A nurse is reinforcing discharge teaching with a client about how to care for a newly created ileal conduit. Which of the following instructions should the nurse include in the teaching?

Change the ostomy pouch daily.

Empty the ostomy pouch when it is 2/3 full.

Trim the opening of the ostomy seal to be 1/2 inch wider than the stoma.

Apply lotion to the peristomal skin when changing the ostomy pouch.

Answer and Explanation

The Correct Answer is B

Choice A reason: Changing the ostomy pouch daily is not typically necessary. Most pouches can be worn comfortably for several days before needing to be changed. Frequent changes are not only unnecessary but can also irritate the skin around the stoma.

Choice B reason: Emptying the ostomy pouch when it is 2/3 full is recommended to prevent leaks and overfilling, which can lead to discomfort and potential skin irritation. It is important to monitor the fullness of the pouch and empty it regularly to maintain hygiene and comfort.

Choice C reason: Trimming the opening of the ostomy seal to be 1/2 inch wider than the stoma is incorrect. The opening should be cut to match the size of the stoma to ensure a snug fit that prevents leakage and protects the skin around the stoma.

Choice D reason: Applying lotion to the peristomal skin when changing the ostomy pouch is not advised. Lotions or creams can interfere with the adhesive of the ostomy appliance and should be avoided. The peristomal skin should be clean and dry to ensure proper adhesion of the ostomy appliance.

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Correct Answer is C

Explanation

Choice A reason: Checking the client's blood pressure every 8 hours is important, but it is not as critical as monitoring urine output in the immediate postoperative period. Blood pressure should be monitored regularly, but changes in urine output can provide more immediate information about the new kidney's function.

Choice B reason: Monitoring for hypokalemia is important, as it can be a sign of acute rejection; however, hyperkalemia is more commonly associated with acute rejection due to the kidney's inability to excrete potassium. Therefore, while electrolyte monitoring is crucial, the focus is typically on hyperkalemia rather than hypokalemia.

Choice C reason: Assessing urine output hourly is essential for a client who has undergone a kidney transplant. Urine output is a direct indicator of the new kidney's function, and any significant decrease could indicate a complication such as acute rejection or obstruction.

Choice D reason: Administering opioids orally for pain management is part of postoperative care, but it is not the priority over monitoring urine output and kidney function.

A. "Were you careful to not have carbohydrates after the run?" B. "It is normal to feel this way after a morning run." C. "It becomes easier when exercise is a routine." D. "Did you decrease your insulin intake before you exercised?"

Correct Answer is D

Explanation

Choice A reason: Advising the client to avoid carbohydrates after exercise is not appropriate. Carbohydrates are necessary to replenish glycogen stores after exercise, and individuals with diabetes need to monitor their blood sugar levels to manage carbohydrate intake accordingly.

Choice B reason: Saying it is normal to feel exhausted after a morning run does not address the client's symptoms of diaphoresis, increased heart rate, and palpitations, which could be signs of hypoglycemia, a common risk for individuals with type 1 diabetes after exercise.

Choice C reason: While it's true that exercise can become easier with routine, this statement does not address the client's immediate concerns about their symptoms following exercise.

Choice D reason: Asking if the client decreased their insulin intake before exercising is an appropriate response. Individuals with type 1 diabetes need to adjust their insulin dosage to account for physical activity, which can significantly lower blood glucose levels.

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A nurse is reinforcing discharge teaching with a client about how to care for a newly created ileal conduit. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is 12 hours postoperative following a kidney transplant. Which of the following actions should the nurse include in the plan of care?

Correct Answer is C

Explanation

A nurse in a clinic is assessing a client who has type 1 diabetes mellitus. The client is diaphoretic, has a heart rate of 92/min, and reports palpitations. The client states, "I went for my morning run and feel exhausted." Which of the following responses should the nurse make?

Correct Answer is D

Explanation

A patient is exhibiting an altered level of consciousness and is unresponsive to verbal stimuli. To elicit a response from a painful stimulus, the nurse would:

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