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During a preoperative consultation for EMERGENCY ostomy surgery, the two PRIMARY
objectives for the WOC Nurse are stoma site selection and:
Select one:
a. Explanation of how to empty the pouch.
b. Demonstration of ostomy equipment.
c. Decrease patient's anxiety about the ostomy surgery.
d. Identification of discharge plans. - ( ANSWER)-c. Decrease patient's anxiety about the
ostomy surgery.
When selecting an abdominal stoma site, evidence-based practice states that the stoma
should be located:
Select one:
a. lateral to the rectus muscle.
b. above the beltline.
c. on the apex of the infraumbilical bulge.
d. near the umbilicus. - ( ANSWER)-c. on the apex of the infraumbilical bulge.
You are selecting a stoma site pre-op for a patient having an ileal pouch anal anastomosis
(IPAA) and temporary loop ileostomy. The patient has no abdominal scars but you notice
the abdomen to be soft and slightly protruding. With the patient in the supine position, you
palpate for the rectus muscle, make an indelible ink mark in the RLQ, confirm they can see
,the site while lying down and cover the mark with a transparent dressing. What step have
you omitted?
Select one:
a. To check the potential stoma site with the patient in a sitting and standing position.
b. To ask the patient if they prefer the right side or the left side.
c. To consult with the surgeon to verify the site selected would be appropriate.
d. To apply a sample pouch to confirm the site is away from scars and the umbilicus. - (
ANSWER)-a. To check the potential stoma site with the patient in a sitting and standing
position.
Mr. Moore is having surgery for a low rectal cancer located below the dentate line. During
your pre-op visit you utilize the PLISSIT model to introduce the topic of sexuality. What
might you say to the patient that is an example of giving Permission to the patient to discuss
this topic?
Select one:
a. Most people have questions about routine issues of living prior to surgery: diet, exercise,
sexual activity, clothing, etc.
b. Most patients wonder about sexual function after APR and there are numerous things for
us to discuss that could happen to impact your sexual function.
c. Counseling the patient to see a counselor for sexual dysfunction issues.
d. The stoma should not be used for sexual intimacy as it may be damaged and has no
feeling. - ( ANSWER)-a. Most people have questions about routine issues of living prior to
surgery: diet, exercise, sexual activity, clothing, etc.
Which of the following surgical procedures involves a wide resection of the sigmoid colon,
rectum and anus?
,Select one:
a. Abdominoperineal Resection (APR)
b. Total Proctocolectomy (TPC)
c. Ileal Pouch Anal Anastomosis (IPAA)
d. Low Anterior Resection (LAR) - ( ANSWER)-a. Abdominoperineal Resection (APR)
Preoperative care of the neonate undergoing ostomy surgery is best described by saying
that:
Select one:
a. Teaching parents about the ostomy and what is to occur helps with family adaptation.
b. 75% of stomas are performed when the neonate is under 1 year of life. Preop care is
minimal for the WOC nurse in pediatrics.
c. The WOC Nurse will be marking stomas in surgery as pediatric surgeons determine the
stoma is necessary.
d. Abdominal assessment in pediatrics will be more difficult than in the adult as the
abdomen is smaller. - ( ANSWER)-b. 75% of stomas are performed when the neonate is
under 1 year of life. Preop care is minimal for the WOC nurse in pediatrics.
You are providing a preoperative visit for a patient about to undergo a temporary loop stoma
and low anterior resection (LAR). Why is a temporary loop stoma usually utilized in these
procedures?
Select one:
a. To decrease the incidence of bleeding.
b. Decrease the potential of diarrhea within the gut following this procedure.
c. To divert stool away from the distal anastomosis while it heals.
d. Enhance perfusion to the proximal colon. - ( ANSWER)-c. To divert stool away from the
distal anastomosis while it heals.
, The surgical treatment of choice for the patient with a carcinoma in the upper and middle
third of the rectum is:
Select one:
a. Abdominoperineal resection (APR)
b. Low anterior resection (LAR)
c. Total proctocolectomy with ileostomy (TPC)
d. Ileal pouch anal anastomosis (IPAA) - ( ANSWER)-b. Low anterior resection (LAR)
Your patient with diverticulosis is concerned about infection and the need for surgery.
However, through patient teaching you can to correct misinformation and tell him that
diverticulosis is very common and not an indication for surgery. Diverticulosis differs from
diverticulitis in that diverticulitis may require surgery because it involves:
Select one:
a. Formation of herniations in the intestinal wall.
b. High intraluminal pressures in the intestinal wall.
c. Inflammation or infection of sac-like pouches.
d. Low intraluminal pressures of the bowel wall. - ( ANSWER)-c. Inflammation or infection of
sac-like pouches.
Which of the following signs or symptoms are associated with diverticulitis?
Select one:
a. Fever, malaise, RUQ pain.
b. Nausea/vomiting, RLQ pain.
c. LLQ pain, fever, nausea/vomiting.