A nurse is teaching a dent who is preoperative for a sigmoid colostomy. Which of the following statements should the nurse include?

"Your colostomy will not produce formed steel.”

"You will have a stoma in your left lower abdomen.”

"You should expect your store to be a purple color."

“The end of the stoma will be painful after this procedure.”

Answer and Explanation

The Correct Answer is B

A. "Your colostomy will not produce formed stool.” A sigmoid colostomy produces formed stool because it is at the end of the large intestine, where water is absorbed.

B. "You will have a stoma in your left lower abdomen." A sigmoid colostomy is placed in the left lower quadrant (LLQ) of the abdomen.

C. "You should expect your stoma to be a purple color." A healthy stoma should be pink to red and moist. A purple, dusky, or dark-colored stoma may indicate ischemia and requires immediate evaluation.

D. "The end of the stoma will be painful after this procedure." The stoma itself does not have nerve endings, so it should not be painful. However, the surrounding abdominal incision may be sore.

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Correct Answer is A

Explanation

A. "My immune system reacts to gluten and damages the villi in my gut.": Celiac disease is an autoimmune disorder in which gluten triggers an immune response that damages the small intestinal villi, leading to malabsorption.

B. "I have an allergy to the proteins that are found in wheat.": Celiac disease is not a wheat allergy; it is an autoimmune condition triggered by gluten, a protein found in wheat, barley, and rye.

C. "I am glad that I can still eat rye bread." : Rye contains gluten and must be avoided in celiac disease.

D. "The bacteria in my gut are unable to digest gluten." : Celiac disease is not caused by bacterial inability to digest gluten but by an autoimmune response to gluten.

A. Decrease in the respiratory rate from 20 to 16/min. B. Increase in the heart rate from 88 to 110/min C. Decrease in the urinary output from 50 mL to 30 ml per hour. D. increase in the temperature from 99.5°F to 101.5°F

Correct Answer is B

Explanation

A. Decrease in the respiratory rate from 20 to 16/min: Hypovolemic shock typically causes tachypnea (increased respiratory rate) as the body tries to increase oxygen delivery. A decreasing respiratory rate is not an expected finding.

B. Increase in the heart rate from 88 to 110/min: Tachycardia is an early sign of hypovolemic shock because the heart compensates for low blood volume by pumping faster.

C. Decrease in the urinary output from 50 mL to 30 mL per hour: A drop in urine output suggests early organ perfusion issues, but hypovolemic shock is suspected when urine output falls below 20 mL/hr.

D. Increase in the temperature from 99.5°F to 101.5°F: Fever suggests infection or inflammatory response, not hypovolemic shock. Shock typically causes hypothermia (low body temperature) as circulation is compromised.

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A nurse is teaching a dent who is preoperative for a sigmoid colostomy. Which of the following statements should the nurse include?

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Naxlex Comprehensive Predictor Exams

The nurse is teaching a newly diagnosed client with celiac disease. Which of the following statements made by the client indicate understanding on the teaching?

Correct Answer is A

Explanation

A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding, which finding indicates to the nurse that the client may be developing hypovolemic shock?

Correct Answer is B

Explanation

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