The nurse is emptying an ileostomy pouch for a patient Which assessment finding will the nurse report immediately?
Continuous output from the stoma
Presence of blood in the stool
Malodorous Stool
Liquid consistency with hard stool particles
The Correct Answer is B
A. Continuous output from the stoma. Ileostomies typically have continuous liquid output, which is expected.
B. Presence of blood in the stool: Blood in the stool can indicate stomal irritation, ulceration, or bleeding from the intestines, which requires immediate medical attention.
C. Malodorous stool. While foul-smelling stool can suggest an issue (e.g., infection), it is not necessarily an emergency.
D. Liquid consistency with hard stool particles. Ileostomy output is expected to be liquid, and occasional solid particles may occur if certain foods are not fully digested.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Get three fecal smears from one bowel movement. FIT only requires one sample per bowel movement, but it is best to test multiple separate bowel movements for accuracy.
B. Collect one fecal smear from three separate bowel movements. FIT testing detects blood proteins using antibodies, and blood presence in stool can be intermittent. Collecting samples from different days increases accuracy.
C. Obtain one fecal smear from an early morning bowel movement. Time of day does not matter, but multiple samples from different bowel movements are preferred.
D. Get three fecal smears when you see blood in your bowel movement. FIT is meant to detect hidden (occult) blood that is not visible.
Correct Answer is B
Explanation
A. Rye. Rye contains gluten, which must be avoided in celiac disease.
B. Rice. Rice is gluten-free and safe for individuals with celiac disease.
C. Barley. Barley contains gluten and should be avoided.
D. Wheat. Wheat contains gluten and is a primary trigger for celiac symptoms.
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