Evolve HESI Practice Exam

What is the appropriate response by the nurse when a client expresses concern about the size of their colostomy stoma?

1. The stoma will become smaller when the swelling decreases.

2. You need to adjust your expectations about the stoma's size.

3. This is a normal size for a stoma.

4. Try not to worry too much about it now.

The correct answer is: The stoma will become smaller when the swelling decreases.

The appropriate response, which states that the stoma will become smaller when the swelling decreases, is correct because it recognizes and addresses the client’s immediate concerns about the size of their colostomy stoma. Postoperative swelling is a common occurrence after the creation of a stoma, and it is essential for the client to understand that this swelling is typically temporary. Over time, as the tissue heals and edema reduces, the stoma usually shrinks to a more stable and manageable size. This response not only provides reassurance that the current size is not permanent but also educates the client about the healing process, which can help alleviate anxiety and foster understanding. In contrast, other responses may not provide the necessary support or information. Suggesting that the client needs to adjust their expectations does not offer reassurance or acknowledge their current feelings. Stating that the size is normal without context may not be as helpful, since clients may not have a basis for comparison and need more specific information regarding postoperative changes. Finally, advising the client to not worry too much does not address their specific concerns and may come across as dismissive, rather than validating their feelings and providing useful information.