The client with inflammatory bowel disease is having surgery for a temporary colostomy. It will be a transverse colostomy, with the stoma located as shown. What will be the consistency of the stool from the colostomy?

Choice A reason: In fever, pyrogens reset the hypothalamic thermoregulatory set point, causing the body to raise core temperature via shivering and vasoconstriction. Once reached, diaphoresis and flushing occur to dissipate heat, preventing overheating. This statement accurately describes the body’s response to achieving the fever’s set point in pneumonia.

Choice B reason: Exogenous pyrogens (e.g., bacterial toxins) act via endogenous pyrogens (cytokines) to reset the hypothalamic, not anterior pituitary, set point. The pituitary regulates hormones, not thermoregulation. This statement is inaccurate, as it misidentifies the anatomical site and mechanism of fever induction.

Choice C reason: Hyperthermia involves uncontrolled heat gain (e.g., heat stroke), not a regulated fever like in pneumonia. The client’s diaphoresis and flushing indicate intact heat loss mechanisms, not failure. This statement is inaccurate, as fever, not hyperthermia, drives the observed symptoms in this scenario.

Choice D reason: Endogenous pyrogens (e.g., IL-1, IL-6) stimulate prostaglandins, not leukotrienes, to reset the hypothalamic set point in fever. Leukotrienes are involved in allergic responses, not thermoregulation. This statement is inaccurate, as it misattributes the biochemical mediator of fever in pneumonia.

Choice A reason: Methotrexate, a DMARD, inhibits folate metabolism, suppressing immune activity in rheumatoid arthritis. A common side effect is nausea, resulting from gastrointestinal mucosal irritation due to folate antagonism. This affects rapidly dividing cells in the gut, making nausea a recognized complication requiring monitoring or antiemetic support.

Choice B reason: Joint swelling is a symptom of active rheumatoid arthritis, not a complication of methotrexate. Methotrexate reduces joint inflammation by inhibiting immune responses. Persistent swelling suggests inadequate disease control, not a drug side effect, making this finding unrelated to methotrexate complications.

Choice C reason: Generalized aching and stiffness are symptoms of rheumatoid arthritis itself, not methotrexate complications. Methotrexate aims to alleviate these by reducing synovial inflammation. If these persist, it indicates disease activity, not a drug side effect, making this finding incorrect for a methotrexate complication.

Choice D reason: Rheumatoid nodules are a feature of rheumatoid arthritis, not a side effect of methotrexate. These subcutaneous nodules result from chronic inflammation, not drug toxicity. Methotrexate may reduce nodule formation by controlling disease activity, making this finding unrelated to medication complications.