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 ["A","C","D","E"]

Explanation

A. Serum phosphorus is crucial to monitor in patients at risk for refeeding syndrome. Hypophosphatemia is a key sign of the syndrome and can lead to severe complications, such as respiratory failure and cardiac arrhythmias.
B. Serum blood glucose levels are important to monitor, especially since refeeding syndrome can cause rapid shifts in glucose metabolism. However, it is not a primary test to diagnose refeeding syndrome. Blood glucose monitoring will be part of the overall management, but not the core test for the syndrome.
C. Serum calcium should be monitored because it can also decrease in refeeding syndrome due to shifts in phosphate and magnesium levels, which may affect calcium metabolism.
D. Serum potassium is essential to monitor because hypokalemia often occurs in refeeding syndrome as the body shifts electrolytes into cells. This can cause muscle weakness, arrhythmias, and other serious complications.
E. Serum magnesium is also important to check, as hypomagnesemia is commonly seen in refeeding syndrome and can contribute to neurological and cardiac symptoms.

A. Night sweats B. Narrowed pulse pressure C. Confusion D. Bradycardia

Correct Answer is C

Explanation

A. Night sweats are more commonly associated with conditions like tuberculosis or certain cancers, rather than pneumonia, although they could occasionally be seen in severe pneumonia.
B. Narrowed pulse pressure is not a typical sign of pneumonia and is more indicative of conditions such as shock or heart failure.
C. Confusion is a classic and often overlooked symptom of pneumonia in older adults. Pneumonia in this population can present with altered mental status or confusion rather than typical respiratory symptoms like cough and fever.
D. Bradycardia is not a typical finding in pneumonia. In fact, tachycardia (an increased heart rate) is more commonly seen as the body tries to compensate for the infection.

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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

A patient with anorexia nervosa shows signs of malnutrition and is prescribed parenteral nutrition. If the client develops refeeding syndrome, what laboratory tests does the nurse expect the healthcare provider to order? (Select all that apply.)

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

Explanation

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Correct Answer is C

Explanation

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A nurse is caring for a client who is receiving total parenteral nutrition and develops refeeding syndrome. The nurse should expect which of the following laboratory findings?

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