Preparation With Complete Questions And Correct
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SECTION 1: SURGICAL PROCEDURES & INDICATIONS
1. A patient is diagnosed with low rectal cancer located distal to the dentate
line. Which surgical procedure is most appropriate?
A. Low anterior resection (LAR)
B. Ileal pouch anal anastomosis (IPAA)
C. Abdominoperineal resection (APR)
D. Sigmoid colectomy
Correct Answer: C
Rationale: APR is indicated for very low rectal tumors below the dentate line
where sphincter preservation is not possible. It involves removal of the rectum and
anus with permanent colostomy formation. LAR and IPAA are sphincter-preserving
procedures used for higher lesions .
2. Which condition most commonly requires an ileal pouch anal anastomosis
(IPAA)?
A. Crohn's disease
B. Ulcerative colitis and familial adenomatous polyposis
C. Diverticulitis
D. Irritable bowel syndrome
,Correct Answer: B
Rationale: IPAA is primarily indicated for ulcerative colitis and familial
adenomatous polyposis because both conditions require total colectomy. Crohn's
disease is generally not suitable due to risk of recurrence in the pouch .
3. A patient with an abdominoperineal resection will have which type of
ostomy?
A. Permanent colostomy
B. Temporary ileostomy
C. Permanent ileostomy
D. Temporary colostomy
Correct Answer: A
Rationale: An abdominoperineal resection involves removal of the rectum, anus,
and sphincter mechanism with formation of a permanent end colostomy. Closure
of the ostomy is not possible when the anus and sphincter have been removed .
4. A 7-month-old infant with suspected Hirschsprung's disease will most likely
undergo which procedure?
A. Loop ileostomy
B. Diverting colostomy
C. End colostomy
D. Ileal conduit
Correct Answer: B
Rationale: Hirschsprung's disease causes functional bowel obstruction; initial
management often involves diverting colostomy to decompress the bowel before
definitive repair .
,5. A temporary loop ileostomy is primarily created to:
A. Increase absorption
B. Divert stool from a healing anastomosis
C. Improve bowel motility
D. Reduce infection risk in kidneys
Correct Answer: B
Rationale: Loop ileostomies protect distal surgical sites by diverting the fecal
stream while healing occurs .
6. A patient with muscle-invasive urothelial (bladder) cancer is scheduled for
surgery. Which procedure should the nurse expect?
A. Simple cystectomy
B. ACE procedure
C. Ileal vesicostomy
D. Radical cystectomy
Correct Answer: D
Rationale: Once bladder cancer invades the muscle, a radical cystectomy is
recommended for those healthy enough to undergo major surgery. This involves
removing the bladder, surrounding fatty tissue, lymph glands, and pelvic organs .
7. Which statement correctly describes ulcerative colitis?
A. Transmural inflammation with skip lesions
B. Begins in the rectum and extends proximally
C. Affects the entire GI tract
D. Causes fistula formation frequently
, Correct Answer: B
Rationale: Ulcerative colitis starts in the rectum and spreads continuously upward.
It is limited to the colon and involves only mucosal layers. Skip lesions and
transmural involvement are features of Crohn's disease .
8. A key feature of Crohn's disease is:
A. Continuous lesion pattern
B. Skip lesions
C. Rectal-only involvement
D. Superficial inflammation
Correct Answer: B
Rationale: Crohn's disease is patchy with skip lesions throughout the GI tract. This
distinguishes it from ulcerative colitis, which has continuous inflammation .
9. A patient with Crohn's disease is most likely to present with which symptom
during disease recurrence?
A. Bloody diarrhea only
B. Obstructive abdominal pain
C. Absence of perianal disease
D. Rectal sparing with no symptoms
Correct Answer: B
Rationale: Crohn's disease causes transmural inflammation that may lead to
strictures and bowel obstruction, resulting in crampy or obstructive abdominal
pain. Bloody diarrhea is more typical of ulcerative colitis .