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Ostomy Care: Pre and Post Test for Nurses, Exams of Nursing

A pre/post test for nurses on ostomy care, covering topics such as cleansing the stoma and peristomal skin, preventive strategies for patients, and different types of ostomies. It includes questions and answers to assess nursing knowledge.

Typology: Exams

2023/2024

Available from 04/12/2024

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ATI-OSTOMY CARE PRE/POST TEST
A nurse is replacing the ostomy appliance for a patient whose newly created
colostomy is functioning. After removing the pouch, which of the following
should the nurse do first?
A. Measure the stroma
B. Cover the stroma with gauze
C. Remove the backing on the skin barrier
D. Cleanse the stoma and the peristomal skin - correct answer Answer: Cleanse
the stoma and the peristomal skin
- To facilitate the nurse's assessment of the stoma and the peristomal skin, the
nurse must remove any effluent adhering to the area.
A nurse is teaching a patient with a new ileostomy about incorporating preventive
strategies at home. To prevent excoriation and breakdown of the peristomal skin,
the nurse should instruct the patient to
A. Apply hydrocortisone cream to the skin when changing the appliance.
B. Empty the pouch when it is no more than half full.
C. Wash the peristomal skin frequently with deodorizing soap and water.
D. Choose a time shortly after a meal for replacing the pouch. - correct answer
Answer: Empty the pouch when it is no more than half full
- Waiting until the pouch is more than half full increases the risk of leakage.
Ileostomy effluent is irritating to peristomal skin, so patients should replace the
pouch when it is one third to one half full.
Patients should avoid the use of soap, especially oil or lotion based soaps. They
leave a residue that can interfere with pouch adhesion and increase the risk of
leakage. They should cleanse the skin and warm tap water. For times when soap
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ATI-OSTOMY CARE PRE/POST TEST

A nurse is replacing the ostomy appliance for a patient whose newly created colostomy is functioning. After removing the pouch, which of the following should the nurse do first? A. Measure the stroma B. Cover the stroma with gauze C. Remove the backing on the skin barrier D. Cleanse the stoma and the peristomal skin - correct answer Answer: Cleanse the stoma and the peristomal skin

  • To facilitate the nurse's assessment of the stoma and the peristomal skin, the nurse must remove any effluent adhering to the area. A nurse is teaching a patient with a new ileostomy about incorporating preventive strategies at home. To prevent excoriation and breakdown of the peristomal skin, the nurse should instruct the patient to A. Apply hydrocortisone cream to the skin when changing the appliance. B. Empty the pouch when it is no more than half full. C. Wash the peristomal skin frequently with deodorizing soap and water. D. Choose a time shortly after a meal for replacing the pouch. - correct answer Answer: Empty the pouch when it is no more than half full
  • Waiting until the pouch is more than half full increases the risk of leakage. Ileostomy effluent is irritating to peristomal skin, so patients should replace the pouch when it is one third to one half full. Patients should avoid the use of soap, especially oil or lotion based soaps. They leave a residue that can interfere with pouch adhesion and increase the risk of leakage. They should cleanse the skin and warm tap water. For times when soap

is essential and if their provider allows it, they should only use a mild, pH balanced soap. A nurse is providing preoperative teaching for an older adult patient who has diverticulitis and is scheduled for a creation of a double barrel colostomy in the sigmoid colon. Which of the following instructions should the nurse include in the teaching? A. Irrigate both stomas periodically to promote drainage. B. Tape a dry gauze pad over the distal stoma to collect drainage. C. Change the proximal stroma's appliance every other day. D. Expect liquid to drain from both stomas - correct answer Answer : Tape a dry gauze pad over the distal stoma to collect drainage

  • The distal stoma (also called a mucous fistula) secretes mucus; it does not drain feces. A dry gauze is usually sufficient. With a double barrel colostomy, irrigation might not be necessary at all. If it is, it would only apply to one stoma, not both. Ostomy appliances remain in place for up to 7 days and do not need to be replaced every other day. A nurse is providing preoperative teaching for a patient who has colon cancer. The surgeon informed the patient that his entire large intestine and rectum will be removed. The nurse should explain the type of ostomy he will have is A. a cecostomy B. a loop colostomy C. an ileostomy D. a decending colostomy - correct answer Answer: an ileostomy

While the nurse is teaching a patient how to replace her ostomy pouching system, the patient reports that removing the skin barrier is sometimes painful. Which of the following should the nurse suggest? A. Lift up on both sides of the skin barrier simultaneously. B. Release one corner of the barrier and pull it quickly over the stoma. C. Push the skin away from the barrier while removing it. D. Gently roll the barrier end over end across the stoma. - correct answer Answer: Push the skin away from the barrier while removing it. Pushing the skin away from the barrier helps prevent skin stripping, which can be painful and make the skin sensitive to adhesive. If the patient is having difficulty with the initial release of the barrier, it may help if she starts in one corner and gently pulls across the stoma while pushing the skin away from the barrier. Lifting the skin from both sides at once will pull directly on the dermis and possibly traumatize the skin. Rolling the skin barrier end over end will pull directly on the dermis and possibly traumatize the skin. A patient who has bladder cancer tells the nurse that, of the various urinary diversion options the surgeon presented, she prefers one that will allow her to have some control over urinary elimination. The nurse should explain the option that will allow that is A. a Kock's pouch B. an ileal conduit C. a cutaneous ureterostomy D. a nephrostomy - correct answer Answer: a Kock's pouch This is a continent ileal bladder conduit that does not require an external drainage collection device because the patient self-catheterizes every 2 to 4 hours to remove urine. The device will control the patient desires.

An ileal conduit is a passageway for urine to flow from the kidneys to the outside of the body. With this type of diversion, urine flows as it is produces, so the patient will not be able to control it. A cutaneous ureterostomy allows urine to flow from a ureteral opening to the outside of the body. Urine flows through the stoma as it is produces, so the patient will not be able to control it. A nephrostomy allows urine to flow from the kidney to the outside of the body. Urine flows through the stoma as it is produced, so the patient will not be able to control it. A nurse is teaching a patient how to apply an extended wear skin barrier. Which of the following strategies should the nurse instruct the patient to use for maximal adherence? A. Use an oil based lotion on the peristromal area B. Apply the skin barrier while the skin is slightly moise C. Leave the residue from the previous appliance on the skin D. Press gently around the barrier for 1 to 2 minutes - correct answer Answer: Press gently around the barrier for 1 to 2 minutes

  • The pressure sensitive tackifiers and heat sensitive polymers of the skin barrier require adequate pressure and warmth (from the fingers) to ensure adherence.