Priority Decision: A patient with ulcerative colitis has a total proctocolectomy with formation of a terminal ileum stom What is the most important nursing intervention for this patient postoperatively?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Measure the ileostomy output to determine the status of the patient's fluid balance. This is the most important nursing intervention postoperatively for a patient with a total proctocolectomy and ileostomy. Measuring the ileostomy output is crucial as it helps assess the patient's fluid balance, enabling early detection of dehydration or electrolyte imbalances, common postoperative complications. Monitoring output volume, color, consistency, and changes over time can provide valuable information on the patient's condition. Option B is incorrect as changing the ileostomy appliance every 3 to 4 hours is unnecessary and may lead to skin breakdown. Option C is incorrect as stating the ostomy is temporary may not be accurate for all patients and can cause confusion. Option D is incorrect as a high-fiber, low-carbohydrate diet is not typically recommended postoperatively for ileostomy patients. Educationally, understanding the rationale behind the priority nursing intervention postoperatively for patients with ileostomies is crucial for providing safe and effective care. By emphasizing the importance of monitoring ileostomy output for fluid balance assessment, nurses can prevent complications and promote optimal patient outcomes.

Correct Answer: D

Rationale: The correct answer is D) Primary sclerosing cholangitis. Primary sclerosing cholangitis is a chronic liver disease characterized by inflammation and scarring of the bile ducts inside and outside the liver. It is commonly associated with ulcerative colitis, an inflammatory bowel disease. The patient's symptoms of jaundice, itching, steatorrhea, and liver enlargement are indicative of liver dysfunction and bile duct involvement, which align with primary sclerosing cholangitis. Option A) Cirrhosis is a chronic liver disease characterized by liver scarring due to various factors such as alcoholism, viral hepatitis, or non-alcoholic fatty liver disease. While cirrhosis can present with jaundice and liver enlargement, the presence of ulcerative colitis and steatorrhea in this case points more towards primary sclerosing cholangitis. Option B) Acute liver failure is a rapid deterioration of liver function, leading to hepatic encephalopathy and coagulopathy. The patient's symptoms are more indicative of a chronic rather than acute liver condition. Option C) Hepatorenal syndrome is a condition where there is kidney failure in the setting of advanced liver disease. The patient's symptoms do not specifically point towards kidney involvement at this stage. Educationally, understanding the relationship between primary sclerosing cholangitis and ulcerative colitis is crucial for nurses caring for patients with these conditions. Recognizing the symptoms and complications of primary sclerosing cholangitis can aid in early detection and management to improve patient outcomes. Nurses should also be aware of the differential diagnoses for liver diseases to provide comprehensive care and support to patients with gastrointestinal conditions.

Correct Answer: B

Rationale: In the context of Med-Surg Gastrointestinal NCLEX questions, the correct answer to the question of the risk factor associated with cancer of the pancreas is B) Cigarette smoking. Understanding this involves knowledge of the relationship between cigarette smoking and pancreatic cancer. Cigarette smoking is a well-established risk factor for pancreatic cancer due to the carcinogens present in tobacco smoke that can damage the pancreas over time, leading to the development of cancerous cells. Option A) Alcohol intake is not directly linked to pancreatic cancer, although heavy alcohol consumption can contribute to other gastrointestinal issues. Option C) Exposure to asbestos is associated with lung cancer, particularly mesothelioma, but not pancreatic cancer. Option D) Increased dietary intake of spoiled milk products is not a recognized risk factor for pancreatic cancer. Educationally, it is crucial for nursing students preparing for the NCLEX to grasp the specific risk factors for different types of cancer, as this knowledge can inform patient education, prevention strategies, and early detection efforts. Understanding the correlation between cigarette smoking and pancreatic cancer underscores the importance of smoking cessation interventions in reducing the risk of developing this deadly disease.

Correct Answer: B

Rationale: The correct answer is B) Interferon and ribavirin for treating chronic hepatitis C. Interferon helps the immune system fight the virus, while ribavirin inhibits viral replication. This combination therapy has been shown to be effective in managing chronic hepatitis C. Option A) Sulfasalazine is used for inflammatory bowel disease like ulcerative colitis and Crohn's disease, not for hepatitis C. Option C) Metronidazole and ciprofloxacin are antibiotics used for bacterial infections, not for hepatitis C caused by a virus. Option D) Acetaminophen is a pain reliever but should be used cautiously in patients with liver disease due to the risk of hepatotoxicity. Understanding the appropriate treatment for chronic hepatitis C is crucial for nurses and healthcare providers caring for patients with this condition. It is important to be aware of the medications used, their mechanisms of action, and potential side effects to provide safe and effective care. Treatment of hepatitis C has evolved over the years, so staying updated on current guidelines and recommendations is essential for providing quality patient care.