A client diagnosed with ulcerative colitis has a new ileostomy. Which statement indicates the client needs more teaching concerning the ileostomy?

"I should clean the stoma site with warm water and mild soap."

"I can continue to participate in physical activities and exercise."

"I should avoid eating high-fiber foods."

"I should change the ostomy bag every day."

Answer and Explanation

The Correct Answer is D

A. Cleaning the stoma site with warm water and mild soap is appropriate and the correct way to maintain stoma hygiene. No harsh chemicals or abrasive materials should be used.
B. It is safe for the client to continue participating in physical activities and exercise, as long as they feel comfortable and take necessary precautions to protect the stoma.
C. Clients with an ileostomy are generally advised to avoid high-fiber foods, especially right after surgery, to reduce the risk of blockages.
D. The ostomy bag should typically be changed every 3 to 7 days, depending on the type of bag used and the amount of output. Changing it every day is unnecessary unless there are signs of leakage or skin irritation.

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Correct Answer is C

Explanation

A. While this patient is scheduled for a physical therapy session, it is not an urgent concern that would require immediate attention.
B. A routine follow-up appointment for a non-urgent condition can be managed at a later time and does not take priority over more acute concerns.
C. A patient with altered mental status and confusion should be assessed first. This could indicate a serious underlying issue such as infection, hypoxia, or a neurological condition. Altered mental status in any patient warrants immediate attention to prevent further complications.
D. Although the patient with pleuritis is in pain, moderate pleuritis is typically not an urgent condition, and pain management can be provided after more pressing concerns are addressed.

A. Brush the client's teeth with a suction toothbrush every 12 hr. B. Provide humidity by maintaining moisture within the ventilator tubing. C. Position the head of the client's bed in the flat position. D. Turn the client every 4 hr.

Correct Answer is A

Explanation

A. Brushing the client's teeth with a suction toothbrush every 12 hours is a key intervention to reduce the risk of ventilator-associated pneumonia (VAP). Oral hygiene helps to decrease the accumulation of bacteria in the mouth, which could potentially be aspirated into the lungs and cause infection. This should be done more frequently, often every 4–6 hours, to reduce bacterial colonization.
B. Providing humidity to the ventilator tubing is necessary to maintain adequate moisture and prevent airway dryness, but it does not directly reduce the risk of VAP. Oral care and head-of-bed positioning are more crucial in preventing infection.
C. The head of the client's bed should be kept elevated, not flat, to reduce the risk of aspiration, which can lead to VAP. Keeping the head of the bed at a 30–45 degree angle is recommended.
D. Turning the client every 4 hours is important for preventing pressure ulcers and promoting circulation but is not the most effective intervention for reducing the risk of VAP. Frequent oral care and appropriate positioning are more important.

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A client diagnosed with ulcerative colitis has a new ileostomy. Which statement indicates the client needs more teaching concerning the ileostomy?

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Naxlex Comprehensive Predictor Exams

Which patient should the nurse assess first after receiving a change-of-shift report?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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