NCWO Ostomy Management 1 — Questions and Answers
Question 1: A healthy stoma should appear:
- Pale pink or white with a dry surface
- Beefy red or pink and moist (Correct answer)
- Dark purple or black indicating adequate perfusion
- Flat and flush with the abdominal skin
Correct answer: Beefy red or pink and moist
A normal, healthy stoma is beefy red or pink with a moist mucosal surface, reflecting good vascular perfusion of the intestinal mucosa.
Question 2: When should the stoma pouch opening be cut relative to stoma size?
- Exactly the same diameter as the stoma
- 1/8 inch (3 mm) larger than the stoma (Correct answer)
- 1/2 inch (12 mm) larger than the stoma
- As large as possible to prevent leakage
Correct answer: 1/8 inch (3 mm) larger than the stoma
The pouch opening should be cut 1/8 inch (3 mm) larger than the stoma to prevent constriction while minimizing exposed peristomal skin contact with effluent.
Question 3: A colostomy located in the sigmoid colon produces output that is most likely:
- Liquid and continuous throughout the day
- Formed or semi-formed stool, often once or twice daily (Correct answer)
- Bile-colored, watery, and very high volume
- Bloody and mucous-rich at all times
Correct answer: Formed or semi-formed stool, often once or twice daily
A sigmoid colostomy is located at the end of the large intestine, so stool is typically well-formed and output pattern is often predictable.
Question 4: The peristomal skin complication most commonly associated with enzymatic damage from small bowel effluent is:
- Pseudoverrucous lesions
- Parastomal hernia
- Irritant contact dermatitis (chemical dermatitis) (Correct answer)
- Folliculitis from hair removal
Correct answer: Irritant contact dermatitis (chemical dermatitis)
Small bowel effluent contains active digestive enzymes that cause irritant (chemical) contact dermatitis when they come into prolonged contact with peristomal skin.
Question 5: An ileostomy differs from a colostomy in that ileostomy output is:
- Formed and odorous, collected in an open-ended pouch
- Liquid to semi-liquid with high digestive enzyme content, requiring continuous pouching (Correct answer)
- Gas only, managed with a gas-venting pouch
- Intermittent and can be managed with irrigation
Correct answer: Liquid to semi-liquid with high digestive enzyme content, requiring continuous pouching
Ileostomy output is liquid to semi-liquid due to the proximal location in the bowel and contains active digestive enzymes, requiring a secure, continuously worn pouching system.
Question 6: Stomal prolapse is best described as:
- Retraction of the stoma below the skin surface
- Telescoping of the bowel outward through the stoma, elongating it (Correct answer)
- Parastomal bulge caused by intestinal herniation
- Mucocutaneous separation at the stoma base
Correct answer: Telescoping of the bowel outward through the stoma, elongating it
Stomal prolapse occurs when the bowel telescopes outward through the stoma opening, resulting in an elongated stoma that may be difficult to manage.
NCWO Ostomy Management 1
A healthy stoma should appear: