Ostomy Care Exam 3 Study Guide: Actual Nursing Practice Questions, Answers, and Rationales

Ostomy Care Exam 3 Study Guide: Actual
Nursing Practice Questions, Answers, and
Rationales

1. A nurse assesses a patient's stoma on day 2 post-op and notes it is dark
purple and dry. What is the priority nursing action?

 A. Document the finding as normal postoperative swelling.

 B. Apply a generous layer of petroleum jelly to moisten it.

 C. Notify the healthcare provider immediately.

 D. Wash the stoma with warm water and re-evaluate in 2 hours.

2. When changing an ostomy appliance, how should the nurse remove the old
skin barrier?

 A. Pull the wafer quickly upward from the bottom edge.

 B. Push the skin gently away from the adhesive barrier.

 C. Use alcohol swabs to dissolve the adhesive completely.

 D. Peel the barrier back at a sharp 90-degree angle from the stoma.

3. A patient with a new ileostomy asks why their pouch needs to be emptied so
frequently. Which response by the nurse is accurate?

 A. "Your colon is absorbing less water, making the stool soft."

,  B. "The drainage will become solid once you start eating regular food."

 C. "An ileostomy bypasses the large intestine, resulting in continuous
liquid output."

 D. "We can give you medications to make your stool fully formed."

4. At what capacity should an ostomy pouch be emptied to prevent leaks and
skin separation?

 A. When it is completely full

 B. When it is 1/3 to 1/2 full

 C. Every 2 hours regardless of volume

 D. When it reaches 3/4 full

5. When cutting a new skin barrier wafer, what size should the nurse select?

 A. Exactly matching the measured stoma size

 B. 1/8 inch larger than the stoma measurement

 C. 1/4 inch larger than the stoma measurement

 D. 1/2 inch smaller than the stoma to ensure a tight fit

6. A nurse teaches a patient with a new ileostomy about dietary hazards. Which
food item should the patient avoid initially to prevent obstruction?

 A. Popcorn and nuts

 B. Yogurt and buttermilk

 C. Cream of wheat

,  D. Pureed applesauce

7. Which finding indicates a patient with a new ileostomy is experiencing a
common metabolic complication?

 A. Weight gain of 3 pounds in 2 days

 B. Decreased urine output and dry mucous membranes

 C. Elevated serum potassium levels

 D. Increased blood pressure

8. A patient with a sigmoid colostomy asks if they will ever have formed stool
again. What is the nurse's best answer?

 A. "No, all ostomies produce continuous liquid stool."

 B. "Yes, but only if you take antidiarrheal medications daily."

 C. "Yes, a sigmoid colostomy produces formed stool that can often be
regulated."

 D. "Yes, but you must limit your fluid intake to 1 liter per day."

9. Which cleaning solution should the nurse use on the peristomal skin during a
routine appliance change?

 A. Hydrogen peroxide

 B. Povidone-iodine (Betadine)

 C. Moist alcohol wipes

 D. Mild soap and warm water (or water alone)

, 10. The nurse secures a new extended-wear wafer over a stoma. What action
maximizes its adhesion?

 A. Holding a warm hand over the barrier for 30 to 60 seconds.

 B. Drying the area immediately with a commercial heat gun.

 C. Applying a thick layer of moisture barrier ointment under the wafer.

 D. Taping all four outer edges with heavy paper tape right away.

11. A patient with a urostomy notes that their urine looks cloudy with strings of
mucus. What should the nurse suspect?

 A. An immediate, severe urinary tract infection

 B. A completely normal finding for an ileal conduit

 C. Systemic kidney failure

 D. Severe internal pouch leakage

12. During a home health visit, the nurse notes the peristomal skin is red, raw,
and weeping. Which product should be applied?

 A. Ostomy powder (crust method)

 B. Petroleum ointment

 C. Zinc oxide paste

 D. Alcohol-based skin prep pads

13. A patient is scheduled for a continent urinary diversion (Kock's pouch). What
must be included in the teaching?