Question 1

What is caused by some adhesive pouch material used to hold the appliance in place?

Accepted Answer

A)  Melting of the pouch 
B)  Excoriation of the stoma 
C)  Allergic reaction 
D)  Unpleasant odor 
A)  Melting of the pouch 
B)  Excoriation of the stoma 
C)  Allergic reaction 
D)  Unpleasant odor

Question 2

A baby born without a urinary bladder has a surgically created cutaneous ureterostomy.One stoma exists.What should be discussed with the child's family regarding the care?

Accepted Answer

A)  "This urinary diversion is permanent, and urine will drain from it continually." 
B)  "In the future, a second surgery will offer an exit for the urine from the other kidney." 
C)  "This pouch needs to be changed only once a week." 
D)  "You should notify the surgeon if the stoma becomes paler in color." 
A)  "This urinary diversion is permanent, and urine will drain from it continually." 
B)  "In the future, a second surgery will offer an exit for the urine from the other kidney." 
C)  "This pouch needs to be changed only once a week." 
D)  "You should notify the surgeon if the stoma becomes paler in color."

Question 3

A patient is receiving discharge instructions and shares with the nurse that he intends to do a lot of traveling.What instruction should the nurse include?

Accepted Answer

A)  "Pack plenty of extra colostomy supplies in your checked airline luggage.Some places you might visit do not always carry the supplies you will need." 
B)  "Exercise caution with new foods, especially local fruits and vegetables because they may cause diarrhea or gas." 
C)  "If visiting somewhere where drinking local water is not advised, irrigating the colostomy with the local water is still okay." 
D)  "Repeat back to me what we just talked about so that you will remember everything you have been taught." 
A)  "Pack plenty of extra colostomy supplies in your checked airline luggage.Some places you might visit do not always carry the supplies you will need." 
B)  "Exercise caution with new foods, especially local fruits and vegetables because they may cause diarrhea or gas." 
C)  "If visiting somewhere where drinking local water is not advised, irrigating the colostomy with the local water is still okay." 
D)  "Repeat back to me what we just talked about so that you will remember everything you have been taught."

Question 4

A patient with an ostomy asks the nurse what limitations should be observed in the immediate postoperative period when at home.What is the most informative information that the nurse should share?

Accepted Answer

A)  Avoid heavy lifting for at least 3 months. 
B)  Limit fluid intake to no more than 1000 mL/day. 
C)  Wear loose clothing without belts or elastic. 
D)  Cover your appliance with plastic sheeting while showering. 
A)  Avoid heavy lifting for at least 3 months. 
B)  Limit fluid intake to no more than 1000 mL/day. 
C)  Wear loose clothing without belts or elastic. 
D)  Cover your appliance with plastic sheeting while showering.

Question 5

A 47-year-old patient with a permanent colostomy reports some abdominal discomfort and rigidity 3 days after surgery.Which assessment should the nurse report and record?

Accepted Answer

A)  Vital signs are temperature, 100$\degree$ F; pulse, 92 beats/min; and blood pressure, 160/98 mm Hg. 
B)  Stoma is swollen and red; small amount of blood is observed at the base. 
C)  Pouch has drained 110 mL of green-brown liquid, oozing from the pouch edges. 
D)  Stoma is protruding. 
A)  Vital signs are temperature, 100$\degree$ F; pulse, 92 beats/min; and blood pressure, 160/98 mm Hg. 
B)  Stoma is swollen and red; small amount of blood is observed at the base. 
C)  Pouch has drained 110 mL of green-brown liquid, oozing from the pouch edges. 
D)  Stoma is protruding.

Question 6

A patient comes to the industrial nurse and is frantic because the stoma to the colostomy has prolapsed 1 year after surgery.What is the best response by the nurse?

Accepted Answer

A)  "If there are still feces coming from the stoma, then it is not blocked.Contact your surgeon for an evaluation." 
B)  "You must come in immediately because the stoma may completely retract into your abdomen." 
C)  "This is an emergency situation because it has stenosed." 
D)  "Don't worry about that.Coughing or sneezing might have caused the prolapse.It will come back out in a few hours." 
A)  "If there are still feces coming from the stoma, then it is not blocked.Contact your surgeon for an evaluation." 
B)  "You must come in immediately because the stoma may completely retract into your abdomen." 
C)  "This is an emergency situation because it has stenosed." 
D)  "Don't worry about that.Coughing or sneezing might have caused the prolapse.It will come back out in a few hours."

Question 7

A nurse is aware that many patients with ostomies have an altered self-image.What might this cause?

Accepted Answer

A)  Inadequate self-care 
B)  Altered sexual function 
C)  Nonadherence to diet 
D)  Irrational anger 
A)  Inadequate self-care 
B)  Altered sexual function 
C)  Nonadherence to diet 
D)  Irrational anger

Question 8

A patient asks a nurse if karaya products can be used to seal the urostomy appliance.On what knowledge should the nurse base a response?

Accepted Answer

A)  Any adhesive is effective on a urostomy appliance. 
B)  Urine breaks down karaya products. 
C)  Karaya products can cause urinary infections. 
D)  Formation of urine crystals is increased with the use of karaya products. 
A)  Any adhesive is effective on a urostomy appliance. 
B)  Urine breaks down karaya products. 
C)  Karaya products can cause urinary infections. 
D)  Formation of urine crystals is increased with the use of karaya products.

Exam 18: The Patient With an Ostomy

What is caused by some adhesive pouch material used to hold the appliance in place?

A baby born without a urinary bladder has a surgically created cutaneous ureterostomy.One stoma exists.What should be discussed with the child's family regarding the care?

A patient is receiving discharge instructions and shares with the nurse that he intends to do a lot of traveling.What instruction should the nurse include?

A patient with an ostomy asks the nurse what limitations should be observed in the immediate postoperative period when at home.What is the most informative information that the nurse should share?

A 47-year-old patient with a permanent colostomy reports some abdominal discomfort and rigidity 3 days after surgery.Which assessment should the nurse report and record?

A patient comes to the industrial nurse and is frantic because the stoma to the colostomy has prolapsed 1 year after surgery.What is the best response by the nurse?

A nurse is aware that many patients with ostomies have an altered self-image.What might this cause?

A patient asks a nurse if karaya products can be used to seal the urostomy appliance.On what knowledge should the nurse base a response?

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

Psychobiological Disorders

Substance Abuse

First Aid, Emergency Care, and Disaster Management

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