A nurse is teaching a newly licensed nurse about the function of the large intestine.
Which of the following information should the nurse include?
It produces vitamin D.
It prevents the reflux of food into the esophagus.
It absorbs liquid to form stool.
It secretes enzymes to digest food.
The Correct Answer is C
Choice C rationale
The large intestine absorbs water and electrolytes from the remaining indigestible food matter, forming and eliminating solid waste (stool). This absorption process is vital for
maintaining the body's fluid and electrolyte balance.
Choice A rationale
The large intestine does not produce vitamin D; this occurs in the skin when exposed to sunlight. The large intestine’s primary functions are absorption and waste formation.
Choice B rationale
Preventing the reflux of food into the esophagus is the function of the lower esophageal sphincter, not the large intestine. The large intestine deals with waste processing rather than regulating esophageal function.
Choice D rationale
The secretion of digestive enzymes is a function of the pancreas, stomach, and small intestine. The large intestine does not secrete enzymes but focuses on absorbing water and electrolytes.
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Correct Answer is B
Explanation
Choice A rationale
Placing the client into a right lateral position is not the standard position for administering an enema. The left lateral (Sims') position is commonly used as it facilitates the flow of the
solution into the colon.
Choice B rationale
Warming the enema solution to room temperature helps ensure the client's comfort and can prevent cramping and discomfort. Cold solutions can cause discomfort and cramping,
making the procedure less tolerable for the client.
Choice C rationale
Sterile technique is not required for administering an enema. Clean technique is generally sufficient unless otherwise indicated by the client’s condition or specific medical orders.
Choice D rationale
Lubricating the tubing is essential to ensure smooth insertion and prevent trauma to the rectal mucosa, but an oil-based lubricant is not typically used as it can interfere with the
absorption of the enema solution. Water-soluble lubricants are preferred.
Correct Answer is D
Explanation
Choice A rationale
A sigmoid colostomy usually produces stool that is more formed compared to an ileostomy. This is because the colostomy is created from the sigmoid colon, where water absorption occurs.
Choice B rationale
The stoma should not be painful after the procedure. Pain may indicate complications, and the stoma itself lacks nerve endings.
Choice C rationale
The stoma should be a bright red or pink color, indicating good blood supply. A purple color could suggest ischemia or poor blood flow.
Choice D rationale
A sigmoid colostomy is typically located in the left lower abdomen because the sigmoid colon is situated in this area of the body.