The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care.

What is the nurse's most appropriate response to this observation?

Remind the patient that they will be responsible for caring for the ileostomy after discharge.

Reassure the patient that this procedure will be reversed in a few months.

Acknowledge the patient's reluctance and initiate discussion to explore their feelings.

Discuss with the medical team during interdisciplinary rounds the need for a psychiatric referral.

Answer and Explanation

The Correct Answer is C

Choice A reason: Reminding the patient that they will be responsible for caring for the ileostomy after discharge may increase their anxiety and reluctance. It does not address the underlying concerns or feelings.

Choice B reason: Reassuring the patient that the procedure will be reversed in a few months is not always accurate and may provide false hope. Each patient's situation is unique, and not all ileostomies are temporary.

Choice C reason: Acknowledging the patient's reluctance and initiating a discussion to explore their feelings is the most appropriate response. This approach allows the nurse to understand the patient's concerns, provide emotional support, and offer practical solutions to help the patient feel more comfortable with ostomy care.

Choice D reason: Discussing the need for a psychiatric referral during interdisciplinary rounds is not the immediate step. The nurse should first address the patient's feelings and concerns directly and provide support.

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Correct Answer is C

Explanation

Choice A reason: Adhering to the medication regimen even when not experiencing symptoms is crucial for managing multiple sclerosis (MS). MS is a chronic condition that requires consistent treatment to prevent relapses and slow disease progression. This statement indicates proper understanding of medication adherence.

Choice B reason: Maintaining regular physical activity and exercise with planned rest periods is important for managing MS. Physical activity helps maintain muscle strength, flexibility, and overall health, while planned rest periods prevent overexertion and fatigue. This statement indicates proper understanding of balancing activity and rest.

Choice C reason: Soaking in a hot bath every night to help with muscle weakness and fatigue requires further teaching. Heat can exacerbate MS symptoms, leading to increased fatigue and muscle weakness. Patients with MS are often advised to avoid hot baths and instead use cool or lukewarm water for comfort. This statement indicates a misunderstanding of how to manage symptoms effectively.

Choice D reason: Identifying strategies to control anxiety and physical stress to prevent exacerbations is important for managing MS. Stress can trigger MS relapses and worsen symptoms. Developing stress management techniques helps reduce the risk of exacerbations. This statement indicates proper understanding of the importance of stress management.

A. pH 7.26, PaCO2 59, HCO3 30 B. pH 7.46, PaCO2 30, HCO3 24 C. pH 7.48, PaCO2 42, HCO3 29 D. pH 7.31, PaCO2 34, HCO3 18

Correct Answer is C

Explanation

Choice A reason: The lab results pH 7.26, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This finding is inconsistent with the expected results for a patient with small bowel obstruction and nasogastric suction, which typically leads to metabolic alkalosis due to loss of gastric acid.

Choice B reason: The lab results pH 7.46, PaCO2 30, HCO3 24 suggest a slightly alkaline state with normal bicarbonate levels, which could indicate respiratory alkalosis with compensation. However, for a patient with a small bowel obstruction and nasogastric suction, this is less likely.

Choice C reason: The lab results pH 7.48, PaCO2 42, HCO3 29 indicate metabolic alkalosis. This is a common finding in patients with small bowel obstruction who have been on nasogastric suction, which removes stomach acids and leads to an increase in bicarbonate levels. The elevated pH and bicarbonate levels are consistent with this condition.

Choice D reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis. This finding is inconsistent with the expected results for a patient with small bowel obstruction and nasogastric suction, which typically leads to

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The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care. What is the nurse's most appropriate response to this observation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching a patient with a new diagnosis of multiple sclerosis (MS) about self-care with this condition. What patient statement indicates to the nurse that the patient requires further teaching?

Correct Answer is C

Explanation

The nurse is caring for a patient diagnosed with small bowel obstruction. A nasogastric tube with low continuous suction has been in place for 72 hours. Upon reviewing the blood work, which lab results will the nurse expect to see?

Correct Answer is C

Explanation

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The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care.

What is the nurse's most appropriate response to this observation?