Ostomy Certification Exam Set 2 – Questions/Answers
Which of the following patient instructions should be included during d/c
teaching for a patient with a nephrostomy tube inserted 3 days ago? Right
Ans - Apply a sterile gauze dressing daily for 2 weeks and change PRN for
leakage.
You are providing home care teaching for the family of a patient on
continuous enteral tube feeding. It is important to educate the family on
prevention of tube occlusion. Your teaching would include what? Right Ans
- Flush the tube with 30ml of warm H2O q4h.
You are consulted because a patient is complaining of excessive moisture &
irritation around his g-tube. Upon inspection of the tube site, you note some
bleeding, erythema, and hypergranulation tissue. Optimal treatment would
include what? Right Ans - Applying an external tube stabilization device.
A patient diagnosed with common bile duct cancer has a triple-lumen g-tube
called a gj-tube. The correct port to use for enteral feedings is which one?
Right Ans - Jejunal port
Mrs. F has a colocutaneous fistula. You are seeing her for teaching prior to d/c
home. You explain that she is on enteral nutrition via PEG tube because of
what? Right Ans - It provides maintenance of normal intestinal function.
A urethrocutaneous fistula is the most common complication of the following?
Right Ans - Correction of epispadias in male patients with bladder extrophy.
A foley cath has been placed in an incontinent patient to decrease urine
contamination into a sacral PI. The sacral drsg continues to be saturated and
you note a large amount of yellow drainage coming from the vagina. You
suspect that the patient may have a what? Right Ans - Vesicovaginal fistula.
You receive a phone call from an out-of-state patient visiting the area. He
needs pouching supplies. He has been wearing a pouch for 2 years and
remember his nurse saying it was "stomatized" and "high output." You suspect
the patient has what? Right Ans - Chronic fistula with >500ml/24h output.
, What safety info is most important for the patient with a continent urinary
diversion? Right Ans - Wear a medic alert bracelet that says "Continent
Urinary Diversion."
A paraplegic with complete urinary and fecal incontinence has a hx of UTI and
has acquired a stage 4 sacral PI with osteomyelitis. Urinary and fecal
diversions are planned. The patient has chosen an Indiana pouch continent
urinary diversion. What pre-op prep does the patient require to be successful
with long-term mgmt.? Right Ans - An understanding that he/she must be
motivated and capable of stoma cathing.
Failure to adequately empty the neobladder after each void or cath may result
in what complication? Right Ans - Urinary stone formation within the
reservoir.
You have been asked to see Mrs. Z because she has several questions about
the catheters that she uses for her continent urostomy. she tells you that she is
throwing the catheters away after each use. You inform her that? Right Ans
- Catheters are reusable and will last 3 months with proper care.
You are seeing a 50 year old male who underwent a cystectomy for bladder
cancer. You are seeing him on the first post-op day to perform & demonstrate
the irrigation of the orthotopic neobladder through the foley cath placed in
the urethra. You teach him to do what? Right Ans - Instill 60ml of NS &
allow it to drain. Repeat until clear.
A foley cath is placed through the urinary meatus into the neobladder in
surgery. After the foley is removed what voiding/cath schedule would you
give the patient to ensure gradual expansion of the reservoir? Right Ans -
Increase the time from q2h/day & q3h/night until a 6h interval is achieved.
The goal to ensure catheter patency in the Indiana pouch in the early post-op
period is best achieved by doing what? Right Ans - Irrigation of the
catheter with 60mls of NS q3-4h.
A patient with bladder cancer has been offered the choice between the
Indiana pouch and an orthotopic neobladder by his surgeon. In your pre-
operative teaching what info would you give the patient to help him with
making the choice? Right Ans - Most patients can urinate freely with the
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