Colostomy By Rnpedia.Com

34 Questions | Total Attempts: 5180

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Colostomy By Rnpedia.Com

Choose the letter of the correct answer.


Questions and Answers
  • 1. 
    Arthur Cruz, a 45 year old artist, has recently had an abdominoperineal resection and colostomy. Mr. Cruz accuses the nurse of being uncomfortable during a dressing change, because his “wound looks terrible.” The nurse recognizes that the client is using the defense mechanism known as:
    • A. 

      Reaction Formation

    • B. 

      Sublimation

    • C. 

      Intellectualization

    • D. 

      Projection

  • 2. 
    When preparing to teach a client with colostomy how to irrigate his colostomy, the nurse should plan to perform the procedure:
    • A. 

      When the client would have normally had a bowel movement

    • B. 

      After the client accepts he had a bowel movement

    • C. 

      Before breakfast and morning care

    • D. 

      At least 2 hours before visitors arrive

  • 3. 
    When observing an ostomate do a return demonstration of the colostomy irrigation, the nurse notes that he needs more teaching if he:
    • A. 

      Stops the flow of fluid when he feels uncomfortable

    • B. 

      Lubricates the tip of the catheter before inserting it into the stoma

    • C. 

      Hangs the bag on a clothes hook on the bathroom door during fluid insertion

    • D. 

      Discontinues the insertion of fluid after only 500 ml of fluid has been instilled

  • 4. 
    When doing colostomy irrigation at home, a client with colostomy should be instructed to report to his physician :
    • A. 

      Abdominal cramps during fluid inflow

    • B. 

      Difficulty in inserting the irrigating tube

    • C. 

      Passage of flatus during expulsion of feces

    • D. 

      Inability to complete the procedure in half an hour

  • 5. 
    A client with colostomy refuses to allow his wife to see the incision or stoma and ignores most of his dietary instructions. The nurse on assessing this data, can assume that the client is experiencing:
    • A. 

      A reaction formation to his recent altered body image.

    • B. 

      A difficult time accepting reality and is in a state of denial.

    • C. 

      Impotency due to the surgery and needs sexual counseling

    • D. 

      Suicide thoughts and should be seen by psychiatrist

  • 6. 
    The nurse would know that dietary teaching had been effective for a client with colostomy when he states that he will eat:
    • A. 

      Food low in fiber so that there is less stool

    • B. 

      Everything he ate before the operation but will avoid those foods that cause gas

    • C. 

      Bland foods so that his intestines do not become irritated

    • D. 

      Soft foods that are more easily digested and absorbed by the large intestines

  • 7. 
    The nurse is caring for a male client postoperatively following creation of a colostomy. Which nursing diagnosis should the nurse include in the plan of care?
    • A. 

      Sexual dysfunction

    • B. 

      Body image, disturbed

    • C. 

      Fear related to poor prognosis

    • D. 

      Nutrition: more than body requirements, imbalanced

  • 8. 
    The nurse is performing a colostomy irrigation on a male client. During the irrigation, the client begins to complain of abdominal cramps. What is the appropriate nursing action?
    • A. 

      Notify the physician

    • B. 

      Stop the irrigation temporarily

    • C. 

      Increase the height of the irrigation

    • D. 

      Medicate for pain and resume the irrigation

  • 9. 
    The nurse is teaching a female client how to perform a colostomy irrigation. To enhance the effectiveness of the irrigation and fecal returns, what measure should the nurse instruct the client to do?
    • A. 

      Increase fluid intake

    • B. 

      Place heat on the abdomen

    • C. 

      Perform the irrigation in the evening

    • D. 

      Reduce the amount of irrigation solution

  • 10. 
    The nurse is caring for a client with a colostomy. The client tells the nurse that he makes small pin holes in the drainage bag to help relieve gas. The nurse should teach him that this action:
    • A. 

      Destroys the odor-proof seal

    • B. 

      Wont affect the colostomy system

    • C. 

      Is appropriate for relieving the gas in a colostomy system

    • D. 

      Destroys the moisture barrier seal

  • 11. 
    A Client is scheduled to have a descending colostomy. He’s very anxious and has many questions regarding the surgical procedure, care of stoma, and lifestyle changes. It would be most appropriate for the nurse to make a referral to which member of the health care team?
    • A. 

      Social worker

    • B. 

      Registered dietician

    • C. 

      Occupational therapist

    • D. 

      Enterostomal nurse therapist

  • 12. 
    SITUATION: Michiel, A male patient diagnosed with colon cancer was newly put in colostomy. Michiel shows the BEST adaptation with the new colostomy if he shows which of the following?
    • A. 

      Look at the ostomy site

    • B. 

      Participate with the nurse in his daily ostomy care

    • C. 

      Ask for leaflets and contact numbers of ostomy support groups

    • D. 

      Talk about his ostomy openly to the nurse and friends

  • 13. 
    The nurse plans to teach Michiel about colostomy irrigation. As the nurse prepares the materials needed, which of the following item indicates that the nurse needs further instruction?
    • A. 

      Plain NSS / Normal Saline

    • B. 

      K-Y Jelly

    • C. 

      Tap water

    • D. 

      Irrigation sleeve

  • 14. 
    The nurse should insert the colostomy tube for irrigation at approximately  
    • A. 

      1-2 inches

    • B. 

      3-4 inches

    • C. 

      6-8 inches

    • D. 

      12-18 inches

  • 15. 
    The maximum height of irrigation solution for colostomy is  
    • A. 

      5 inches

    • B. 

      12 inches

    • C. 

      18 inches

    • D. 

      24 inches

  • 16. 
    Which of the following behavior of the client indicates the best initial step in learning to care for his colostomy?  
    • A. 

      Ask to defer colostomy care to another individual

    • B. 

      Promises he will begin to listen the next day

    • C. 

      Agrees to look at the colostomy

    • D. 

      States that colostomy care is the function of the nurse while he is in the hospital

  • 17. 
    While irrigating the client’s colostomy, Michiel suddenly complains of severe cramping. Initially, the nurse would
    • A. 

      Stop the irrigation by clamping the tube

    • B. 

      Slow down the irrigation

    • C. 

      Tell the client that cramping will subside and is normal

    • D. 

      Notify the physician

  • 18. 
    The next day, the nurse will assess Michiel’s stoma. The nurse noticed that a prolapsed stoma is evident if she sees which of the following?
    • A. 

      A sunken and hidden stoma

    • B. 

      A dusky and bluish stoma

    • C. 

      A narrow and flattened stoma

    • D. 

      Protruding stoma with swollen appearance

  • 19. 
    Michiel asked the nurse, what foods will help lessen the odor of his colostomy. The nurse best response would be  
    • A. 

      Eat eggs

    • B. 

      Eat cucumbers

    • C. 

      Eat beet greens and parsley

    • D. 

      Eat broccoli and spinach

  • 20. 
    The nurse will start to teach Michiel about the techniques for colostomy irrigation. Which of the following should be included in the nurse’s teaching plan?
    • A. 

      Use 500 ml to 1,000 ml NSS

    • B. 

      Suspend the irrigant 45 cm above the stoma

    • C. 

      Insert the cone 4 cm in the stoma

    • D. 

      If cramping occurs, slow the irrigation

  • 21. 
    The nurse knew that the normal color of Michiel’s stoma should be
    • A. 

      Brick Red

    • B. 

      Gray

    • C. 

      Blue

    • D. 

      Pale Pink

  • 22. 
    Nurse Michelle should know that the drainage is normal 4 days after a sigmoid colostomy when the stool is:
    • A. 

      Green liquid

    • B. 

      Solid formed

    • C. 

      Loose, bloody

    • D. 

      Semiformed

  • 23. 
    The nurse teaches the patient whose surgery will result in a sigmoid colostomy that the feces expelled through the colostomy will be
    • A. 

      Solid.

    • B. 

      Semi-mushy.

    • C. 

      Mushy.

    • D. 

      Fluid.

  • 24. 
    When irrigating a colostomy, the nurse lubricates the catheter and gently inserts it into the stoma no more than _______ inches
    • A. 

      3”

    • B. 

      2”

    • C. 

      4”

    • D. 

      5”

  • 25. 
    Discharge instructions for a patient who has been operated on for colorectal cancer include irrigating the colostomy. The nurse knows her teaching is effective when the patient states he’ll contact the doctor if:
    • A. 

      He experiences abdominal cramping while the irrigant is infusing

    • B. 

      He has difficulty inserting the irrigation tube into the stoma

    • C. 

      He expels flatus while the return is running out

    • D. 

      He’s unable to complete the procedure in 1 hour

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