Nursing Elites

1. The client has had a new colostomy created 2 days earlier. The client is beginning to pass malodorous flatus from the stoma. The nurse interprets that

• A. This indicates inadequate preoperative bowel preparation.
• B. This is a normal, expected event.
• C. The client is experiencing early signs of ischemic bowel.
• D. The client should not have the nasogastric tube removed.

Correct answer: B

Rationale: As peristalsis returns following creation of a colostomy, the client begins to pass malodorous flatus. This indicates returning bowel function and is an expected event. Within 72 hours of surgery, the client should begin passing stool via the colostomy.

2. The client with ascites is scheduled for a paracentesis. The nurse is assisting the physician in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure?

• A. Supine
• B. Left side-lying
• C. Right side-lying
• D. Upright position.

Correct answer: D

Rationale: An upright position allows the intestine to float posteriorly and helps prevent intestinal laceration during catheter insertion.

3. Which stoma would you expect a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown?

• A. Ileostomy.
• B. Ascending colostomy.
• C. Transverse colostomy.
• D. Descending colostomy.

Correct answer: A

Rationale: An ileostomy would have a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown.

4. Which of the following dietary measures would be useful in preventing esophageal reflux?

• A. Eating small, frequent meals
• B. Increasing fluid intake
• C. Avoiding air swallowing with meals
• D. Adding a bedtime snack to the dietary plan

Correct answer: A

Rationale: Eating small, frequent meals helps prevent esophageal reflux.

5. You’re advising a 21 y.o. with a colostomy who reports problems with flatus. What food should you recommend?

• A. Peas
• B. Cabbage
• C. Broccoli
• D. Yogurt

Correct answer: D

Rationale: Yogurt can help reduce problems with flatus in patients with a colostomy.

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