NR 325 Adult Health II Postoperative Ostomy
Care Case Study 2026 |Practice Questions &
Answers with Rationales | Miguel Flores
Nursing Exam Prep.
1. A nurse is assessing Miguel Flores shortly after ostomy surgery. Which
finding indicates a healthy newly created stoma?
A. Pale and dry appearance
B. Dark purple appearance
C. Moist, pink-to-red appearance
D. Black and firm appearance
Answer: C. Moist, pink-to-red appearance
Rationale: A healthy stoma should be moist and pink to red because it has a rich
blood supply. Pale, dusky, purple, or black discoloration may indicate impaired
perfusion.
2. Which postoperative assessment is most important when evaluating a new
stoma?
A. Hair distribution around the abdomen
B. Stoma color and perfusion
C. Hand-grip strength
D. Visual acuity
Answer: B. Stoma color and perfusion
Rationale: Changes in stoma color can indicate compromised circulation and
require prompt assessment.
,3. Miguel asks why the stoma is expected to appear swollen immediately after
surgery. What is the best response?
A. “Swelling always indicates infection.”
B. “Some postoperative edema is expected during early healing.”
C. “The stoma should remain swollen permanently.”
D. “Swelling means the stoma has stopped functioning.”
_Answer: B. “Some postoperative edema is expected during early healing.”
Rationale: Mild edema is common immediately after ostomy creation and
generally decreases as healing progresses.
4. Which stoma finding requires immediate notification of the healthcare
provider?
A. Moist pink tissue
B. Mild postoperative edema
C. Dark or black discoloration
D. Small amount of expected drainage
_Answer: C. Dark or black discoloration
Rationale: Dark, dusky, or black tissue may indicate inadequate blood supply and
possible ischemia or necrosis.
5. What is the primary purpose of an ostomy appliance?
A. Prevent intestinal motility
B. Collect intestinal or urinary effluent
C. Sterilize the stoma
D. Increase abdominal pressure
_Answer: B. Collect intestinal or urinary effluent
,Rationale: The pouching system collects effluent from the stoma while protecting
surrounding skin.
6. Which intervention best protects the skin surrounding Miguel's stoma?
A. Scrubbing the skin vigorously
B. Applying alcohol routinely
C. Ensuring the appliance opening fits appropriately
D. Leaving the skin continuously wet
_Answer: C. Ensuring the appliance opening fits appropriately
Rationale: A properly fitted appliance minimizes leakage and contact between
effluent and peristomal skin.
7. A nurse observes liquid stool leaking beneath Miguel's pouch. What should
the nurse do first?
A. Ignore the leakage
B. Assess the pouch fit and peristomal skin
C. Apply antibiotic ointment routinely
D. Restrict all oral fluids
_Answer: B. Assess the pouch fit and peristomal skin
Rationale: Leakage commonly results from an improperly fitted pouch and can
cause significant skin irritation.
8. Which characteristic is expected from an ileostomy?
A. Usually produces formed stool
B. Usually produces liquid to semiliquid effluent
C. Produces urine only
D. Produces no output
_Answer: B. Usually produces liquid to semiliquid effluent
, Rationale: Because much of the colon is bypassed, ileostomy output is generally
more liquid and contains digestive enzymes.
9. Why is dehydration a particular concern for a patient with an ileostomy?
A. The stomach stops producing acid
B. The colon may no longer absorb as much water
C. The kidneys stop functioning
D. The patient cannot absorb carbohydrates
_Answer: B. The colon may no longer absorb as much water
Rationale: The colon normally contributes significantly to water and electrolyte
absorption. Ileostomy patients may therefore have increased fluid losses.
10. Which assessment finding may suggest dehydration in an ileostomy
patient?
A. Moist mucous membranes
B. Clear urine with normal output
C. Dizziness and decreased urine output
D. Stable body weight
_Answer: C. Dizziness and decreased urine output
Rationale: Dizziness and reduced urine output can occur with inadequate fluid
volume.
11. Which nursing action is appropriate when measuring a stoma for a new
pouch?
A. Measure the stoma at its widest point
B. Cut the opening substantially larger than the stoma
C. Measure according to the manufacturer's instructions
D. Avoid measuring after surgery
Care Case Study 2026 |Practice Questions &
Answers with Rationales | Miguel Flores
Nursing Exam Prep.
1. A nurse is assessing Miguel Flores shortly after ostomy surgery. Which
finding indicates a healthy newly created stoma?
A. Pale and dry appearance
B. Dark purple appearance
C. Moist, pink-to-red appearance
D. Black and firm appearance
Answer: C. Moist, pink-to-red appearance
Rationale: A healthy stoma should be moist and pink to red because it has a rich
blood supply. Pale, dusky, purple, or black discoloration may indicate impaired
perfusion.
2. Which postoperative assessment is most important when evaluating a new
stoma?
A. Hair distribution around the abdomen
B. Stoma color and perfusion
C. Hand-grip strength
D. Visual acuity
Answer: B. Stoma color and perfusion
Rationale: Changes in stoma color can indicate compromised circulation and
require prompt assessment.
,3. Miguel asks why the stoma is expected to appear swollen immediately after
surgery. What is the best response?
A. “Swelling always indicates infection.”
B. “Some postoperative edema is expected during early healing.”
C. “The stoma should remain swollen permanently.”
D. “Swelling means the stoma has stopped functioning.”
_Answer: B. “Some postoperative edema is expected during early healing.”
Rationale: Mild edema is common immediately after ostomy creation and
generally decreases as healing progresses.
4. Which stoma finding requires immediate notification of the healthcare
provider?
A. Moist pink tissue
B. Mild postoperative edema
C. Dark or black discoloration
D. Small amount of expected drainage
_Answer: C. Dark or black discoloration
Rationale: Dark, dusky, or black tissue may indicate inadequate blood supply and
possible ischemia or necrosis.
5. What is the primary purpose of an ostomy appliance?
A. Prevent intestinal motility
B. Collect intestinal or urinary effluent
C. Sterilize the stoma
D. Increase abdominal pressure
_Answer: B. Collect intestinal or urinary effluent
,Rationale: The pouching system collects effluent from the stoma while protecting
surrounding skin.
6. Which intervention best protects the skin surrounding Miguel's stoma?
A. Scrubbing the skin vigorously
B. Applying alcohol routinely
C. Ensuring the appliance opening fits appropriately
D. Leaving the skin continuously wet
_Answer: C. Ensuring the appliance opening fits appropriately
Rationale: A properly fitted appliance minimizes leakage and contact between
effluent and peristomal skin.
7. A nurse observes liquid stool leaking beneath Miguel's pouch. What should
the nurse do first?
A. Ignore the leakage
B. Assess the pouch fit and peristomal skin
C. Apply antibiotic ointment routinely
D. Restrict all oral fluids
_Answer: B. Assess the pouch fit and peristomal skin
Rationale: Leakage commonly results from an improperly fitted pouch and can
cause significant skin irritation.
8. Which characteristic is expected from an ileostomy?
A. Usually produces formed stool
B. Usually produces liquid to semiliquid effluent
C. Produces urine only
D. Produces no output
_Answer: B. Usually produces liquid to semiliquid effluent
, Rationale: Because much of the colon is bypassed, ileostomy output is generally
more liquid and contains digestive enzymes.
9. Why is dehydration a particular concern for a patient with an ileostomy?
A. The stomach stops producing acid
B. The colon may no longer absorb as much water
C. The kidneys stop functioning
D. The patient cannot absorb carbohydrates
_Answer: B. The colon may no longer absorb as much water
Rationale: The colon normally contributes significantly to water and electrolyte
absorption. Ileostomy patients may therefore have increased fluid losses.
10. Which assessment finding may suggest dehydration in an ileostomy
patient?
A. Moist mucous membranes
B. Clear urine with normal output
C. Dizziness and decreased urine output
D. Stable body weight
_Answer: C. Dizziness and decreased urine output
Rationale: Dizziness and reduced urine output can occur with inadequate fluid
volume.
11. Which nursing action is appropriate when measuring a stoma for a new
pouch?
A. Measure the stoma at its widest point
B. Cut the opening substantially larger than the stoma
C. Measure according to the manufacturer's instructions
D. Avoid measuring after surgery
