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

Correct Answer: D

Rationale: The correct answer is D: Semiformed. This indicates proper colostomy function. Green liquid (A) suggests rapid transit time. Solid formed (B) can indicate constipation. Loose, bloody (C) indicates inflammation or infection. Semiformed (D) is the ideal consistency for colostomy drainage, indicating proper digestion and absorption.

Correct Answer: A

Rationale: The correct answer is A: Bone fracture. Osteoporosis is a condition characterized by weakened bones, making the individual more susceptible to fractures. Teaching the client about this major complication is crucial for prevention and management. Fractures are a significant concern due to the increased risk of falls and fragility of the bones. Loss of estrogen (choice B) is a contributing factor to osteoporosis but not a major complication. Negative calcium balance (choice C) is a consequence of osteoporosis but not the primary major complication. Dowager's hump (choice D) is a visible sign of advanced osteoporosis but not the major complication. Overall, educating the client about bone fractures is essential for their understanding and proactive measures to prevent further complications.

Correct Answer: B

Rationale: The correct answer is B: Fine crackles. In heart failure, fluid accumulates in the lungs, causing fine crackles on auscultation. Tracheal breath sounds (A) are normal and heard over the trachea. Coarse crackles (C) are associated with conditions like pneumonia, not heart failure. Friction rubs (D) are typically heard in conditions like pericarditis, not heart failure. Therefore, the presence of fine crackles is a key indicator of fluid overload in the lungs, which is common in heart failure.

Correct Answer: C

Rationale: The correct answer is C: To determine the extent of lesions. A chest X-ray is done to evaluate the presence and extent of lesions in the lungs, which helps in assessing the severity of tuberculosis infection. This is important for determining the appropriate treatment plan and monitoring the progression of the disease. Incorrect answers: A: To confirm the diagnosis - Chest X-ray alone cannot confirm the diagnosis of tuberculosis, as other tests such as sputum culture or PCR are needed. B: To determine if a repeat skin test is needed - Chest X-ray is not used to determine the need for a repeat skin test, as the decision for repeat testing is based on clinical judgment and guidelines. D: To determine if this is a primary or secondary infection - Chest X-ray may provide some information, but the distinction between primary and secondary infection is usually based on clinical history and other diagnostic tests.

Correct Answer: C

Rationale: The correct answer is C: Cocaine. Cocaine is a potent stimulant drug that can cause symptoms such as substernal chest pain, palpitations, and sinus tachycardia. Given the client's presentation of chest pain and racing heart, along with the absence of cardiac history, cocaine use should be considered and questioned. Barbiturates (A), opioids (B), and benzodiazepines (D) are less likely to cause sinus tachycardia and substernal chest pain compared to cocaine. It is important to focus on cocaine as a potential cause in this scenario due to its known cardiovascular effects.