1. On assessment of a patient with a colostomy, you note the stoma is located on the right area of the abdomen. Due to its location, this is known as what type of colostomy?
A. Descending Colostomy
D. Ascending Colostomy
2. Thinking back to the patient in Question 1, what type of stool would you expect the stoma to be excreting?
A. Liquid stool
B. Lose to partly formed stool
C. Similar to normal stool
D. Semi-solid stool
3. True or False: An ileostomy is a surgical opening created to bring the large intestine to the surface of the abdomen.
4. Describe, in order, how food travels from the stomach to the rectum:*
A. It exits the stomach into: the cecum to the jejunum to the ileum, then into the duodenum, descending colon, transverse colon, ascending colon, sigmoid colon, and rectum.
B. It exits the stomach into: the duodenum to the ileum to the jejunum, then into the cecum, ascending colon, sigmoid colon, descending colon, transverse colon, and rectum.
C. It exits the stomach into: the ileum to the jejunum to the duodenum, then into the cecum, sigmoid colon, transverse colon, descending colon, ascending colon, and rectum.
D. It exits the stomach into: the duodenum to the jejunum to the ileum, then into the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum.
5. A patient has a double-barrel colostomy of the transverse colon. You note on assessment two stomas, a proximal and distal stoma. What type of stool do you expect to drain from the proximal and distal stomas?*
A. Proximal: lose to partly formed stool; Distal: mucous
B. Proximal: liquid stool; Distal: mucous
C. Proximal: mucous; Distal: lose to partly formed stool
D. Proximal & Distal: lose to partly formed stool
6. A patient is 8 hours post-opt from an colostomy placement. Which finding requires immediate nursing action?*
A. The stoma is swollen and large.
B. The stoma is black.
C. The stoma is not draining any stool.
D. The patient states the site is tender.
7. A patient, who had a colostomy placed yesterday, calls on the call light to say their surgical dressing “fell off”. You will re-apply what type of dressing over the stoma?*
A. Wet to dressing
B. No dressing is needed. You will keep it open to air.
C. Petroleum gauze dressing
D. Telfa gauze
8. You’re providing teaching to a patient with an ileostomy on how to change their pouch drainage system. Which statement is INCORRECT about how to change a pouching system for an ostomy?*
A. Empty the pouch when it is 1/3 to 1/2 full.
B. Change the pouching system every 3-5 days.
C. When measuring the stoma for skin barrier placement, be sure the opening of the skin barrier is a 2/3 inch larger than the stoma.
D. Keep the skin around the stoma clean and dry at all times.
9. You receive a doctor’s order for a patient to take Aspirin EC by mouth daily. The patient has the following medication history: diabetes type 2, peripheral vascular disease, and a permanent ileostomy. What is your next nursing action?*
A. Administer the medication as ordered.
B. Crush the medication and mix it in applesauce.
C. Hold the medication and notify the doctor the patient has an ileostomy.
D. Crush the medication and mix it in pudding.
10. You’re providing diet teaching to a patient with an ileostomy. Which foods should the patient consume in very small amounts or completely avoid?*
A. Peanut butter, bananas, rice
B. Corn, popcorn, nut and seeds
C. Grape juice, bread, and pasta
D. Vinegar, soft drinks, and cured meats
11. A patient, who has a colostomy, asks what type of foods they should avoid to decrease odorous gas. You would tell the patient to avoid:*
A. Onions, alcoholic beverages, eggs, and cabbage
B. Beef, fried foods, lettuce, and rice
C. Apple, pears, nuts, and wheat
D. Potatoes, peas, carrots, and chicken
12. A patient is 2 days post-opt from an ileostomy placement. Which finding requires immediate nursing action?*
A. The stoma is excreting liquid stool.
B. The patient’s potassium level is 2.0
C. The stoma is bright red and moist.
D. The patient reports mucoid drainage from the anus.
13. Which type of colostomy can allow a patient to have bowel continence?*
A. Descending or Sigmoid Colostomy
B. Ascending or Transverse Colostomy
C. Transverse or Descending Colostomy
D. Ascending or Descending Colostomy
14. True or False: Patients with an ileostomy are at greater risk for dehydration and an electrolyte imbalance.*