COCN : WOCNCB Certified Ostomy Care Nurse Exam

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ent with an ileostomy is experiencing a blockage. As the ostomy nurse, which of the followi entions should you prioritize to manage this complication effectively?
courage the patient to drink more fluids and eat soft foods commend immediate pouch removal to assess for dislodgement ruct the patient to take a laxative immediately
vise the patient to perform abdominal massage and position changes er: D
nation: Abdominal massage and position changes can help relieve a blockage by stimulating lsis and promoting the passage of contents through the stoma.
on: 759
a patient education session, the nurse explains the importance of using accessories for stom ccessory would be most beneficial for a patient with a stoma that is flush with the skin?
onvexity insert to enhance stoma projection kin barrier with a built-in filter
ouch cover for aesthetic purposes
Question: 758
A pati ng
interv
1. En
2. Re
3. Inst
4. Ad
Answ Expla
perista
Questi
During a care.
Which a
1. A c
2. A s
3. A p
4. A drainage bag for increased capacity Answer: A
Explanation: A convexity insert can help improve stoma projection, enhancing the fit of the pouch for flush stomas.
Question: 760
A patient with a urostomy is planning to travel internationally. What is the most important advice you can provide to ensure their pouching system remains secure during the trip?
1. Limit fluid intake to avoid frequent restroom visits
2. Pack extra pouches and supplies in their carry-on luggage
3. Use a pouch that is smaller and more discreet
4. Avoid discussing their ostomy with travel companions Answer: B
Explanation: Packing extra pouches and supplies ensures that the patient has what they need in case of emergencies while traveling.
Question: 761
nurse is assessing a patient with a loop stoma who has been experiencing excessive gas and odo accessory might the nurse suggest to help manage these symptoms effectively?
barrier spray nvex wafer
ma cap er pouch
er: D
nation: A filter pouch is designed to manage gas and odor, allowing gas to escape while cont onvex wafers do not address gas issues, while stoma caps and skin barrier sprays serve diff es.
ion: 762
ent with a history of multiple abdominal surgeries now presents with bowel obstruction due ons. What is the surgical indication for intervention in this case?
rovide palliative care estore bowel continuity
elieve the obstruction and prevent ischemia ssess for malignancy
er: C
A r.
Which
1. Skin
2. Co
3. Sto
4. Filt Answ
Expla aining
odor. C erent
purpos
Quest
A pati to
adhesi
1. To p
2. To r
3. To r
4. To a Answ
Explanation: The surgical indication is to relieve the obstruction and prevent ischemia, which can occur if the bowel remains obstructed.
Question: 763
In planning care for a patient with a urostomy, what is the most critical educational point the nurse should emphasize to ensure effective management of their condition?
1. Understanding the importance of hydration and monitoring urine color.
2. Regularly checking the pouch for leaks or odor.
3. Maintaining a consistent schedule for catheter changes.
4. Limiting fluid intake to avoid frequent urination. Answer: A
Explanation: Emphasizing hydration and monitoring urine color is vital for urostomy patients to prevent complications and ensure effective management of their condition.
Question: 764
ly diagnosed ostomy patient is seeking information about local support groups and advocacy ces. Which of the following resources should the nurse recommend that best aligns with the 's need for community support and education?
cal hospital’s outpatient wound care program United Ostomy Associations of America (UOAA) eneral health clinic's pamphlet on diet
line forums without professional oversight er: B
nation: The UOAA provides tailored resources, education, and support specifically for indivi stomies, facilitating community connections and advocacy.
ion: 765
enario where a patient with a loop stoma is experiencing significant output, what is the most priate accessory to recommend to enhance pouch management?
hicker pouch stomy belt
kin barrier
ouch with a built-in filter
er: D
A new resour patient
1. Lo
2. The
3. A g
4. On
Answ
Expla duals
with o
Quest
In a sc appro
1. A t
2. An o
3. A s
4. A p
Answ
Explanation: A pouch with a built-in filter is appropriate for managing significant output as it helps to control odor and can accommodate the increased volume more effectively.
Question: 766
A 60-year-old patient presents with a traumatic injury to the abdomen and signs of bowel perforation. What is the most critical surgical indication for intervention in this scenario?
1. To assess for other injuries
2. To improve nutritional intake
3. To facilitate bowel rest
4. To repair the perforation and prevent peritonitis Answer: D
Explanation: The most critical surgical indication is to repair the perforation and prevent peritonitis, which can be life-threatening.
Question: 767
nurse is assessing a patient who has developed peristomal skin irritation. The patient uses a colloid dressing. Which of the following factors should the nurse consider as a potential caus tation?
dressing is too thick and causes pressure on the skin
dressing may be too small and not covering the stoma adequately patient's skin may be sensitive to the adhesive in the dressing dressing is too porous and allows excessive moisture accumulation
er: C
nation: Skin sensitivity to adhesive materials can lead to irritation, especially with hydrocoll ngs. This requires careful assessment and possible change of products.
ion: 768
a home visit, you notice that a patient with an ostomy is using a pouch that appears too lar toma. What is the most likely consequence of this improper fit?
reased likelihood of leakage and discomfort proved protection against skin irritation hanced pouch capacity for output
eater ease in pouch application
er: A
A
hydro e of
the irri
1. The
2. The
3. The
4. The Answ
Expla oid
dressi
Quest
During ge for
their s
1. Inc
2. Im
3. En
4. Gr
Answ
Explanation: A pouch that is too large can lead to increased leakage and discomfort, as it may not conform well to the stoma's shape.
Question: 769
In caring for a patient with a loop stoma, the nurse observes increased output and mucous discharge. What should the nurse do first in response to these findings?
1. Increase the frequency of pouch changes.
2. Notify the healthcare provider.
3. Educate the patient about dietary changes.
4. Document the findings and monitor for changes. Answer: B
Explanation: Notifying the healthcare provider is the priority action because increased output and mucous discharge may indicate complications that require further evaluation and intervention.
Question: 770
an assessment, a nurse discovers that a patient with a colostomy has developed significant leakage heir pouch. What is the most appropriate initial step in managing this complication?
ange the pouch immediately
ruct the patient to increase fluid intake ess the stoma for infection or irritation commend a different pouching system
er: C
nation: Assessing the stoma for infection or irritation is crucial to determine the underlying c kage before deciding on management.
ion: 771
essing the outcomes of a continent reservoir procedure, which factor is paramount in predicti erm success of continence?
gical technique used
ient adherence to follow-up ervoir capacity
pe of reservoir created er: C
During from t
1. Ch
2. Inst
3. Ass
4. Re
Answ
Expla ause of
the lea
Quest
In ass ng the
long-t
1. Sur
2. Pat
3. Res
4. Ty
Answ
Explanation: Reservoir capacity directly influences continence, as a larger capacity can accommodate greater stool volume, reducing the frequency of evacuations.
Question: 772
In a patient with an ileostomy, which of the following findings would indicate a potential obstruction requiring immediate intervention?
1. Watery output with a foul odor
2. Stoma appears slightly swollen with no discomfort
3. Increased flatulence and belching
4. Sudden decrease in stoma output accompanied by abdominal pain Answer: D
Explanation: A sudden decrease in output along with abdominal pain may indicate an obstruction, which necessitates immediate evaluation and intervention.
Question: 773
ention due to the potential for complications?
rkening of the skin around the stoma
mall amount of effluent with a normal appearance reased frequency of catheterization without pain
d tenderness around the stoma er: A
nation: Darkening of the skin around the stoma could indicate compromised blood flow or ne itating immediate intervention to prevent serious complications.
ion: 774
nurse is educating a patient who has undergone a surgical procedure resulting in an ileostomy. W ent by the patient indicates a need for further teaching regarding potential complications?
hould monitor for signs of dehydration."
in irritation can occur if the bag is not applied correctly." an expect my output to be thick and formed."
eed to be aware of possible blockages in the stoma." er: C
nation: Patients with an ileostomy typically have a more liquid output due to the part of the
In a patient with a continent diversion, which assessment finding would necessitate immediate nursing interv
1. Da
2. A s
3. Inc
4. Mil Answ
Expla crosis,
necess
Quest
A hich
statem
1. "I s
2. "Sk
3. "I c
4. "I n
Answ Expla
intestine involved. A thick and formed output is not expected, indicating a need for further education.
Question: 775
A bariatric patient is scheduled for an ostomy due to complications from obesity. Which of the following is the most important factor to consider in preoperative planning for this patient?
1. The surgical technique to be used
2. Type of ostomy appliance
3. Nutritional status and planning
4. Postoperative pain management Answer: C
Explanation: Bariatric patients may have specific nutritional needs and challenges; addressing these preoperatively is crucial for optimal recovery and ostomy management post-surgery.
Question: 776
erral to a dietitian
Trial of conservative management iation of a new medication regimen gical revision
er: D
nation: If a fistula has not shown signs of healing after six weeks, surgical intervention may ary to address the underlying issue and promote closure.
ion: 777
ent with an ileostomy is concerned about weight loss since surgery. Which of the following mendations should be prioritized to help increase caloric intake while maintaining normal ou
rease intake of raw vegetables for fiber oid all dairy products to prevent gas
us on high-calorie, low-fiber foods mit protein sources to avoid diarrhea
er: C
nation: High-calorie, low-fiber foods can help increase caloric intake without significantly sing output, which is important for patients with an ileostomy.
A patient presents with a fistula that has been present for over six weeks. What is the most appropriate next step in management if there is no sign of healing?
A. Ref B.
1. Init
2. Sur Answ
Expla be
necess
Quest
A pati dietary
recom tput?
1. Inc
2. Av
3. Foc
4. Li
Answ Expla
increa
Question: 778
A nurse is assessing a patient who has developed a colocutaneous fistula following a colon resection. The patient expresses feelings of embarrassment and isolation. What is the most effective initial approach for the nurse to take in addressing the psychosocial issues associated with this condition?
1. Refer the patient to a support group for individuals with ostomies
2. Encourage the patient to talk about their feelings and concerns regarding the fistula
3. Provide educational materials about fistula management
4. Suggest the patient focus on physical recovery rather than emotional distress Answer: B
Explanation: Allowing the patient to express their feelings and concerns is a crucial initial step in addressing psychosocial issues and promoting emotional well-being.

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