A nurse is completing discharge teaching about ostomy care with a client who has a new stoma. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

"Use povidone-iodine to clean around the stoma."

"Cut the opening of the pouch / of an inch larger than the stoma."

"Empty the ostomy pouch when it becomes one-third full of contents."

"Place a piece of gauze over the stoma while changing the pouch."

"Expect the stoma to turn a purple-blue color as it heals."

Answer and Explanation

Correct Answer : B,C,D

A.   Povidone-iodine is not recommended for cleaning around the stoma as it may cause irritation.
B.   Ensuring the pouch opening is slightly larger than the stoma helps prevent irritation and ensures proper fit.
C.   Regular emptying of the ostomy pouch prevents leakage and skin irritation. It also prevents it from becoming too heavy and pulling away from the skin.
D.   The nurse should advise the client to place a piece of gauze over the stoma while changing the pouch to protect it from injury and contamination.
E.   A purplish-blue change in the stoma is an indication of impaired blood supply to the stoma and should be promptly reported to the healthcare provider.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

A. While decreased appetite may be concerning, it is not typically considered a priority over potential complications related to immobility.
B. Left lower extremity tenderness could indicate deep vein thrombosis (DVT), a serious complication of prolonged bed rest that requires immediate attention to prevent pulmonary embolism.
C. Increased heart rate during physical activity may be expected after a period of bed rest and can be addressed with gradual reconditioning.

D. Musculoskeletal weakness is a common consequence of immobility and would be addressed as part of the client's rehabilitation but is not an immediate priority compared to potential complications like DVT.

A. When documenting the medication administration B. Before selecting the medication container C. While removing medication from the container D. When providing client education about the medication E. At the client's bedside before administering the medication

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

Explanation

A. Comparing the medication administration record with the medication container should occur before documentation to ensure accuracy.
B. This step ensures that the nurse is administering the correct medication to the client.
C. Comparing the medication against the administration record while removing it from the container helps prevent errors.
D. While important, this step does not directly involve comparing the medication container with the administration record.
E. Verifying the medication at the bedside ensures the right medication is given to the right patient at the right time.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is completing discharge teaching about ostomy care with a client who has a new stoma. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client whose therapy has included bed rest for several weeks. Which of the following findings should the nurse identify as the priority?

Correct Answer is B

Explanation

A nurse is preparing to administer prescribed medications to a client. According to the rights of medication administration, when should the nurse compare the medication administration record against the medication container? (Select all that apply.)

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

Explanation

A nurse is teaching a client about stress management techniques. Which of the following client statements indicates an understanding of the teaching?

A charge nurse is observing a staff nurse performing a wound irrigation for a client who has a pressure injury. Which of the following actions by the staff nurse indicates an understanding of the procedure?

During change-of-shift report, a nurse discovers they overlooked a prescription for a type and cross-match of a client who is to have surgery the next day. Which of the following actions should the nurse take first?

A staff nurse is teaching a newly hired nurse how to complete an informed consent document for a client. The staff nurse should include that the nurse's signature on the form confirms which of the following requirements? (Select all that apply)

A nurse is caring for a client who has an extracellular fluid volume deficit. Which of the following findings should the nurse expect?

A nurse is providing discharge teaching to a client who is at risk for falls. Which of the following information should the nurse include in the teaching?

A nurse is preparing to administer cefoxitin 80 mg/kg/day IV every 6 hr to a 6-year-old child who weighs 20 kg. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A nurse is assessing a client's cranial nerve VII. Which of the following responses should the nurse expect?