The nurse is most likely to report which finding to the primary care provider for a client who has an established colostomy?

The skin under the appliance looks red briefly after removing the appliance.

The stoma color is a deep red-purple.

An ascending colostomy delivers liquid feces.

The stoma extends 1/2 inch above the abdomen.

Answer and Explanation

The Correct Answer is B

Choice A rationale: Redness briefly after removing the appliance might be common due to increased blood flow but does not necessarily indicate an issue.

Choice B rationale: A deep red-purple stoma color can suggest impaired blood supply to the stoma and requires immediate attention.

Choice C rationale: The consistency of output from the colostomy may vary based on the site and type of colostomy and might not necessarily be concerning.

Choice D rationale: The length of the stoma can vary and usually depends on the type of colostomy, and 1/2 inch above the abdomen is within an acceptable range.

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Correct Answer is A

Explanation

Choice A rationale: Plantar fasciitis typically presents with severe pain in the arch of the foot, especially during the first steps in the morning or after prolonged periods of rest.

Choice B rationale: Multiple toe deformities are not typically associated with plantar fasciitis.

Choice C rationale: Redness and severe swelling are not typical findings in plantar fasciitis.

Choice D rationale: Numbness and paresthesia are not common findings in plantar fasciitis.

A. Client with a worse joint deformity since the last visit B. Client with a red, hot, swollen right wrist C. Client who has a puffy-looking area behind the knee D. Client who reports jaw pain when eating

Correct Answer is B

Explanation

Choice A rationale: While joint deformities are concerning in RA, the immediate attention would be required for an acute, red, hot, swollen joint which could indicate an active inflammatory process.
Choice B rationale: Redness, heat, and swelling in a joint are signs of an acute flare in rheumatoid arthritis and might require urgent intervention to manage the inflammation.
Choice C rationale: Puffy-looking areas behind the knee might indicate joint involvement but might not require immediate attention as much as an acutely inflamed joint.
Choice D rationale: Jaw pain while eating can be a symptom of TMJ involvement in RA, but an acutely inflamed joint would generally take precedence.

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The nurse is most likely to report which finding to the primary care provider for a client who has an established colostomy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is performing an assessment of a client with possible plantar fasciitis in the right foot. What assessment finding would the nurse expect in the right foot?

Correct Answer is A

Explanation

A nurse assesses a group of clients who have rheumatoid arthritis (RA). Which client would the nurse see first?

Correct Answer is B

Explanation

When a brain-injured patient responds to nail bed pressure with internal rotation, adduction, and flexion of the arms, how should the nurse report the response?

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