WEB WOC OSTOMY CARE EXAM READY | VERIFIED
QUESTIONS AND ANSWERS | COMPREHENSIVE
LATEST VERSION 2026/2027
1. Q: Where should an ideal stoma site be marked?
ANSWER Within the rectus muscle, on the infraumbilical fat pad, avoiding
scars and creases.
2. Q: Why must the stoma be placed within the rectus muscle?
ANSWER To prevent parastomal herniation.
3. Q: When should preoperative stoma site marking be done?
ANSWER 24-48 hours before surgery, or in the outpatient clinic prior to
admission.
4. Q: The patient should be in what position during stoma marking?
ANSWER Sitting, standing, and lying down to assess for abdominal
creases.
5. Q: Why should the umbilicus not be chosen as a stoma site?
ANSWER It is prone to poor adherence of the pouching system due to its
concave shape.
6. Q: Who is responsible for marking the stoma site?
ANSWER The WOC nurse or an enterostomal therapy (ET) nurse.
7. Q: What clothing should the patient wear during marking?
ANSWER Their typical clothing to ensure the stoma clears the belt line.
8. Q: Should a stoma be placed over a bony prominence?
ANSWER No, it will cause pain and pressure necrosis.
9. Q: Why are previous surgical scars avoided during marking?
,ANSWER They impair blood supply and increase the risk of adhesions or
poor healing.
10. Q: What is the "bikini line" rule for stoma marking?
ANSWER Avoid placing the stoma where a patient's undergarments or
waistbands will cross it.
**Anatomy, Physiology & Types of Ostomies**
11. Q: What is the effluent of an end ileostomy?
ANSWER Liquid to paste-like, continuous, and highly enzymatic.
12. Q: What is the effluent of a descending colostomy?
ANSWER Formed stool, similar to normal bowel movements.
13. Q: What is the effluent of an ascending colostomy?
ANSWER Liquid to semi-liquid, similar to ileostomy effluent.
14. Q: Which type of ostomy requires the patient to wear a closed-end
pouch?
ANSWER A descending or sigmoid colostomy with formed stool.
15. Q: What type of ostomy typically requires a drainable pouch?
ANSWER An ileostomy or ascending colostomy.
16. Q: What is a loop ileostomy?
ANSWER A stoma created by bringing a loop of bowel through the
abdomen, often with a proximal and distal opening, usually temporary.
17. Q: What is the function of a distal loop (mucus fistula) in a loop
ileostomy?
ANSWER To drain mucus from the defunctionalized distal bowel.
18. Q: What is a continent urinary diversion (e.g., Kock pouch)?
ANSWER An internal reservoir created from bowel that is catheterized
periodically, requiring no external pouch.
19. Q: What is an Indiana pouch?
, ANSWER A continent urinary diversion where the cecum is used as the
reservoir and the ileocecal valve is used for continence.
20. Q: What is the most common type of permanent urinary diversion?
ANSWER Incontinent ileal conduit (urostomy).
21. Q: What is the effluent of an ileal conduit?
ANSWER Urine mixed with mucus.
22. Q: Why is mucus present in ileal conduit effluent?
ANSWER Because the bowel segment continues to secrete mucus even
though it is now part of the urinary tract.
23. Q: What is a Hartmann’s pouch?
ANSWER The closed distal end of the rectum/left colon following an end
colostomy.
24. Q: Which procedure involves the complete removal of the colon,
rectum, and anus, resulting in a permanent end ileostomy?
ANSWER Proctocolectomy (often for Ulcerative Colitis).
25. Q: What is a transverse colostomy?
ANSWER A stoma created from the transverse colon, usually in the upper
abdomen, often loop and temporary.
26. Q: What is the primary indication for an ileostomy in Crohn's disease?
ANSWER To divert fecal stream to allow diseased bowel to heal, though
permanent is sometimes needed.
27. Q: Can a patient with a urostomy feel the urge to urinate?
ANSWER No, the ureters are implanted into the conduit, bypassing the
bladder.
28. Q: What is the normal pH range of urostomy effluent?
ANSWER Slightly acidic to neutral, but can become alkaline if infected.
29. Q: What is a "double-barrel" ostomy?
ANSWER Two separate stomas (proximal functioning and distal non-
functioning) created on the abdominal wall.
, 30. Q: What is an end stoma?
ANSWER A single stoma created by dividing the bowel, with the distal
end either removed or closed (Hartmann’s).
**Stoma Assessment & Characteristics**
31. Q: What is the normal color of a healthy stoma?
ANSWER Pink to red, resembling the inside of the mouth (buccal
mucosa).
32. Q: What does a dark, purplish-black stoma indicate?
ANSWER Ischemia or necrosis.
33. Q: What does a pale, pink stoma indicate?
ANSWER Anemia or poor perfusion.
34. Q: How long does it take for postoperative stoma edema to subside?
ANSWER 6 to 8 weeks.
35. Q: When should stoma measurements be taken?
ANSWER At the base (where it meets the skin), not at the tip.
36. Q: Why should you not measure a stoma at the tip?
ANSWER Post-op edema makes the tip larger than the base, leading to a
poorly fitting wafer.
37. Q: What shape is a normal stoma?
ANSWER Round or oval (bud-shaped).
38. Q: What is a "flush" stoma?
ANSWER A stoma that is at skin level with no protrusion.
39. Q: What is a "retracted" stoma?
ANSWER A stoma that has pulled below the skin level.
40. Q: What is stoma prolapse?
ANSWER The protrusion of the stoma beyond its normal length, often
caused by increased intra-abdominal pressure.
QUESTIONS AND ANSWERS | COMPREHENSIVE
LATEST VERSION 2026/2027
1. Q: Where should an ideal stoma site be marked?
ANSWER Within the rectus muscle, on the infraumbilical fat pad, avoiding
scars and creases.
2. Q: Why must the stoma be placed within the rectus muscle?
ANSWER To prevent parastomal herniation.
3. Q: When should preoperative stoma site marking be done?
ANSWER 24-48 hours before surgery, or in the outpatient clinic prior to
admission.
4. Q: The patient should be in what position during stoma marking?
ANSWER Sitting, standing, and lying down to assess for abdominal
creases.
5. Q: Why should the umbilicus not be chosen as a stoma site?
ANSWER It is prone to poor adherence of the pouching system due to its
concave shape.
6. Q: Who is responsible for marking the stoma site?
ANSWER The WOC nurse or an enterostomal therapy (ET) nurse.
7. Q: What clothing should the patient wear during marking?
ANSWER Their typical clothing to ensure the stoma clears the belt line.
8. Q: Should a stoma be placed over a bony prominence?
ANSWER No, it will cause pain and pressure necrosis.
9. Q: Why are previous surgical scars avoided during marking?
,ANSWER They impair blood supply and increase the risk of adhesions or
poor healing.
10. Q: What is the "bikini line" rule for stoma marking?
ANSWER Avoid placing the stoma where a patient's undergarments or
waistbands will cross it.
**Anatomy, Physiology & Types of Ostomies**
11. Q: What is the effluent of an end ileostomy?
ANSWER Liquid to paste-like, continuous, and highly enzymatic.
12. Q: What is the effluent of a descending colostomy?
ANSWER Formed stool, similar to normal bowel movements.
13. Q: What is the effluent of an ascending colostomy?
ANSWER Liquid to semi-liquid, similar to ileostomy effluent.
14. Q: Which type of ostomy requires the patient to wear a closed-end
pouch?
ANSWER A descending or sigmoid colostomy with formed stool.
15. Q: What type of ostomy typically requires a drainable pouch?
ANSWER An ileostomy or ascending colostomy.
16. Q: What is a loop ileostomy?
ANSWER A stoma created by bringing a loop of bowel through the
abdomen, often with a proximal and distal opening, usually temporary.
17. Q: What is the function of a distal loop (mucus fistula) in a loop
ileostomy?
ANSWER To drain mucus from the defunctionalized distal bowel.
18. Q: What is a continent urinary diversion (e.g., Kock pouch)?
ANSWER An internal reservoir created from bowel that is catheterized
periodically, requiring no external pouch.
19. Q: What is an Indiana pouch?
, ANSWER A continent urinary diversion where the cecum is used as the
reservoir and the ileocecal valve is used for continence.
20. Q: What is the most common type of permanent urinary diversion?
ANSWER Incontinent ileal conduit (urostomy).
21. Q: What is the effluent of an ileal conduit?
ANSWER Urine mixed with mucus.
22. Q: Why is mucus present in ileal conduit effluent?
ANSWER Because the bowel segment continues to secrete mucus even
though it is now part of the urinary tract.
23. Q: What is a Hartmann’s pouch?
ANSWER The closed distal end of the rectum/left colon following an end
colostomy.
24. Q: Which procedure involves the complete removal of the colon,
rectum, and anus, resulting in a permanent end ileostomy?
ANSWER Proctocolectomy (often for Ulcerative Colitis).
25. Q: What is a transverse colostomy?
ANSWER A stoma created from the transverse colon, usually in the upper
abdomen, often loop and temporary.
26. Q: What is the primary indication for an ileostomy in Crohn's disease?
ANSWER To divert fecal stream to allow diseased bowel to heal, though
permanent is sometimes needed.
27. Q: Can a patient with a urostomy feel the urge to urinate?
ANSWER No, the ureters are implanted into the conduit, bypassing the
bladder.
28. Q: What is the normal pH range of urostomy effluent?
ANSWER Slightly acidic to neutral, but can become alkaline if infected.
29. Q: What is a "double-barrel" ostomy?
ANSWER Two separate stomas (proximal functioning and distal non-
functioning) created on the abdominal wall.
, 30. Q: What is an end stoma?
ANSWER A single stoma created by dividing the bowel, with the distal
end either removed or closed (Hartmann’s).
**Stoma Assessment & Characteristics**
31. Q: What is the normal color of a healthy stoma?
ANSWER Pink to red, resembling the inside of the mouth (buccal
mucosa).
32. Q: What does a dark, purplish-black stoma indicate?
ANSWER Ischemia or necrosis.
33. Q: What does a pale, pink stoma indicate?
ANSWER Anemia or poor perfusion.
34. Q: How long does it take for postoperative stoma edema to subside?
ANSWER 6 to 8 weeks.
35. Q: When should stoma measurements be taken?
ANSWER At the base (where it meets the skin), not at the tip.
36. Q: Why should you not measure a stoma at the tip?
ANSWER Post-op edema makes the tip larger than the base, leading to a
poorly fitting wafer.
37. Q: What shape is a normal stoma?
ANSWER Round or oval (bud-shaped).
38. Q: What is a "flush" stoma?
ANSWER A stoma that is at skin level with no protrusion.
39. Q: What is a "retracted" stoma?
ANSWER A stoma that has pulled below the skin level.
40. Q: What is stoma prolapse?
ANSWER The protrusion of the stoma beyond its normal length, often
caused by increased intra-abdominal pressure.
