MEDICAL SURGICAL LPN COMPREHENSIVE
STUDY GUIDE 2026 ADULT HEALTH AND
MEDICAL SURGICAL NURSING PRINCIPLES
◉ Christine Warren, 45 years old, has a long history of ulcerative
colitis, and non-surgical treatment no longer relieved her symptoms.
She underwent a total proctocolectomy and a permanent ileostomy
12 hours ago.
The nurse should contact the physician immediately if Mrs. Warren
has which of these findings?
1) The stoma appears pale and dry.
2) The stoma appears red and shiny.
3) There is 200 mL of dark green output from the stoma.
4) There is 50 mL of serosanguinous drainage from the stoma.
Answer: 1) The stoma appears pale and dry.
Rationale: If there is an adequate blood supply to the stoma, the
color is pink or red, and the stoma is moist as a result of mucous
production. A pale dry color suggests ischemia of the stoma or
bowel and must be reported immediately to the physician. With an
ileostomy initially after surgery, the output is a loose, dark green
liquid that may contain some blood. The ileostomy usually begins to
drain within 24 of surgery at more than one liter per day.
,◉ When changing Mrs. Warren's ileostomy bag, the nurse notices
that the peristomal skin is irritated.
Which of these actions by the nurse would be appropriate before
reapplying the appliance?
1) Wash the area with antiseptic soap and water.
2) Clean the site with Dakin's solution.
3) Use a solid skin barrier.
4) Obtain an order for a topical antibiotic. Answer: 3) Use a solid
skin barrier.
Rationale: The drainage from the stoma can quickly irritate the
surrounding tissue. Therefore, a solid skin barrier, with a pectin base
or karaya wafer that has a measurable thickness and hydrocolloid
adhesive properties, should be applied.
◉ Which of these comments, if made by Mrs. Warren before her
surgery, would indicate that she had concerns about her body
image?
1) "I will have to stop my aerobics classes."
2) "I'm so afraid I may not survive the surgery."
3) "I need to go shopping for some loose, baggy clothes."
,4) "I'm concerned that this may be only the first of many surgeries."
Answer: 3) "I need to go shopping for some loose, baggy clothes."
Rationale:Body image refers to a person's perception of self and
determines how the person interacts with others. One does not need
to purchase special clothing after ileostomy surgery, although some
minor adjustments may be needed for comfort, e.g., stretch
underwear or pantyhose for support.
◉ To get TEST BANK for Medical-Surgical Nursing: Concepts for
Clinical Judgment and Collaborative Care 11th Edition by Donna D.
Ignatavicius, All chapters 1 - 74
email or copy these links to get the
full test banks. Each link has a different versions
http://www.stuvia.com/doc/7290675
http://www.stuvia.com/doc/8342084
http://www.stuvia.com/doc/9267657
http://www.stuvia.com/doc/7153071
, http://www.stuvia.com/doc/7069048 Answer:
http://www.stuvia.com/doc/7290675
◉ Lewis Palmer, 45 years old, has a history of multiple myocardial
infarctions and is a heavy smoker. He takes warfarin sodium
(Coumadin) daily. Two weeks ago, he had a right femoral-popliteal
bypass, which became occluded 24 hours ago. He is admitted
following an angioplasty of the femoral-popliteal bypass graft. Mr.
Palmer is receiving continuous IV heparin.
Because Mr. Palmer is receiving heparin, it is essential for the nurse
to
1) monitor his prothrombin time.
2) observe him for signs of pulmonary embolism.
3) limit his intake of foods high in vitamin K.
4) check the femoral puncture site at frequent intervals. Answer: 4)
check the femoral puncture site at frequent intervals.
Rationale: Since bleeding is a common side effect of heparin, it is
vital to check the operative site, the femoral puncture area, for signs
of bleeding.
◉ Attempts to revascularize Mr. Palmer's leg are unsuccessful, and
Mr. Palmer has a below-knee amputation (BKA) of his right
extremity and is returned to the medical-surgical unit with an
intravenous infusion in place. His orders include: heparin drip,
STUDY GUIDE 2026 ADULT HEALTH AND
MEDICAL SURGICAL NURSING PRINCIPLES
◉ Christine Warren, 45 years old, has a long history of ulcerative
colitis, and non-surgical treatment no longer relieved her symptoms.
She underwent a total proctocolectomy and a permanent ileostomy
12 hours ago.
The nurse should contact the physician immediately if Mrs. Warren
has which of these findings?
1) The stoma appears pale and dry.
2) The stoma appears red and shiny.
3) There is 200 mL of dark green output from the stoma.
4) There is 50 mL of serosanguinous drainage from the stoma.
Answer: 1) The stoma appears pale and dry.
Rationale: If there is an adequate blood supply to the stoma, the
color is pink or red, and the stoma is moist as a result of mucous
production. A pale dry color suggests ischemia of the stoma or
bowel and must be reported immediately to the physician. With an
ileostomy initially after surgery, the output is a loose, dark green
liquid that may contain some blood. The ileostomy usually begins to
drain within 24 of surgery at more than one liter per day.
,◉ When changing Mrs. Warren's ileostomy bag, the nurse notices
that the peristomal skin is irritated.
Which of these actions by the nurse would be appropriate before
reapplying the appliance?
1) Wash the area with antiseptic soap and water.
2) Clean the site with Dakin's solution.
3) Use a solid skin barrier.
4) Obtain an order for a topical antibiotic. Answer: 3) Use a solid
skin barrier.
Rationale: The drainage from the stoma can quickly irritate the
surrounding tissue. Therefore, a solid skin barrier, with a pectin base
or karaya wafer that has a measurable thickness and hydrocolloid
adhesive properties, should be applied.
◉ Which of these comments, if made by Mrs. Warren before her
surgery, would indicate that she had concerns about her body
image?
1) "I will have to stop my aerobics classes."
2) "I'm so afraid I may not survive the surgery."
3) "I need to go shopping for some loose, baggy clothes."
,4) "I'm concerned that this may be only the first of many surgeries."
Answer: 3) "I need to go shopping for some loose, baggy clothes."
Rationale:Body image refers to a person's perception of self and
determines how the person interacts with others. One does not need
to purchase special clothing after ileostomy surgery, although some
minor adjustments may be needed for comfort, e.g., stretch
underwear or pantyhose for support.
◉ To get TEST BANK for Medical-Surgical Nursing: Concepts for
Clinical Judgment and Collaborative Care 11th Edition by Donna D.
Ignatavicius, All chapters 1 - 74
email or copy these links to get the
full test banks. Each link has a different versions
http://www.stuvia.com/doc/7290675
http://www.stuvia.com/doc/8342084
http://www.stuvia.com/doc/9267657
http://www.stuvia.com/doc/7153071
, http://www.stuvia.com/doc/7069048 Answer:
http://www.stuvia.com/doc/7290675
◉ Lewis Palmer, 45 years old, has a history of multiple myocardial
infarctions and is a heavy smoker. He takes warfarin sodium
(Coumadin) daily. Two weeks ago, he had a right femoral-popliteal
bypass, which became occluded 24 hours ago. He is admitted
following an angioplasty of the femoral-popliteal bypass graft. Mr.
Palmer is receiving continuous IV heparin.
Because Mr. Palmer is receiving heparin, it is essential for the nurse
to
1) monitor his prothrombin time.
2) observe him for signs of pulmonary embolism.
3) limit his intake of foods high in vitamin K.
4) check the femoral puncture site at frequent intervals. Answer: 4)
check the femoral puncture site at frequent intervals.
Rationale: Since bleeding is a common side effect of heparin, it is
vital to check the operative site, the femoral puncture area, for signs
of bleeding.
◉ Attempts to revascularize Mr. Palmer's leg are unsuccessful, and
Mr. Palmer has a below-knee amputation (BKA) of his right
extremity and is returned to the medical-surgical unit with an
intravenous infusion in place. His orders include: heparin drip,
