ATI RN Comprehensive Online Practice A with NGN ACTUAL REAL PRACTICE EXAM UPDATED QUESTION AND DETAILED ANSWER WITH RATIONALES ANSWERS.

ATI RN Comprehensive Online Practice A with NGN ACTUAL REAL PRACTICE EXAM UPDATED QUESTION AND DETAILED ANSWER WITH RATIONALES ANSWERS. A nurse is providing colostomy care for a client using a two-piece pouching system. Which of the following actions should the nurse take? - ANSWERplace the skin barrier over the stoma and hold for 30 seconds to activate the adhesive in the skin. barrier Rationale. why are the other answers incorrect? - cleanse the stoma site with povidone-iodine for 15 seconds: the skin at the stoma site should be cleansed with a washcloth and warm water to reduce risk of skin irritation - dampen the skin before apply the skin barrier and the ostomy pouch: the nurse should thoroughly dry the skin around the stoma using a patting motion before applying the skin barrier to ensure the pouch adheres to the clients skin - cut the skin barrier opening 0.6 cm larger than the stoma: do not cut the skin barrier opening more than 0.3 cm larger than the stoma to reduce the risk of skin irritation A nurse is assessing a client who has sickle cell anemia. The nurse should identify which of the following findings as a manifestation of vaseocclusive crisis? - ANSWER-hematuria because it is a manifestation that results from ischemia of the kidneys Rationale. what answers are not signs of vast-occlusive crisis? - diminished reflexes, hyperglycemia, hearing loss what are other signs of vast-occlusive crisis? painful swelling of the hands and feet, visual disturbances A nurse is providing client education to a postpartum client who has decided to bottle feed the newborn. Which of the following instructions should the nurse include in the teaching to help prevent the discomfort of engorgement? - ANSWER-place ice packs on the breasts for 15 min several times per day because this helps reduce swelling and relieve pain Rationale. why are the other instructions incorrect? - allow the newborn to breastfeed temporarily: avoid nipple stimulation because this will increase milk production - relieve pressure by expressing milk daily: avoid expressing milk to prevent further milk production - sleep with a loose fitting bra to prevent nipple stimulation: wear a tight fighting, supportive bra or a breast binder to decrease discomfort caused by engorgement