2026/2027 | 200 Questions and Verified Answers | Brand New
Version
1. A patient presents with a stoma that is dusky purple and cool to the touch. What is the priority
action?
A) Apply a skin barrier powder
B) Notify the surgeon immediately
C) Increase oral fluid intake
D) Change the pouching system to a convex wafer
Answer: B) Notify the surgeon immediately
Explanation: An ischemic stoma (dusky purple/blue, cool) indicates compromised blood supply and is a
surgical emergency. Prompt notification is essential to prevent necrosis.
2. Which type of ostomy produces semiformed stool with minimal digestive enzymes?
A) Ileostomy
B) Cecostomy
C) Descending colostomy
D) Transverse loop colostomy
Answer: C) Descending colostomy
Explanation: A descending colostomy outputs semiformed stool because most water absorption occurs
in the ascending and transverse colon, leaving the descending colon with more solid waste and fewer
enzymes.
,3. A patient with an ileostomy reports thick, pasty output. Which intervention is most appropriate?
A) Restrict all fluids
B) Increase intake of water and lowfiber fluids
C) Add highfiber foods like raw vegetables
D) Take loperamide daily
Answer: B) Increase intake of water and lowfiber fluids
Explanation: Thick output in ileostomy can lead to blockage. Increasing fluids (water, broth, juice) helps
thin the effluent. Highfiber foods increase blockage risk.
4. The nurse observes peristomal skin with red, weeping, irregular borders matching the shape of the
cut wafer. This is most likely:
A) Candidiasis
B) Contact dermatitis from adhesive
C) Mechanical injury from improper removal
D) Folliculitis
Answer: B) Contact dermatitis from adhesive
Explanation: Red, weeping, irregular borders exactly matching the wafer shape indicate an allergic or
irritant contact dermatitis to the adhesive.
5. Which pouching system feature is best for a patient with a flush stoma and a creased, uneven
abdominal surface?
A) Flat wafer
B) Convex wafer
C) Twopiece system with flat flange
,D) Closedend pouch
Answer: B) Convex wafer
Explanation: Convexity applies gentle pressure to push the peristomal skin outward, helping a flush
stoma protrude into the pouch for better drainage and seal.
6. A patient with a urostomy reports mucus strands in the urine. What is the correct interpretation?
A) Sign of urinary tract infection
B) Normal finding because intestinal mucosa produces mucus
C) Indicates stomal stenosis
D) Requires immediate antibiotic therapy
Answer: B) Normal finding because intestinal mucosa produces mucus
Explanation: Urostomies are constructed from ileal or colonic segments that continuously produce
mucus; mucus in urine is expected and normal.
7. A patient is 2 days postop from a Brooke Ileostomy. The stoma is dark red, moist, and slightly
edematous. The nurse should:
A) Notify the surgeon immediately for possible necrosis
B) Document as a normal postoperative finding
C) Apply an ice pack to reduce swelling
D) Request a stat surgical consult
Answer: B) Document as a normal postoperative finding
Explanation: A "beefy red" or dark pink stoma that is moist and slightly swollen is expected in the first
48–72 hours postop.
, 8. A patient with a new Jejunostomy is at highest risk for which complication?
A) Constipation
B) Severe dehydration and electrolyte imbalance
C) Formation of hard stool bolus
D) Vitamin B12 deficiency only
Answer: B) Severe dehydration and electrolyte imbalance
Explanation: Because the jejunum is higher in the GI tract, output is very high (watery) and nutrient
absorption time is minimal, leading to rapid dehydration.
9. During preoperative site selection for a stoma, the nurse should avoid:
A) The apex of the infraumbilical mound
B) Skin folds, scars, and the belt line
C) The rectus muscle
D) The right lower quadrant
Answer: B) Skin folds, scars, and the belt line
Explanation: Placing a stoma in a skin fold or under a belt line leads to pouch leakage and skin
breakdown.
10. A patient with a Sigmoid Colostomy asks why their stool is formed while their friend with an
Ileostomy has liquid stool. The nurse explains:
A) The friend has an infection