OSTOMY BOOK - MODULE 1
QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS ALREADY
PASSED!!!
Question 1 Breakdown
Which intervention by a WOC nurse is directed at reducing a non-modifiable
risk factor for colorectal cancer development?
Correct Answer: C. Investigating a family history of polyps
Rationale:
Non-modifiable risk factors are baseline genetic or demographic traits that
an individual cannot change (e.g., family history, age, genetic mutations,
personal history of adenomatous polyps or inflammatory bowel disease).
Investigating family history allows the nurse to identify high-risk individuals
early to establish increased endoscopic surveillance.
Modifiable risk factors are lifestyle behaviors that can be actively modified
to reduce overall risk. Options A (high-fiber diet), B (low-fat diet), and D
(exercise plan) represent interventions targeting modifiable risk factors.
Question 2 Breakdown
The WOC nurse is providing teaching to a patient diagnosed with familial
adenomatous polyposis (FAP). What information accurately describes this
condition?
Correct Answer: A. FAP is inherited in an autosomal dominant pattern
with a 100% risk of developing colon cancer by age 40 years.
Rationale:
Pathophysiology: Classic FAP is caused by an inherited germline mutation
in the APC (adenomatous polyposis coli) gene on chromosome 5. It follows
an autosomal dominant inheritance pattern (50% chance of transmission to
offspring).
, Clinical Course: Individuals develop hundreds to thousands of
adenomatous polyps during adolescence and young adulthood. Left
untreated, malignant transformation of at least one polyp to colorectal
carcinoma is essentially 100% inevitable, typically occurring around age
40.
Why the Other Options are Incorrect:
B is incorrect: Segmental resection is inadequate due to the dense "carpet"
of polyps throughout the large bowel. Prophylactic total colectomy or
proctocolectomy is the definitive surgical standard.
C is incorrect: Mismatch repair (MMR) gene mutations and microsatellite
instability (MSI) describe Lynch Syndrome (Hereditary Nonpolyposis
Colorectal Cancer / HNPCC), not FAP.
D is incorrect: Endometrial, ovarian, and urinary tract cancers are classic
extracolonic manifestations of Lynch Syndrome. Extracolonic
manifestations of FAP primarily include duodenal/periampullary
adenocarcinomas, gastric polyps, desmoid tumors, osteomas, thyroid
carcinoma, and hepatoblastoma.
A 55-year-old patient visits a gastroenterologist with complaints of anal bleeding
upon defecation. Which test would most likely be ordered for this patient to
perform diagnostic biopsies and/or therapeutic procedures?
A. FOBT
B. Sigmoidoscopy or colonoscopy
C. CT colonography
D. Virtual colonoscopy
Sigmoidoscopy or colonoscopy
Which symptom is not characteristic of colorectal cancer?
, A. Nonspecific abdominal pain
B. Weight loss
C. Fatigue
D. Increased stool caliber
Increased stool caliber
A patient is diagnosed with colon cancer manifested by a tumor that invades to the
submucosa. What stage of cancer would be documented?
Stage 0
Stage I
Stage II
Stage III
Stage I
A patient with a TNM stage IVa rectal cancer would need to meet which
diagnostic requirement for this staging?
A. Tumor invading surface of visceral peritoneum
B. Metastasis to one to three regional lymph nodes
C. Distant metastasis confined to one organ or site
D. Distant metastases in more than one organ/site or the peritoneum
Distant metastasis confined to one organ or site
QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS ALREADY
PASSED!!!
Question 1 Breakdown
Which intervention by a WOC nurse is directed at reducing a non-modifiable
risk factor for colorectal cancer development?
Correct Answer: C. Investigating a family history of polyps
Rationale:
Non-modifiable risk factors are baseline genetic or demographic traits that
an individual cannot change (e.g., family history, age, genetic mutations,
personal history of adenomatous polyps or inflammatory bowel disease).
Investigating family history allows the nurse to identify high-risk individuals
early to establish increased endoscopic surveillance.
Modifiable risk factors are lifestyle behaviors that can be actively modified
to reduce overall risk. Options A (high-fiber diet), B (low-fat diet), and D
(exercise plan) represent interventions targeting modifiable risk factors.
Question 2 Breakdown
The WOC nurse is providing teaching to a patient diagnosed with familial
adenomatous polyposis (FAP). What information accurately describes this
condition?
Correct Answer: A. FAP is inherited in an autosomal dominant pattern
with a 100% risk of developing colon cancer by age 40 years.
Rationale:
Pathophysiology: Classic FAP is caused by an inherited germline mutation
in the APC (adenomatous polyposis coli) gene on chromosome 5. It follows
an autosomal dominant inheritance pattern (50% chance of transmission to
offspring).
, Clinical Course: Individuals develop hundreds to thousands of
adenomatous polyps during adolescence and young adulthood. Left
untreated, malignant transformation of at least one polyp to colorectal
carcinoma is essentially 100% inevitable, typically occurring around age
40.
Why the Other Options are Incorrect:
B is incorrect: Segmental resection is inadequate due to the dense "carpet"
of polyps throughout the large bowel. Prophylactic total colectomy or
proctocolectomy is the definitive surgical standard.
C is incorrect: Mismatch repair (MMR) gene mutations and microsatellite
instability (MSI) describe Lynch Syndrome (Hereditary Nonpolyposis
Colorectal Cancer / HNPCC), not FAP.
D is incorrect: Endometrial, ovarian, and urinary tract cancers are classic
extracolonic manifestations of Lynch Syndrome. Extracolonic
manifestations of FAP primarily include duodenal/periampullary
adenocarcinomas, gastric polyps, desmoid tumors, osteomas, thyroid
carcinoma, and hepatoblastoma.
A 55-year-old patient visits a gastroenterologist with complaints of anal bleeding
upon defecation. Which test would most likely be ordered for this patient to
perform diagnostic biopsies and/or therapeutic procedures?
A. FOBT
B. Sigmoidoscopy or colonoscopy
C. CT colonography
D. Virtual colonoscopy
Sigmoidoscopy or colonoscopy
Which symptom is not characteristic of colorectal cancer?
, A. Nonspecific abdominal pain
B. Weight loss
C. Fatigue
D. Increased stool caliber
Increased stool caliber
A patient is diagnosed with colon cancer manifested by a tumor that invades to the
submucosa. What stage of cancer would be documented?
Stage 0
Stage I
Stage II
Stage III
Stage I
A patient with a TNM stage IVa rectal cancer would need to meet which
diagnostic requirement for this staging?
A. Tumor invading surface of visceral peritoneum
B. Metastasis to one to three regional lymph nodes
C. Distant metastasis confined to one organ or site
D. Distant metastases in more than one organ/site or the peritoneum
Distant metastasis confined to one organ or site
