The nurse is teaching a client about sexual modifications for clients with an ostomy. Which of the following strategies would the nurse suggest when anticipating sexual activity?

Correct Answer: B

Rationale: The correct answer is B because limiting foods that activate the bowel can help reduce the chances of embarrassing situations during sexual activity. Certain foods can cause gas or increase stool output, which may affect the client's confidence and comfort. Leaving the stoma open to air and covering with a towel (choice A) is not recommended during sexual activity as it may lead to odor and potential leakage. Bathing and applying a fresh pouch after sex (choice C) is important for hygiene but does not directly address preparation for sexual activity. Consulting with an ostomy support group (choice D) is beneficial for emotional support but does not specifically address strategies for anticipating sexual activity.

Correct Answer: D

Rationale: The correct answer is D because providing adequate support to the incision during coughing, deep breathing, and turning is essential postoperatively to prevent complications such as wound dehiscence or infection in obese patients who have undergone bariatric surgery. Supporting the incision helps reduce stress on the surgical site and promotes proper healing. Choice A is incorrect because irrigating and repositioning the nasogastric tube is not a specific nursing intervention related to the care of the incision after bariatric surgery. Choice B is incorrect because delaying ambulation can increase the risk of complications such as deep vein thrombosis and pneumonia in postoperative obese patients. Choice C is incorrect because keeping the patient positioned on the side to facilitate respiratory function is important, but it is not directly related to supporting the incision during activities that increase intra-abdominal pressure.

Correct Answer: D

Rationale: The correct answer is D because corticosteroids inhibit the synthesis of mucus and prostaglandins, which are important for protecting the stomach lining. Without enough mucus and prostaglandins, the stomach lining becomes more susceptible to damage from stomach acid, leading to the development of peptic ulcers. Choice A is incorrect because the enzyme urease is associated with the development of Helicobacter pylori infection, not peptic ulcers directly. Choice B is incorrect because corticosteroids actually decrease hydrochloric acid secretion. Choice C is incorrect because a decreased rate of mucous cell renewal would lead to decreased mucus production, which could contribute to peptic ulcers, but it is not the primary mechanism associated with corticosteroids.

Correct Answer: C

Rationale: The correct answer is C: Check the amount and character of gastric drainage and the patency of the NG tube. This is the priority nursing intervention because the patient is experiencing nausea and vomiting, which could indicate potential complications related to the NG tube, such as blockage or displacement. By checking the gastric drainage and NG tube patency, the nurse can assess if the patient's symptoms are related to these issues and take appropriate actions to address them. Choice A is incorrect because assessing the abdomen for distention and bowel sounds is important but not the priority in this situation where the patient is experiencing nausea and vomiting. Choice B is incorrect as inspecting the surgical site and drainage in the Jackson-Pratt drain is also important but not as urgent as checking the NG tube patency in this case. Choice D is incorrect as administering medication should not be the first action taken without first assessing the underlying cause of the symptoms.

Correct Answer: C

Rationale: The correct answer is C because 8 hours post colostomy surgery, a purplish stoma that is shiny and moist with mucus indicates adequate blood supply and tissue perfusion, which are signs of a healthy stoma. A is incorrect as hyperactive, high-pitched bowel sounds are not expected immediately post-surgery. B is incorrect as a brick-red, puffy stoma oozing blood could indicate poor perfusion. D is incorrect as liquid fecal drainage is not expected immediately post-surgery; it usually starts a few days later.