Nursing Elites

1. 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.

2. You’re caring for a patient with a sigmoid colostomy. The stool from this colostomy is:

• A. Formed
• B. Semisolid
• C. Semiliquid
• D. Watery

Correct answer: A

Rationale: The stool from a sigmoid colostomy is typically formed.

3. The nurse assesses the client's understanding of the relationship between body position and gastroesophageal reflux. Which response would indicate that the client understands measures to avoid problems with reflux while sleeping?

• A. I can elevate the foot of the bed 4 to 6 inches.
• B. I can sleep on my stomach with my head turned to the left.
• C. I can sleep on my back without a pillow under my head.
• D. I can elevate the head of the bed 4 to 6 inches.

Correct answer: D

Rationale: Sleeping with the head of the bed elevated encourages movement of food through the esophagus by gravity. By fostering esophageal acid clearance, gravity helps keep the acidic pepsin and alkaline biliary secretions from contacting the esophagus. Elevating the foot of the bed does not affect clearance of esophageal acid. Sleeping on the stomach with the head turned to the left will not decrease reflux incidence. Sleeping flat without a pillow under the head does not enhance clearance.

4. Which of the following symptoms would a client in the early stages of peritonitis exhibit?

• A. Abdominal distention
• B. Abdominal pain and rigidity
• C. Hyperactive bowel sounds
• D. Right upper quadrant pain

Correct answer: B

Rationale: In the early stages of peritonitis, the client would exhibit abdominal pain and rigidity due to inflammation.

5. A client has a nasogastric tube inserted at the time of abdominal perineal resection with permanent colostomy. This tube will most likely be removed when the client demonstrates:

• A. Absence of nausea and vomiting.
• B. Passage of mucus from the rectum.
• C. Passage of flatus and feces from the colostomy.
• D. Absence of stomach drainage for 24 hours.

Correct answer: C

Rationale: A sign indicating that a client's colostomy is open and ready to function is passage of feces and flatus. When this occurs, gastric suction is ordinarily discontinued, and the client is allowed to start taking fluids and food orally. Absence of bowel sounds would indicate that the tube should remain in place because peristalsis has not yet returned. Absence of nausea and vomiting is not a criterion for judging whether or not gastric suction should be continued. Passage of mucus from the rectum will not occur in this client because the rectum is removed in this surgery. Absence of stomach drainage is not a criterion for judging whether or not gastric suction should be continued.

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