WEB WOC OSTOMY CARE Final Exam
Newest Exam Preparation With Complete
Questions And Correct Answers With
Rationales | Already Graded A
1. A patient with ulcerative colitis unresponsive to medication is scheduled for a total
proctocolectomy. Which stoma type will most likely be created?
CORRECT ANSWER: Brooke ileostomy
– Rationale: Total proctocolectomy removes the colon, rectum, and anus, requiring a
permanent end ileostomy. The Brooke ileostomy is the standard construction with a
spouted shape to direct effluent away from the skin.
2. Which surgical procedure for rectal cancer located 2 cm from the anal verge results in a
permanent colostomy?
CORRECT ANSWER: Abdominoperineal resection (APR)
– Rationale: APR removes the rectum, anus, and sigmoid colon for low rectal cancers,
leaving no option for reanastomosis, thus requiring a permanent end colostomy.
3. Postoperative day 2 after ileostomy creation, the stoma appears dusky and purple. What
is the priority nursing action?
CORRECT ANSWER: Notify the surgeon immediately
– Rationale: Dusky or purple discoloration indicates compromised blood flow, possibly
ischemia or necrosis. Immediate surgical evaluation is critical to prevent stomal
sloughing.
,4. A patient’s colostomy effluent is thick and paste-like. Which dietary adjustment can help
manage this consistency?
CORRECT ANSWER: Increase fluid intake
– Rationale: Thick effluent in colostomies is normal, but if overly thick, increasing fluids
and adding soft, moist foods like applesauce or cooked vegetables can help maintain
optimal consistency.
5. What is the primary reason for spouting an ileostomy during construction?
CORRECT ANSWER: To protect peristomal skin from enzymatic effluent
– Rationale: The spout directs liquid, enzyme-rich ileal effluent away from the skin
surface, reducing contact and preventing chemical dermatitis.
6. A nurse observes mucocutaneous separation at the stoma-skin junction. Which
intervention is most appropriate?
CORRECT ANSWER: Apply skin barrier powder and cover with convex wafer
– Rationale: Mucocutaneous separation requires filling the defect with powder, then
using a convex pouch to apply gentle pressure, promoting healing and preventing
leakage.
7. Which preoperative teaching topic is most essential for a patient undergoing urinary
diversion with an ileal conduit?
CORRECT ANSWER: How to apply a urostomy pouch around the stoma
– Rationale: Patients with an ileal conduit need lifelong pouching. Preoperative
teaching includes pouch application, drainage, and skin care to ensure independence.
, 8. A patient with a colostomy reports a bulge around the stoma when coughing. What
complication is most likely?
CORRECT ANSWER: Parastomal hernia
– Rationale: Bulging with increased intra-abdominal pressure (coughing) is classic for
parastomal hernia—a weakening of the abdominal wall around the stoma.
9. Which stoma type is least likely to be completely diverting?
CORRECT ANSWER: Loop stoma
– Rationale: A loop stoma brings a loop of bowel to the surface with a supporting rod;
fecal matter can partially pass into the distal limb, making it incompletely diverting.
10. A patient with an ileostomy has high output (over 1500 mL/day). Which complication is
the highest priority to monitor?
CORRECT ANSWER: Dehydration and electrolyte imbalance
– Rationale: High ileostomy output rapidly depletes water, sodium, and potassium,
leading to hypovolemia and metabolic acidosis. Monitor intake, output, and electrolytes.
11. What is the normal color of a healthy stoma?
CORRECT ANSWER: Pink to red
– Rationale: Healthy stomas are moist, pink, or red due to the rich blood supply of the
intestinal mucosa. Pale or purple indicates ischemia; black indicates necrosis.
12. A patient with a sigmoid colostomy reports constipation. Which intervention should the
nurse suggest first?
CORRECT ANSWER: Increase oral fluid and fiber intake
Newest Exam Preparation With Complete
Questions And Correct Answers With
Rationales | Already Graded A
1. A patient with ulcerative colitis unresponsive to medication is scheduled for a total
proctocolectomy. Which stoma type will most likely be created?
CORRECT ANSWER: Brooke ileostomy
– Rationale: Total proctocolectomy removes the colon, rectum, and anus, requiring a
permanent end ileostomy. The Brooke ileostomy is the standard construction with a
spouted shape to direct effluent away from the skin.
2. Which surgical procedure for rectal cancer located 2 cm from the anal verge results in a
permanent colostomy?
CORRECT ANSWER: Abdominoperineal resection (APR)
– Rationale: APR removes the rectum, anus, and sigmoid colon for low rectal cancers,
leaving no option for reanastomosis, thus requiring a permanent end colostomy.
3. Postoperative day 2 after ileostomy creation, the stoma appears dusky and purple. What
is the priority nursing action?
CORRECT ANSWER: Notify the surgeon immediately
– Rationale: Dusky or purple discoloration indicates compromised blood flow, possibly
ischemia or necrosis. Immediate surgical evaluation is critical to prevent stomal
sloughing.
,4. A patient’s colostomy effluent is thick and paste-like. Which dietary adjustment can help
manage this consistency?
CORRECT ANSWER: Increase fluid intake
– Rationale: Thick effluent in colostomies is normal, but if overly thick, increasing fluids
and adding soft, moist foods like applesauce or cooked vegetables can help maintain
optimal consistency.
5. What is the primary reason for spouting an ileostomy during construction?
CORRECT ANSWER: To protect peristomal skin from enzymatic effluent
– Rationale: The spout directs liquid, enzyme-rich ileal effluent away from the skin
surface, reducing contact and preventing chemical dermatitis.
6. A nurse observes mucocutaneous separation at the stoma-skin junction. Which
intervention is most appropriate?
CORRECT ANSWER: Apply skin barrier powder and cover with convex wafer
– Rationale: Mucocutaneous separation requires filling the defect with powder, then
using a convex pouch to apply gentle pressure, promoting healing and preventing
leakage.
7. Which preoperative teaching topic is most essential for a patient undergoing urinary
diversion with an ileal conduit?
CORRECT ANSWER: How to apply a urostomy pouch around the stoma
– Rationale: Patients with an ileal conduit need lifelong pouching. Preoperative
teaching includes pouch application, drainage, and skin care to ensure independence.
, 8. A patient with a colostomy reports a bulge around the stoma when coughing. What
complication is most likely?
CORRECT ANSWER: Parastomal hernia
– Rationale: Bulging with increased intra-abdominal pressure (coughing) is classic for
parastomal hernia—a weakening of the abdominal wall around the stoma.
9. Which stoma type is least likely to be completely diverting?
CORRECT ANSWER: Loop stoma
– Rationale: A loop stoma brings a loop of bowel to the surface with a supporting rod;
fecal matter can partially pass into the distal limb, making it incompletely diverting.
10. A patient with an ileostomy has high output (over 1500 mL/day). Which complication is
the highest priority to monitor?
CORRECT ANSWER: Dehydration and electrolyte imbalance
– Rationale: High ileostomy output rapidly depletes water, sodium, and potassium,
leading to hypovolemia and metabolic acidosis. Monitor intake, output, and electrolytes.
11. What is the normal color of a healthy stoma?
CORRECT ANSWER: Pink to red
– Rationale: Healthy stomas are moist, pink, or red due to the rich blood supply of the
intestinal mucosa. Pale or purple indicates ischemia; black indicates necrosis.
12. A patient with a sigmoid colostomy reports constipation. Which intervention should the
nurse suggest first?
CORRECT ANSWER: Increase oral fluid and fiber intake
