Question 1

What should the initial assessment of a patient that just returned from surgery for the creation of an Indiana pouch include?

Accepted Answer

A)  Drainage of urine from the Penrose drain at the operative site 
B)  Condition and color of the stoma 
C)  Appearance of mucus in the urine 
D)  Copious and odorous urine drainage from the incision 
A)  Drainage of urine from the Penrose drain at the operative site 
B)  Condition and color of the stoma 
C)  Appearance of mucus in the urine 
D)  Copious and odorous urine drainage from the incision A

Question 2

What is the most effective way for a nurse to help provide support to the patient with an ostomy who has ineffective regimen management?

Accepted Answer

A)  Ask a volunteer from the American Cancer Society or United Ostomy Association to visit. 
B)  Ask a volunteer from the Reach for Recovery Society to visit. 
C)  Send a close family member for psychiatric counseling. 
D)  Obtain humor books pertaining to illness, such as Anatomy of an Illness, or watch several episodes of The Three Stooges on television. 
A)  Ask a volunteer from the American Cancer Society or United Ostomy Association to visit. 
B)  Ask a volunteer from the Reach for Recovery Society to visit. 
C)  Send a close family member for psychiatric counseling. 
D)  Obtain humor books pertaining to illness, such as Anatomy of an Illness, or watch several episodes of The Three Stooges on television. A

Question 3

What should a nurse instruct the patient to do to ensure a good fit of the appliance to avoid leakage?

Accepted Answer

A)  Place the pouch only when lying down. 
B)  Check pouch placement to ensure a firm seal. 
C)  Confirm that the pouch fits tightly to the edges of the stoma. 
D)  Confirm that the pouch covers the entire abdomen. 
A)  Place the pouch only when lying down. 
B)  Check pouch placement to ensure a firm seal. 
C)  Confirm that the pouch fits tightly to the edges of the stoma. 
D)  Confirm that the pouch covers the entire abdomen. B

Question 4

What should a nurse suggest to a patient with a colostomy choose when selecting an appropriate diet to reduce excess gas or diarrhea?

Accepted Answer

A)  Roast beef, mashed potatoes, and peeled stewed tomatoes 
B)  Broiled pork chop, boiled potato, and corn on the cob 
C)  Broiled trout, mashed potatoes, and spinach 
D)  Barbeque pork on a white bun, coleslaw, and French fries 
A)  Roast beef, mashed potatoes, and peeled stewed tomatoes 
B)  Broiled pork chop, boiled potato, and corn on the cob 
C)  Broiled trout, mashed potatoes, and spinach 
D)  Barbeque pork on a white bun, coleslaw, and French fries

Question 5

What should be considered when deciding placement of a stoma? (Select all that apply.)

Accepted Answer

A)  Good seal 
B)  Stabilization from the abdominal rectus 
C)  Ease of self-care 
D)  Inoffensive appearance 
E)  Proximity to the umbilicus 
A)  Good seal 
B)  Stabilization from the abdominal rectus 
C)  Ease of self-care 
D)  Inoffensive appearance 
E)  Proximity to the umbilicus

Question 6

A patient who has had a temporary colostomy to rest his ulcerated bowel says, "I don't know how I will continue to work at my job with this thing stuck to my stomach." Which response by the nurse is most likely to stimulate communication?

Accepted Answer

A)  "This is only a temporary adjustment for you, and the colostomy will be reanastomosed in less than 6 months." 
B)  "A nurse with special training will be in to help you." 
C)  "What is there about your job that you feel you cannot do?" 
D)  "Many people feel as you do, but they learn to dress and act and work just like they did before the surgery." 
A)  "This is only a temporary adjustment for you, and the colostomy will be reanastomosed in less than 6 months." 
B)  "A nurse with special training will be in to help you." 
C)  "What is there about your job that you feel you cannot do?" 
D)  "Many people feel as you do, but they learn to dress and act and work just like they did before the surgery."

Question 7

Which is the best nursing strategy for encouraging an ostomy patient to perform self-care?

Accepted Answer

A)  Plan to change the pouch when family members will be present, and have the patient watch and listen to the procedure. 
B)  Frequently tell the patient that if he or she does not learn stoma self-care, no one is going to do it for him or her. 
C)  Encourage the patient to watch the stoma care procedure, gradually encouraging participation. 
D)  Shield the patient from sight of the stoma until the patient actually asks to see it. 
A)  Plan to change the pouch when family members will be present, and have the patient watch and listen to the procedure. 
B)  Frequently tell the patient that if he or she does not learn stoma self-care, no one is going to do it for him or her. 
C)  Encourage the patient to watch the stoma care procedure, gradually encouraging participation. 
D)  Shield the patient from sight of the stoma until the patient actually asks to see it.

Question 8

A patient asks if rectal suppositories can be used to assist with constipation problems with his colostomy.What should the nurse clarify regarding suppositories?

Accepted Answer

A)  They can be used in double-barreled colostomies. 
B)  They can be used in a stoma. 
C)  They should not ever be used in a colostomy. 
D)  They will not penetrate well enough to relieve constipation. 
A)  They can be used in double-barreled colostomies. 
B)  They can be used in a stoma. 
C)  They should not ever be used in a colostomy. 
D)  They will not penetrate well enough to relieve constipation.

Question 9

What is the primary advantage of a J-pouch anal anastomosis procedure?

Accepted Answer

A)  No odor 
B)  Easier to irrigate 
C)  Near-normal bowel elimination 
D)  Less problem with diarrhea 
A)  No odor 
B)  Easier to irrigate 
C)  Near-normal bowel elimination 
D)  Less problem with diarrhea

Question 10

What might the continual loss of liquid stool result in with an ileostomy patient?

Accepted Answer

A)  Acidosis 
B)  Alkalosis 
C)  Erosion of stoma 
D)  Colitis 
A)  Acidosis 
B)  Alkalosis 
C)  Erosion of stoma 
D)  Colitis

Question 11

Which assessment by a nurse caring for an immediate postoperative patient with an ileal conduit should be reported or receive attention immediately?

Accepted Answer

A)  Lack of bowel sounds 
B)  Distended abdomen 
C)  Mucus present in the urine 
D)  Small amount of blood in the drainage 
A)  Lack of bowel sounds 
B)  Distended abdomen 
C)  Mucus present in the urine 
D)  Small amount of blood in the drainage

Question 12

A 20-year-old patient with a permanent colostomy asks whether she will be able to become pregnant.What is the most informative response by the nurse?

Accepted Answer

A)  "No.The colostomy weakened the pelvic floor to the point that it will not support a pregnancy." 
B)  "Yes.Pregnancy may be accomplished with artificial insemination because the fallopian tubes are usually damaged by a colostomy." 
C)  "No.The abdominal pressure exerted by a pregnancy will cause the prolapse of the stoma." 
D)  "Yes.The colostomy will not interfere with pregnancy or delivery." 
A)  "No.The colostomy weakened the pelvic floor to the point that it will not support a pregnancy." 
B)  "Yes.Pregnancy may be accomplished with artificial insemination because the fallopian tubes are usually damaged by a colostomy." 
C)  "No.The abdominal pressure exerted by a pregnancy will cause the prolapse of the stoma." 
D)  "Yes.The colostomy will not interfere with pregnancy or delivery."

Question 13

Which term appropriately defines an artificial opening into a body cavity?

Accepted Answer

A)  Gastrostomy 
B)  Ostomy 
C)  Colonoscopy 
D)  Ureterostomy 
A)  Gastrostomy 
B)  Ostomy 
C)  Colonoscopy 
D)  Ureterostomy

Question 14

Why is a patient who has undergone a colostomy instructed to measure the width of the stomas for the first 6 weeks postoperatively before applying each new pouch?

Accepted Answer

A)  The stoma will shrink during this time. 
B)  A poor-fitting pouch will cause infection of the stoma. 
C)  The paste will not adhere. 
D)  Prolapse will result. 
A)  The stoma will shrink during this time. 
B)  A poor-fitting pouch will cause infection of the stoma. 
C)  The paste will not adhere. 
D)  Prolapse will result.

Question 15

What can be caused by lack of thorough cleansing of fecal matter from around a stoma? (Select all that apply.)

Accepted Answer

A)  Fungal infection 
B)  Bacterial infection 
C)  Yeast infection 
D)  Deterioration of the stoma 
E)  Odor 
A)  Fungal infection 
B)  Bacterial infection 
C)  Yeast infection 
D)  Deterioration of the stoma 
E)  Odor

Question 16

A patient with a colostomy continues to worry about odor.What instruction should a nurse provide to allay this concern?

Accepted Answer

A)  Pierce the top of the appliance bag with a pin to allow gas to escape. 
B)  Rinse the pouch in a vinegar solution. 
C)  Wear tight-fitting underwear. 
D)  Improve personal hygiene. 
A)  Pierce the top of the appliance bag with a pin to allow gas to escape. 
B)  Rinse the pouch in a vinegar solution. 
C)  Wear tight-fitting underwear. 
D)  Improve personal hygiene.

Question 17

A postoperative patient with an ostomy has the potential for loss of fluid volume and electrolyte imbalance.Which assessments indicate such loss? (Select all that apply.)

Accepted Answer

A)  Changing mental status 
B)  Twitching 
C)  Poor skin turgor 
D)  Moist mucous membranes 
E)  Weakness 
A)  Changing mental status 
B)  Twitching 
C)  Poor skin turgor 
D)  Moist mucous membranes 
E)  Weakness

Question 18

When a patient complains of urine crystals forming on the urostomy stoma, the home health nurse recommends dissolving them with a pad saturated with ______.

Accepted Answer

The answer of When a patient complains of urine crystals...

Question 19

A patient says, "I hate this yucky paste under my appliance.I think I will just tape it on." What is the best response by the nurse?

Accepted Answer

A)  "Taping will not work!" 
B)  "Taping will not seal the wafer tight enough to prevent leakage or fill increases." 
C)  "Taping with waterproof tape is just as effective as the paste." 
D)  "Taping is far more irritating to the skin than the paste would be." 
A)  "Taping will not work!" 
B)  "Taping will not seal the wafer tight enough to prevent leakage or fill increases." 
C)  "Taping with waterproof tape is just as effective as the paste." 
D)  "Taping is far more irritating to the skin than the paste would be."

Question 20

What are complications that may occur with continent pouches (Kock and Indiana)? (Select all that apply.)

Accepted Answer

A)  Incontinence 
B)  Difficult catheterization 
C)  Pyelonephritis 
D)  Rupture of the pouch 
E)  Peritonitis 
A)  Incontinence 
B)  Difficult catheterization 
C)  Pyelonephritis 
D)  Rupture of the pouch 
E)  Peritonitis

Exam 18: The Patient With an Ostomy

What should the initial assessment of a patient that just returned from surgery for the creation of an Indiana pouch include?

What is the most effective way for a nurse to help provide support to the patient with an ostomy who has ineffective regimen management?

What should a nurse instruct the patient to do to ensure a good fit of the appliance to avoid leakage?

What should a nurse suggest to a patient with a colostomy choose when selecting an appropriate diet to reduce excess gas or diarrhea?

What should be considered when deciding placement of a stoma? (Select all that apply.)

A patient who has had a temporary colostomy to rest his ulcerated bowel says, "I don't know how I will continue to work at my job with this thing stuck to my stomach." Which response by the nurse is most likely to stimulate communication?

Which is the best nursing strategy for encouraging an ostomy patient to perform self-care?

A patient asks if rectal suppositories can be used to assist with constipation problems with his colostomy.What should the nurse clarify regarding suppositories?

What is the primary advantage of a J-pouch anal anastomosis procedure?

What might the continual loss of liquid stool result in with an ileostomy patient?

Which assessment by a nurse caring for an immediate postoperative patient with an ileal conduit should be reported or receive attention immediately?

A 20-year-old patient with a permanent colostomy asks whether she will be able to become pregnant.What is the most informative response by the nurse?

Which term appropriately defines an artificial opening into a body cavity?

Why is a patient who has undergone a colostomy instructed to measure the width of the stomas for the first 6 weeks postoperatively before applying each new pouch?

What can be caused by lack of thorough cleansing of fecal matter from around a stoma? (Select all that apply.)

A patient with a colostomy continues to worry about odor.What instruction should a nurse provide to allay this concern?

A postoperative patient with an ostomy has the potential for loss of fluid volume and electrolyte imbalance.Which assessments indicate such loss? (Select all that apply.)

When a patient complains of urine crystals forming on the urostomy stoma, the home health nurse recommends dissolving them with a pad saturated with ______.

A patient says, "I hate this yucky paste under my appliance.I think I will just tape it on." What is the best response by the nurse?

What are complications that may occur with continent pouches (Kock and Indiana)? (Select all that apply.)

Aspects of Medical-Surgical Nursing

Medical-Surgical Practice Settings

Medical-Surgical Patients: Individuals, Families, and Communities

Health, Illness, Stress, and Coping

Immunity, Inflammation, and Infection

Fluid, Electrolyte, and Acidbase Imbalance

The Patient With Cancer

Pain

Shock

The Older Adult Patient

Falls

Immobility

Delirium and Dementia

Incontinence

Nutrition

Intravenous Therapy

Surgery

Palliative and Hospice Care

Complementary and Alternative Therapies

Neurologic System Introduction

Neurologic Disorders

Cerebrovascular Accident

Spinal Cord Injury

Respiratory System Introduction

Upper Respiratory Disorders

Acute Lower Respiratory Tract Disorders

Chronic Lower Respiratory Tract Disorders

Hematologic System Introduction

Hematologic Disorders

Immunologic System Introduction

Immunologic Disorders

Cardiovascular System Introduction

Cardiac Disorders

Vascular Disorders

Hypertension

Digestive System Introduction

Upper Digestive Tract Disorders

Lower Digestive Tract Disorders

Liver, Gallbladder, and Pancreatic Disorders

Urologic System Introduction

Urologic Disorders

Musculoskeletal System Introduction

Connective Tissue Disorders

Fractures

Amputations

Endocrine System Introduction

Pituitary and Adrenal Disorders

Thyroid and Parathyroid Disorders

Diabetes and Hypoglycemia

Female Reproductive System Introduction

Female Reproductive Disorders

Male Reproductive System Introduction

Male Reproductive Disorders

Sexually Transmitted Infections

Integumentary System Introduction

Skin Disorders

Special Senses Introduction

Eye and Vision Disorders

Ear and Hearing Disorders