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WEB WOC Ostomy Care Final Exam
Questions With Verified Solutions And
Rationales
Section 1: Stoma Assessment & Complications (Questions 1-20)
1. A patient is 48 hours postoperative from a new end colostomy. The stoma
appears dusky with a bluish-purple discoloration and lacks capillary refill. What is
the priority nursing action?
A. Apply a warm compress to improve local perfusion
B. Request immediate surgical consultation for possible bowel ischemia
C. Document the finding and reassess in 24 hours
D. Irrigate the stoma with sterile saline to check patency
Correct Answer: B
Rationale: A dusky, cyanotic stoma with absent capillary refill indicates
compromised blood supply (ischemia/necrosis), which is a surgical emergency.
Thermal application does not fix necrosis, delayed intervention risks perforation,
and irrigation is irrelevant to vascular integrity .
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2. Which type of stoma is MOST likely to develop a prolapse?
A. End colostomy
B. Loop colostomy
C. End ileal conduit
D. Loop ileostomy
Correct Answer: B
Rationale: A prolapse is a telescoping of the bowel through the stoma. While
prolapsing can occur with other stoma types, it most commonly occurs in loop
colostomies, especially those involving the transverse segment. Incidence in
transverse loop colostomies is reported at 7% to 25%, compared with 12% for end
colostomies and 11% for loop ileostomies .
3. A WOC nurse is assessing a new ileostomy on postoperative day 1. Which
finding requires immediate notification of the surgeon?
A. The stoma mucosa is dark red to purple with bluish discoloration at the tips
B. The stoma appears edematous and is slightly larger than expected
C. A small amount of serosanguineous drainage is present on the peristomal skin
D. The stoma is flush with the skin surface with mild bruising of the surrounding
dermis
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Correct Answer: A
Rationale: Dark red to purple discoloration with bluish or blackish hue at the
stoma tips indicates compromised venous return or arterial supply, signaling
ischemia or necrosis. Mild edema is expected postoperatively, serosanguineous
drainage is normal in the first 24-48 hours, and a flush stoma with mild bruising is
suboptimal but not an acute emergency .
4. Which stoma assessment finding requires immediate notification of the
healthcare provider?
A. Stoma appears moist and beefy red
B. Stoma is slightly edematous on postoperative day 2
C. Stoma appears dark purple or black
D. Small amount of bleeding when cleaning the stoma
Correct Answer: C
Rationale: A healthy stoma is moist and beefy red, indicating adequate blood
supply. Dark purple or black discoloration suggests ischemia or necrosis due to
compromised blood flow, which is a surgical emergency. Minor bleeding during
cleaning is expected due to the vascularity of the stoma mucosa .
WEB WOC Ostomy Care Final Exam
Questions With Verified Solutions And
Rationales
Section 1: Stoma Assessment & Complications (Questions 1-20)
1. A patient is 48 hours postoperative from a new end colostomy. The stoma
appears dusky with a bluish-purple discoloration and lacks capillary refill. What is
the priority nursing action?
A. Apply a warm compress to improve local perfusion
B. Request immediate surgical consultation for possible bowel ischemia
C. Document the finding and reassess in 24 hours
D. Irrigate the stoma with sterile saline to check patency
Correct Answer: B
Rationale: A dusky, cyanotic stoma with absent capillary refill indicates
compromised blood supply (ischemia/necrosis), which is a surgical emergency.
Thermal application does not fix necrosis, delayed intervention risks perforation,
and irrigation is irrelevant to vascular integrity .
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2. Which type of stoma is MOST likely to develop a prolapse?
A. End colostomy
B. Loop colostomy
C. End ileal conduit
D. Loop ileostomy
Correct Answer: B
Rationale: A prolapse is a telescoping of the bowel through the stoma. While
prolapsing can occur with other stoma types, it most commonly occurs in loop
colostomies, especially those involving the transverse segment. Incidence in
transverse loop colostomies is reported at 7% to 25%, compared with 12% for end
colostomies and 11% for loop ileostomies .
3. A WOC nurse is assessing a new ileostomy on postoperative day 1. Which
finding requires immediate notification of the surgeon?
A. The stoma mucosa is dark red to purple with bluish discoloration at the tips
B. The stoma appears edematous and is slightly larger than expected
C. A small amount of serosanguineous drainage is present on the peristomal skin
D. The stoma is flush with the skin surface with mild bruising of the surrounding
dermis
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Correct Answer: A
Rationale: Dark red to purple discoloration with bluish or blackish hue at the
stoma tips indicates compromised venous return or arterial supply, signaling
ischemia or necrosis. Mild edema is expected postoperatively, serosanguineous
drainage is normal in the first 24-48 hours, and a flush stoma with mild bruising is
suboptimal but not an acute emergency .
4. Which stoma assessment finding requires immediate notification of the
healthcare provider?
A. Stoma appears moist and beefy red
B. Stoma is slightly edematous on postoperative day 2
C. Stoma appears dark purple or black
D. Small amount of bleeding when cleaning the stoma
Correct Answer: C
Rationale: A healthy stoma is moist and beefy red, indicating adequate blood
supply. Dark purple or black discoloration suggests ischemia or necrosis due to
compromised blood flow, which is a surgical emergency. Minor bleeding during
cleaning is expected due to the vascularity of the stoma mucosa .
