Answer to Question 1
Correct Answer: 1
Rationale 1: Avoiding bladder distention will help eliminate stasis of urine in the bladder which contributes to urinary tract infections, a possible complication of urine flow being obstructed from an enlarged prostate.
Rationale 2: One would want to maintain fluid balance, not imbalance, with a client with urinary obstruction and enlarged prostate. Keeping up with the client's intake and output would be a better goal.
Rationale 3: It is important to keep urine off the skin to prevent breakdown, but with an enlarged prostate the problem will be more of the client retaining urine instead of it being on the skin.
Rationale 4: One would hope if the retention subsides, the client would voice less discomfort, not more.
Answer to Question 2
Correct Answer: 1
Rationale: Black color to the stoma and sloughing are signs of necrosis to the stoma. A healthy stoma should appear pink to red and look moist and shiny. Slight bleeding might occur because the intestinal mucosa is very fragile.