Which stoma would you expect a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown?

Correct Answer: A

Rationale: In this case, the correct answer is A) Ileostomy. An ileostomy typically produces malodorous, enzyme-rich, caustic liquid output that can be yellow, green, or brown in color. This is due to the fact that an ileostomy is created from the small intestine, where digestive enzymes are still present, leading to the characteristic output described. The incorrect options include B) Ascending colostomy, C) Transverse colostomy, and D) Descending colostomy. These types of colostomies are created from the large intestine (colon) where the stool is more formed and less liquid compared to the small intestine. Therefore, they would not produce the same type of malodorous, enzyme-rich, liquid output as an ileostomy. In the context of medical surgical nursing, understanding the different types of stomas and their expected outputs is crucial for providing optimal care to patients with ostomies. Recognizing the characteristics of each type of stoma helps nurses in assessing and managing complications, providing appropriate patient education, and promoting patient comfort and quality of life.

Correct Answer: C

Rationale: In the context of Maria developing peptic ulcer disease due to NSAID use, the correct answer is C) Misoprostol (Cytotec). Misoprostol is a prostaglandin analog that helps prevent NSAID-induced ulcers by promoting mucus production in the stomach, enhancing mucosal defense, and reducing acid secretion. This drug is particularly effective in patients like Maria who require NSAIDs for pain management but are at risk for developing ulcers. Option A) Calcium carbonate (Tums) is an antacid that provides symptomatic relief but does not prevent NSAID-induced ulcers. Option B) Famotidine (Pepcid) is an H2 receptor antagonist that reduces acid production but does not address the underlying issue of mucosal protection. Option D) Sucralfate (Carafate) is a cytoprotective agent that forms a protective barrier over ulcers but does not specifically prevent NSAID-induced ulcers like Misoprostol does. In an educational context, understanding the mechanism of action of drugs used to prevent and treat gastrointestinal issues related to NSAID use is crucial for nursing practice. Nurses need to know the rationale behind selecting Misoprostol in this scenario to provide optimal care for patients like Maria and prevent complications associated with NSAID therapy.

Correct Answer: C

Rationale: In the context of this question about colorectal cancer risk factors, the correct answer is option C) Herman, a 60-year-old who follows a low-fat, high-fiber diet. This option is the least likely to have risk factors for colon cancer because a diet high in fiber and low in fat is associated with a lower risk of developing colorectal cancer. High-fiber diets help maintain bowel regularity and reduce the time that potentially harmful substances are in contact with the colon lining, thus decreasing the risk of cancer development. Option A) Janice, with a 25-year history of ulcerative colitis, is at an increased risk for colorectal cancer as chronic inflammation of the colon is a known risk factor. Option B) George, whose father died of colon cancer, has a family history of the disease which increases his risk. Option D) Sissy, with a history of breast cancer, does not have a direct risk factor for colon cancer related to her breast cancer history. In an educational context, this question highlights the importance of understanding modifiable and non-modifiable risk factors for colorectal cancer. It reinforces the significance of lifestyle factors, such as diet, in cancer prevention. Educating student nurses about risk factors empowers them to assess patients holistically, provide targeted health promotion interventions, and advocate for appropriate screening measures to improve patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Have the doctor called while you remain with the patient, flex the patient's knees, and cover the wound with sterile towels soaked in sterile saline solution. The priority in this situation is to protect the exposed bowel to prevent infection and further complications. By covering the wound with sterile towels soaked in sterile saline solution, you create a barrier against contamination. Flexing the patient's knees helps reduce tension on the abdominal muscles, which can decrease the risk of further bowel protrusion. Option A is incorrect because covering the area with a water-soaked bedsheet is not an appropriate intervention for protecting the exposed bowel. Option B is not the best choice as obtaining vital signs alone does not address the immediate risk of infection and further injury. Option C is also incorrect as having a CAN hold the wound together is not as effective as covering it with sterile towels and calling the doctor for immediate intervention. This scenario emphasizes the importance of rapid assessment and implementation of appropriate interventions to manage post-operative complications effectively in patients with gastrointestinal issues. It highlights the critical thinking skills and quick decision-making required in emergency situations in medical-surgical nursing.

Correct Answer: C

Rationale: In the context of a patient with peritonitis who is NPO and complaining of thirst, the priority action is to provide frequent mouth care, as indicated by the correct answer C. Providing frequent mouth care helps to maintain oral hygiene, reduce dryness, and alleviate the sensation of thirst without compromising the patient's NPO status. It also promotes comfort and prevents complications such as oral mucosal breakdown and infection. Addressing the patient's thirst through mouth care is a non-invasive and safe approach that aligns with the patient's dietary restrictions. The other options are not the priority in this situation: - Option A (Increase the I.V. infusion rate) may not be necessary solely for thirst relief and could potentially lead to fluid overload or other complications. - Option B (Use diversion activities) is not the most appropriate intervention when the patient's primary concern is thirst related to NPO status and peritonitis. - Option D (Give ice chips every 15 minutes) is contraindicated for a patient who is NPO due to the risk of aspiration and potential worsening of the underlying condition. Understanding the rationale behind prioritizing mouth care in this scenario reinforces the importance of individualized patient care, critical thinking, and evidence-based practice in the field of medical-surgical nursing.