how should a nurse care for a patient with a colostomy
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Nursing Elites

ATI LPN

ATI Comprehensive Predictor PN

1. How should a healthcare professional care for a patient with a colostomy?

Correct answer: A

Rationale: Emptying the colostomy bag regularly is essential to prevent leakage and infection. By regularly emptying the bag, the risk of irritation to the skin surrounding the stoma is reduced. Providing a high-fiber diet is important for overall bowel health but is not directly related to colostomy care. While monitoring for signs of infection is crucial, the primary focus should be on proper bag emptying. Changing the colostomy bag every 3 days may not be necessary for all patients and could vary based on individual needs and the type of colostomy.

2. A nurse is providing discharge instructions for a client with diabetes. What is the most important teaching point?

Correct answer: B

Rationale: The correct answer is B: Administer insulin before meals as prescribed. This is the most important teaching point because insulin administration before meals helps manage blood sugar effectively in diabetic patients. Choice A is incorrect because monitoring blood sugar levels weekly may not provide timely information for managing diabetes. Choice C is incorrect as medications for diabetes should be taken as prescribed, not only when feeling unwell. Choice D is incorrect as blood sugar levels should be monitored at various times throughout the day, not just in the morning, to get a complete picture of the patient's condition.

3. What is the most appropriate next step when a client with an NG tube attached to low suctioning becomes nauseated, and the nurse observes a decrease in the flow of gastric secretions?

Correct answer: B

Rationale: The correct answer is to irrigate the NG tube with sterile water. When a client with an NG tube attached to low suctioning becomes nauseated and there is a decrease in the flow of gastric secretions, it indicates a possible blockage in the tube. Irrigating the tube with sterile water can help clear the blockage, allowing for proper suctioning and relieving the client's nausea. Increasing the suction pressure (Choice A) can further worsen the issue by potentially causing harm to the client. Turning the client on their side (Choice C) may not address the underlying problem of tube blockage. Replacing the NG tube with a new one (Choice D) should only be considered if other interventions, like irrigation, fail to clear the blockage.

4. A client with a tracheostomy is exhibiting signs of respiratory distress. What is the first action the nurse should take?

Correct answer: B

Rationale: The correct first action for a client with a tracheostomy exhibiting signs of respiratory distress is to suction the tracheostomy. This helps clear the airway and improve breathing. Increasing the suction setting on the ventilator is not appropriate as the issue may be related to secretions that need to be directly removed. Notifying the physician should come after providing immediate nursing interventions. Encouraging deep breathing exercises is not suitable when the client is in respiratory distress and needs prompt intervention.

5. A client reports difficulty having a bowel movement. What is the most appropriate intervention?

Correct answer: B

Rationale: The correct answer is to encourage the client to increase fiber intake. Fiber helps promote regular bowel movements by adding bulk to the stool, making it easier to pass. Administering a laxative (Choice A) should not be the first-line intervention as it can lead to dependency and may not address the underlying cause of constipation. Advising the client to rest in bed (Choice C) may worsen constipation as physical activity helps stimulate bowel movements. Encouraging the client to exercise (Choice D) is beneficial, but increasing fiber intake is more directly related to improving bowel movements in this scenario.

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