WEB WOC OSTOMY CARE Newest Exam Preparation
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QUESTION 1
A patient with a new end colostomy reports that the effluent is liquid
and continuous. Which phase of bowel recovery is most consistent with
this finding?
A) Immediate postoperative phase
B) Early adaptation phase
C) Maturation phase
D) Chronic phase
Answer: A) Immediate postoperative phase
Explanation: In the immediate postoperative phase, the bowel has not
yet resumed its normal absorptive function, and the effluent is typically
liquid to semi-liquid and continuous. This occurs because peristalsis is
irregular and the colon has not reabsorbed sufficient water. The early
adaptation phase usually sees the effluent becoming more paste-like,
while the maturation phase results in formed stool. The chronic phase
represents the established pattern.
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QUESTION 2
The nurse is teaching a patient about dietary modifications for an
ileostomy. Which food is most likely to cause a blockage?
A) Applesauce
B) Well-cooked broccoli
C) Raw celery
D) White bread
Answer: C) Raw celery
Explanation: Raw celery contains long, stringy fibers that are difficult to
digest and can accumulate at the stoma, leading to a mechanical
blockage. Applesauce and well-cooked broccoli are generally safe as
they are soft and easily digestible. White bread is low in fiber and rarely
causes obstruction. Patients with ileostomies should avoid raw
vegetables with high fiber content and tough skins.
QUESTION 3
A patient with a urostomy reports a urine output of less than 30 mL per
hour over the past four hours. What is the priority nursing action?
A) Increase fluid intake to 3 liters per day
B) Assess the stoma for edema and ischemia
C) Notify the healthcare provider immediately
D) Check the appliance for kinks or obstruction
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Answer: D) Check the appliance for kinks or obstruction
Explanation: The first action is to assess for mechanical obstruction of
the urostomy appliance, as kinking of the tubing or blockage at the
stoma level is a common and easily correctable cause of decreased
output. While increased fluid intake is important, it is not the priority if
an obstruction is present. Notifying the provider is appropriate if the
obstruction is not resolved, but it is not the initial step. Stomal
assessment is relevant but secondary to appliance integrity.
QUESTION 4
Which stomal complication is characterized by the stoma protruding
excessively, often more than 3 centimeters beyond the skin level?
A) Prolapse
B) Retraction
C) Stenosis
D) Ischemia
Answer: A) Prolapse
Explanation: Prolapse is defined as the abnormal protrusion of the
stoma beyond its normal length, typically exceeding 3 centimeters. It
results from increased intra-abdominal pressure or poor fascial fixation.
Retraction is the inward displacement of the stoma below skin level.
Stenosis is narrowing of the stomal opening. Ischemia is characterized
by a dusky, bluish, or black appearance due to compromised blood
supply.
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QUESTION 5
The WOC nurse is assessing a patient's peristomal skin. Which finding is
most indicative of a fungal infection?
A) Erythema with satellite papules
B) Uniform erythema under the adhesive
C) Maceration with white, soggy tissue
D) Ulceration with serous drainage
Answer: A) Erythema with satellite papules
Explanation: Satellite papules or pustules surrounding a central
erythematous area are classic signs of a candidal fungal infection.
Uniform erythema under the adhesive is more consistent with contact
dermatitis. Maceration with white, soggy tissue indicates moisture-
associated skin damage. Ulceration with serous drainage suggests
mechanical trauma or chemical irritation from effluent.
QUESTION 6
A patient with a transverse colostomy is concerned about the odor
from the pouch. Which dietary measure is most effective in reducing
odor?
A) Increasing intake of eggs and fish
B) Increasing intake of yogurt and buttermilk
C) Increasing intake of asparagus and onions