Chapter 26 The Patient with an Ostomy

Chapter 26  The Patient with an Ostomy

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which term appropriately defines an artificial opening into a body cavity?
a.
Gastrostomy
b.
Ostomy
c.
Colonoscopy
d.
Ureterostomy

ANS: B
An ostomy is an artificial opening into a body cavity.

DIF: Cognitive Level: Knowledge REF: p. 414 OBJ: 3
TOP: Terminology KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

2. 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?
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.

ANS: A
During the first 6 weeks, the stoma normally shrinks. The pouch needs to fit as closely to the stoma as is comfortable and safe to prevent skin irritation.

DIF: Cognitive Level: Comprehension REF: p. 427 OBJ: 4 | 7
TOP: Pouch Fit KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. 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.
Vital signs are temperature, 100° 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.

ANS: A
Vital signs, in conjunction with the complaint of abdominal discomfort, should be reported and recorded as possible signs of impending peritonitis.

DIF: Cognitive Level: Application REF: p. 423 OBJ: 4
TOP: Signs of Peritonitis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

4. A nurse is aware that many patients with ostomies have an altered self-image. What might this cause?
a.
Self-care deficits
b.
Sexual dysfunction
c.
Nonadherence to diet
d.
Irrational anger

ANS: B
A damaged self-image or body image may cause patients with ostomies to feel unattractive and embarrassed about possible sexual activity. Open-ended questions assist the patient to talk about their feelings.

DIF: Cognitive Level: Comprehension REF: p. 420 OBJ: 4 | 7
TOP: Self-Concept Issues in an Ostomate
KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

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

ANS: B
Placement of the pouch should provide a good fit and be comfortable in all positions but not too snug on the stoma to risk laceration. The pouch needs to only cover enough of the abdomen to allow for a firm fit.

DIF: Cognitive Level: Application REF: p. 415 OBJ: 4 | 7
TOP: Placement of the Stoma KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort