Chapter 26: The Patient with an Ostomy

Chapter 26: The Patient with an Ostomy

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

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