The nurse is monitoring for stoma prolapse in a client with a colostomy. Which stoma observation should indicate that a prolapse has occurred?

Rationale: A. A moist, shiny appearance is normal and healthy for a stoma. This indicates that the mucosal tissue is well-hydrated and functioning properly. While it is an important observation, it does not indicate prolapse or any pathological change. B. A pink or red stoma signifies good blood flow and is considered healthy. Color changes are critical to monitor for ischemia (pale, dusky, or dark blue) or necrosis, but simply being pink or red does not indicate prolapse. C. A flat or sunken stoma indicates retraction, which is the opposite of prolapse. Retraction occurs when the stoma sinks below skin level, often due to muscle tension, obesity, or surgical technique. While retraction can cause appliance-fitting problems and leakage, it is not a protruding prolapse. D. A prolapsed stoma occurs when the bowel telescopes outward through the stoma, appearing longer than usual, swollen, and protruding. This can impair blood flow, cause edema, and make appliance fitting difficult. Prompt recognition and reporting are essential to prevent complications.