CNA Bowel and Ostomy Care 2 — Questions and Answers
Question 1: When emptying a colostomy pouch, the CNA should empty it when the pouch is how full?
- One-quarter to one-third full (Correct answer)
- Completely full
- One-half to two-thirds full
- Only when the resident requests it
Correct answer: One-quarter to one-third full
Pouches should be emptied when one-quarter to one-third full to prevent the seal from breaking due to weight.
Question 2: A resident has an ileostomy. The CNA notices the stoma output is very watery and high in volume. The BEST action is to:
- Report the finding to the nurse immediately (Correct answer)
- Increase the resident's fluid intake independently
- Apply a larger pouch and document
- Reassure the resident this is normal
Correct answer: Report the finding to the nurse immediately
High-volume liquid output from an ileostomy can indicate dehydration risk and must be reported to the nurse promptly.
Question 3: Which type of ostomy produces liquid stool and requires a drainable pouch at all times?
- Ileostomy (Correct answer)
- Sigmoid colostomy
- Descending colostomy
- Transverse colostomy
Correct answer: Ileostomy
An ileostomy bypasses the entire colon so output is always liquid and continuous, requiring a drainable pouch.
Question 4: When applying a new ostomy wafer (skin barrier), the opening should be cut to:
- 1/8 inch larger than the stoma diameter (Correct answer)
- Exactly the stoma size with no gap
- 1/2 inch larger to allow for swelling
- Match the entire abdomen area
Correct answer: 1/8 inch larger than the stoma diameter
The wafer opening should be cut 1/8 inch (3mm) larger than the stoma to protect peristomal skin without leaving excess skin exposed.
Question 5: A healthy stoma should appear:
- Pink to red and moist (Correct answer)
- Pale and dry
- Dark purple or black
- White with a crusty surface
Correct answer: Pink to red and moist
A healthy stoma is pink to red and moist, indicating good blood flow; dark or pale coloring must be reported immediately.
Question 6: The CNA is caring for a resident with a new colostomy who is embarrassed and refuses to look at the stoma. The BEST response is to:
- Acknowledge feelings and proceed with care calmly and professionally (Correct answer)
- Insist the resident look to learn self-care
- Skip ostomy care and notify the charge nurse the resident refused
- Tell the resident it is not that bad
Correct answer: Acknowledge feelings and proceed with care calmly and professionally
Acknowledging feelings while continuing professional care supports the resident emotionally without forcing readiness for self-care.
Question 7: To protect the skin around a stoma (peristomal skin), the CNA should apply:
- Skin barrier paste or wafer as directed (Correct answer)
- Petroleum jelly directly to the skin
- Talcum powder around the stoma
- Rubbing alcohol to clean and seal
Correct answer: Skin barrier paste or wafer as directed
Skin barrier products protect peristomal skin from stool enzymes and moisture; petroleum jelly, powder, and alcohol can damage the seal or skin.
CNA Bowel and Ostomy Care 2
When emptying a colostomy pouch, the CNA should empty it when the pouch is how full?