicate an anaphylactic reaction.

Choice D reason: Circulatory overload presents with symptoms such as dyspnea, orthopnea, hypertension, and pulmonary edema. The patient's symptoms of itching and a rash do not align with circulatory overload.

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The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care. What is the nurse's most appropriate response to this observation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is admitting a patient whose health history is suggestive of inflammatory bowel disease. Which clinical manifestations and diagnostic findings confirm the diagnosis of Crohn's disease? (Select All That Apply)

Correct Answer is ["A","C","E"]

Explanation

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Correct Answer is B

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The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care.

What is the nurse's most appropriate response to this observation?