a nurse is caring for a client who has just returned from the operating room following the creation of a colostomy the nurse is assessing the drainage
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Nursing Elites

ATI RN

Gastrointestinal System Nursing Exam Questions

1. A nurse is caring for a client who has just returned from the operating room following the creation of a colostomy. The nurse is assessing the drainage in the pouch attached to the site where the colostomy was formed and notes serosanguineous drainage. Which nursing action is most appropriate based on this assessment?

Correct answer: B

Rationale: During the first 24 to 72 hours following surgery, mucus and serosanguineous drainage are expected from the stoma. Documenting the amount and characteristics of the drainage is appropriate. The nurse does not need to notify the physician because this is an expected finding. Applying ice or pressure to the site is not necessary.

2. Which of the following areas is the most common site of fistulas in clients with Crohn’s disease?

Correct answer: A

Rationale: The anorectal area is the most common site of fistulas in clients with Crohn's disease.

3. If a client had irritable bowel syndrome, which of the following diagnostic tests would determine if the diagnosis is Crohn’s disease or ulcerative colitis?

Correct answer: D

Rationale: A colonoscopy with biopsy is the most definitive diagnostic test to differentiate between Crohn's disease and ulcerative colitis.

4. A Penrose drain is in place on the first postoperative day following a cholecystectomy. Serosanguineous drainage is noted on the dressing covering the drain. Which nursing intervention is most appropriate?

Correct answer: B

Rationale: Serosanguineous drainage with a small amount of bile is expected from the Penrose drain for the first 24 hours. Drainage then decreases, and the drain is removed usually within 48 hours. The nurse does not need to notify the physician. A sterile dressing covers the site and should be changed to prevent infection and skin excoriation.

5. You’re preparing a patient with a malignant tumor for colorectal surgery and subsequent colostomy. The patient tells you he’s anxious. What should your initial step be in working with this patient?

Correct answer: A

Rationale: When a patient with a malignant tumor is anxious about colorectal surgery and a colostomy, the initial step is to determine what the patient already knows about colostomies.

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