ATI Ostomy Care Exam Practice – Assessment Technologies
Institute (ATI) – 2026/2027 Academic Year – Verified
Questions and Answers for Professional Nursing Students
Ostomy Fundamentals and Anatomical Considerations
1. A nurse is reinforcing teaching with a client who has colon cancer and is
scheduled for a procedure to remove their entire large intestine and rectum. The
nurse should reinforce with the client that they are scheduled for which of the
following types of ostomy procedure?
A. Cecostomy
B. Loop colostomy
C. Ileostomy
D. Descending colostomy
Answer: C. Ileostomy
Rationale: After removing the entire large intestine and the rectum, the provider will
create an ileostomy to divert feces from the small intestine (ileum) to the abdominal
surface and into an ostomy pouch. A cecostomy is a tube placed in the cecum for
decompression, a loop colostomy involves bringing a loop of colon to the surface, and a
descending colostomy involves only the descending colon.
,2. A nurse is teaching a client who has bladder cancer about urinary diversion
options. The nurse should inform the client that which of the following options
will allow them to have some control over urinary elimination?
A. Kock's pouch
B. Ileal conduit
C. Cutaneous ureterostomy
D. Nephrostomy
Answer: A. Kock's pouch
Rationale: A Kock's pouch is a continent ileal bladder conduit that does not require an
external drainage collection device because the client self-catheterizes every 2 to 4
hours to remove urine. This device allows the client to have some control over urinary
elimination. An ileal conduit and cutaneous ureterostomy require external drainage
bags. A nephrostomy is a tube placed directly into the kidney.
3. A nurse is assessing a client's stoma on the second postoperative day. Which
finding should the nurse report to the provider immediately?
A. The stoma is edematous and pink
B. The stoma is producing liquid effluent
C. The stoma appears dark purple
D. The stoma is tender to touch
Answer: C. The stoma appears dark purple
Rationale: A dark purple or black stoma indicates ischemia or necrosis and requires
immediate provider notification. Mild edema and pink color are expected findings. New
ileostomies produce liquid effluent, which is normal. Tenderness is expected initially.
,4. A nurse is providing education to a patient who will undergo creation of an
ascending colostomy. Which statement accurately describes the expected stool
characteristics for this type of colostomy?
A. Formed and solid with minimal liquid
B. Liquid to semiliquid
C. Semiliquid to semiformed
D. Completely liquid with digestive enzymes
Answer: C. Semiliquid to semiformed
Rationale: An ascending colostomy is located in the ascending colon, where less water
absorption has occurred compared to more distal colostomies. The stool is typically
semiliquid to semiformed.
5. A nurse is assessing a patient with a urostomy who reports that the stoma
appears to have a white, pasty substance on it. What is the nurse's best response?
A. "This is a sign of infection that requires immediate treatment."
B. "This is normal mucus production from the intestinal segment used for the urostomy."
C. "This indicates that your stoma is not functioning properly."
D. "You should scrub this off vigorously with alcohol."
Answer: B. "This is normal mucus production from the intestinal segment used for
the urostomy."
Rationale: The intestinal segment used to create a urostomy continues to produce
mucus, which is normal and expected. This mucus may appear as a white or pasty
substance on or around the stoma. It does not indicate infection or malfunction.
, 6. A nurse is caring for a patient who had a total proctocolectomy with permanent
ileostomy. The nurse should explain that this surgery involves removal of which
structures?
A. The entire colon, rectum, and anus
B. Only the sigmoid colon
C. The small intestine only
D. The rectum and anus only
Answer: A. The entire colon, rectum, and anus
Rationale: A total proctocolectomy involves removal of the entire colon, rectum, and
anus, resulting in a permanent ileostomy. This is typically performed for ulcerative colitis
or familial adenomatous polyposis.
7. A nurse is caring for a patient with a descending colostomy. The nurse should
expect the patient's stool to be which consistency?
A. Liquid with visible digestive enzymes
B. Pasty
C. Formed but soft
D. Hard and pellet-like
Answer: C. Formed but soft
Rationale: A descending colostomy is located in the descending colon where significant
water absorption has occurred. The stool is formed but soft, similar to normal stool
consistency.
Institute (ATI) – 2026/2027 Academic Year – Verified
Questions and Answers for Professional Nursing Students
Ostomy Fundamentals and Anatomical Considerations
1. A nurse is reinforcing teaching with a client who has colon cancer and is
scheduled for a procedure to remove their entire large intestine and rectum. The
nurse should reinforce with the client that they are scheduled for which of the
following types of ostomy procedure?
A. Cecostomy
B. Loop colostomy
C. Ileostomy
D. Descending colostomy
Answer: C. Ileostomy
Rationale: After removing the entire large intestine and the rectum, the provider will
create an ileostomy to divert feces from the small intestine (ileum) to the abdominal
surface and into an ostomy pouch. A cecostomy is a tube placed in the cecum for
decompression, a loop colostomy involves bringing a loop of colon to the surface, and a
descending colostomy involves only the descending colon.
,2. A nurse is teaching a client who has bladder cancer about urinary diversion
options. The nurse should inform the client that which of the following options
will allow them to have some control over urinary elimination?
A. Kock's pouch
B. Ileal conduit
C. Cutaneous ureterostomy
D. Nephrostomy
Answer: A. Kock's pouch
Rationale: A Kock's pouch is a continent ileal bladder conduit that does not require an
external drainage collection device because the client self-catheterizes every 2 to 4
hours to remove urine. This device allows the client to have some control over urinary
elimination. An ileal conduit and cutaneous ureterostomy require external drainage
bags. A nephrostomy is a tube placed directly into the kidney.
3. A nurse is assessing a client's stoma on the second postoperative day. Which
finding should the nurse report to the provider immediately?
A. The stoma is edematous and pink
B. The stoma is producing liquid effluent
C. The stoma appears dark purple
D. The stoma is tender to touch
Answer: C. The stoma appears dark purple
Rationale: A dark purple or black stoma indicates ischemia or necrosis and requires
immediate provider notification. Mild edema and pink color are expected findings. New
ileostomies produce liquid effluent, which is normal. Tenderness is expected initially.
,4. A nurse is providing education to a patient who will undergo creation of an
ascending colostomy. Which statement accurately describes the expected stool
characteristics for this type of colostomy?
A. Formed and solid with minimal liquid
B. Liquid to semiliquid
C. Semiliquid to semiformed
D. Completely liquid with digestive enzymes
Answer: C. Semiliquid to semiformed
Rationale: An ascending colostomy is located in the ascending colon, where less water
absorption has occurred compared to more distal colostomies. The stool is typically
semiliquid to semiformed.
5. A nurse is assessing a patient with a urostomy who reports that the stoma
appears to have a white, pasty substance on it. What is the nurse's best response?
A. "This is a sign of infection that requires immediate treatment."
B. "This is normal mucus production from the intestinal segment used for the urostomy."
C. "This indicates that your stoma is not functioning properly."
D. "You should scrub this off vigorously with alcohol."
Answer: B. "This is normal mucus production from the intestinal segment used for
the urostomy."
Rationale: The intestinal segment used to create a urostomy continues to produce
mucus, which is normal and expected. This mucus may appear as a white or pasty
substance on or around the stoma. It does not indicate infection or malfunction.
, 6. A nurse is caring for a patient who had a total proctocolectomy with permanent
ileostomy. The nurse should explain that this surgery involves removal of which
structures?
A. The entire colon, rectum, and anus
B. Only the sigmoid colon
C. The small intestine only
D. The rectum and anus only
Answer: A. The entire colon, rectum, and anus
Rationale: A total proctocolectomy involves removal of the entire colon, rectum, and
anus, resulting in a permanent ileostomy. This is typically performed for ulcerative colitis
or familial adenomatous polyposis.
7. A nurse is caring for a patient with a descending colostomy. The nurse should
expect the patient's stool to be which consistency?
A. Liquid with visible digestive enzymes
B. Pasty
C. Formed but soft
D. Hard and pellet-like
Answer: C. Formed but soft
Rationale: A descending colostomy is located in the descending colon where significant
water absorption has occurred. The stool is formed but soft, similar to normal stool
consistency.
