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COCN Exam Review 1 Study Guide Solutions Updated Methotrexate - ANSWER-This drug is used in steroid-dependent, active Crohn's disease and in Crohn's disease remission maintenance. There is no evidence to support its use for ulcerative colitis. c - ANSWER-Mr. F. has returned to the outpatient cl...

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  • November 3, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • cocn exam review 1 study guide solutions updated

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Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024




COCN Exam Review 1 Study Guide

Solutions Updated


Methotrexate - ANSWER✔✔-This drug is used in steroid-dependent, active Crohn's disease and in

Crohn's disease remission maintenance. There is no evidence to support its use for ulcerative colitis.


c - ANSWER✔✔-Mr. F. has returned to the outpatient clinic for follow-up two weeks after discharge. He

has an enterocutaneous fistula to his upper abdomen. The fistula is 1 cm in diameter and drains 500-600

ml of liquid green effluent every 24 hours. He is achieving a 3-day wear time using a standard ostomy

pouching system. Upon removal of the pouching system there is denudement at the 6 o'clock position

where the patient has a small but deeply scarred defect. Your recommendation would be to:




a. Cut the skin barrier opening to slightly less than 1cm


b. Change to a high output pouching system


c. Level the skin defect with skin barrier paste or ring


d. Continue his current plan of care without modifications


Laxatives - ANSWER✔✔-__________________ should never be used by a person with an ileostomy

because of the potential for severe dehydration and electrolyte imbalance.




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,Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024


peristomal pyoderma gangrenosum - ANSWER✔✔-idiopathic, inflammatory ulcerative condition of the

peristomal skin. It is thought to start as one or more pustules that break open and form full-thickness

ulcers. The surrounding skin becomes red and purple.


a (The principles of PG wound care include pain management, moisture control and maintenance of a

clean wound base, protection of the wound base, delivery of topical anti-

inflammatory/immunosuppressive preparations, and achieving a predictable pouching system wear time

of at least 24 hours) - ANSWER✔✔-Which of the following treatments is appropriate for a patient with a

full-thickness lesions from peristomal pyoderma gangrenosum?




a. topical steroids


b. topical antifungals


c. topical antibiotics


d. silver nitrate cauterization


vesicovaginal fistula - ANSWER✔✔-an abnormal connection between the bladder and the vagina


60 - ANSWER✔✔-An important aspect of caring for a neobladder is the prevention of the accumulation

of mucous in the pouch. Individuals should be taught to instill _____ ml of normal saline and allow it to

drain. Repeat until clear.


self-efficacy - ANSWER✔✔-Focusing on promoting ________________ with individuals with

psychological problems has been shown to improve self-care.


viral gastroenteritis - ANSWER✔✔-Small meals of bland, low residue foods and adequate fluids are

recommended for acute _________________________________ to meet the patient's dietary needs.

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, Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024


Ideal food choices include boiled starches (rice, wheat, oats) and vegetables, crackers, bananas, soup

and yogurt


6-8 weeks - ANSWER✔✔-Gastrostomy and jejunostomy devices are placed when enteral nutritional

support (tube feeding) is required long-term, generally more than ________________.


jejunostomy - ANSWER✔✔-A _________________ tube is superior to a gastrostomy tube in patients

with high aspiration risk; esophageal or gastric cancer; previous gastric, duodenal, or pancreatic surgery;

or severe gastric paresis


bladder cancer - ANSWER✔✔-Your patient has had an orthotopic bladder replacement. This procedure is

done for _________________.


electric razor - ANSWER✔✔-If the abdomen has a lot of hair, which can cause pain with pouch changes

and folliculitis, hair removal with a(n) ______________________________ is recommended.


Turnbull blowhole colostomy - ANSWER✔✔-The ____________________________ is occasionally

indicated for extremely ill patients with severe toxic megacolon. It is done for simplicity and its ability to

rapidly reduce sepsis.


True - ANSWER✔✔-True or False: A Turnbull blowhole colostomy procedure leaves the diseased colon

behind, leading to persistent toxicity.


antidiarrheal - ANSWER✔✔-_______________________ agents are contraindicated for infectious

enteritis because the organisms become retained in the bowel and cause more reaction.


d - ANSWER✔✔-You are reviewing a list of medications with your patient who is about to be discharged

after having an emergent loop transverse colostomy. One of the medications is Wellbutrin XL, a

sustained-released antidepressant that the patient has taken for the past 3 years. You decide to:


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