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NAWCO-OMS test Format | Course Contents | Course Outline | test Syllabus | test Objectives

- Anatomy/Physiology
- Gastrointestinal (GI) system
- Genitourinary (GU) system
- Principles of Wound Healing
- Partial-Full Thickness healing
- Types wound closure
- Moist wound healing
- Systemic factors that influence healing

- Treatment and management of conditions/etiologies/indications for Fecal or Urinary Diversion Surgery
- Bowel obstruction
- Inflammatory bowel disease
- Ulcerative colitis, Crohn’s disease,
- Gastrointestinal cancers
- acute diverticulitis
- Bladder cancer
- Interstitial cystitis
- Neurogenic bladder
- Refractory radiation cystitis
- Pediatric conditions
- Hirschsprung’s disease
- Imperforate anus
- Necrotizing enterocolitis
- Malrotation with midgut volvulus
- Meconium ileus
- Intussusceptions
- Cloacal exstrophy
- Intestinal atresias
- Intestinal pseudoobstruction
- Intestinal transplant

- Assessment, treatment and management of:
- Gastrointestinal Ostomies
- Colostomy
- Ascending colostomy
- Cecostomy
- Transverse colostomy
- Descending colostomy
- Ileostomy
- Brooke ileostomy
- Gastrointestinal continent diversions
- Kock pouch
- Ileoanal reservoir
- Continent colostomy
- Urinary ostomies
- Urostomy
- Ileal conduit
- Colon conduit
- Uretero-sigmoidostomy
- Jejunum conduit
- Incontinent urinary diversions Ureterostomy, Vesicostomy
- Continent urinary diversions
- Indiana pouch
- Mitrofanoff continent urinary diversion
- Neo- bladder
- Fistulas

- Patient Education
- Pre-operative teaching and counseling:
- anatomy and physiology of the GI or GU system
- procedure
- appearance of the stoma
- appliances
- equipment
- modification and alterations of lifestyle after surgery

- Teaching plan specific patient needs and concerns:
- age
- self care ability
- presurgical life style
- barriers to learning
- patient’s support system
- dietary habits
- physical habits
- financial resources
- receptiveness to education
- social and coping skills
- psychosocial development
- environmental challenges

- Post-operative teaching and counseling:
- Apply, manipulate, empty, and remove pouching system
- stoma care
- bathing
- clothing
- activity restrictions
- medication influence
- dietary considerations
- peristomal skin care
- complications to report
- sexual counseling
- colostomy irrigation and discharge resources

- Assessment and management Peristomal complications:
- Peristomal hernia
- Peristomal fistula
- Peristomal candidiasis
- Folliculitis
- Pseudoverrucous lesions
- pyoderma gangrenosum
- Suture granulomas
- Irritant contact dermatitis
- allergic contact dermatitis
- skin trauma
- Psoriasis and Alkaline encrustations
- Carcinoma of the peristomal skin, Pemphigus

- Assessment and management of stoma and stomal complications:
- Categories, types, clinical characteristics
- Peristomal hernia
- stoma prolapse
- stoma necrosis
- stoma stenosis
- stoma retraction
- mucocutaneous separation
- stomal varices
- stoma fistula
- stoma trauma

- Assessment, management, and modifications for appliances and pouching products including:
- One- piece or two-piece systems
- Systems for fecal or urinary diversions
- Flexible or rigid skin barriers
- Flat or convex skin barriers, and pouching accessories

- Psychosocial Effects of Fecal and Urinary Diversion Surgery:
- Phases of adjustment, quality of life, self esteem, body image
- Relationships, spiritual, cultural, and ethnic considerations
- Health care professional’s role and responsibilities

- Procedures and techniques:
- Containment of stoma effluent
- Colostomy irrigation
- Catheterization of an ileal conduit
- Food blockage
- ileostomy lavage
- medication administration drug absorption
- Pouching fistulas
- Stoma site marking
- Tube management:
- nasogastric tubes
- nephrostomy tubes
- long intestinal tubes
- biliary tubes
- tracheostomy tubes

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NAWCO Ostomy Management Specialist
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Question: 712
A patient with significant weight changes post-ostomy surgery is struggling with pouch fit. What is the most appropriate recommendation?
1. Measure the stoma size frequently and adjust the pouch accordingly
assure them that weight changes do not affect pouching commend they stop any weight changes immediately
er: A
nation: Regularly measuring the stoma size and adjusting the pouch accordingly is crucial to er fit and prevent leaks, especially with significant weight changes.
ion: 713
ent with a new transverse colostomy expresses concerns about odor control. What is the mos ve measure to manage this issue?
ng a pouching system with an odor control filter miting protein intake
reasing fiber intake
plying a deodorizing spray er: A
nation: Using a pouching system with an odor control filter is the most effective measure for ing odor associated with colostomies, providing an ongoing solution rather than temporary f
ion: 714
Use a larger pouching system regardless of fit
2. Re
3. Re
Answ
Expla ensure
a prop
Quest
A pati t
effecti
1. Usi
2. Li
3. Inc
4. Ap
Answ Expla
manag ixes.
Quest
A patient asks about the best way to care for their peristomal skin to prevent complications. Which of the following practices should you emphasize?
1. Keep the area dry at all times
2. Use alcohol-based cleansers for cleaning
3. Apply a barrier cream before pouch application
4. Change the pouch only when it leaks Answer: C
Explanation: Applying a barrier cream is essential to protect the peristomal skin from irritation and leakage, thereby preventing complications.
Question: 715
In managing a patient with a neobladder, which complication is most important to monitor in the early postoperative phase?
1. Infection
2. Neobladder capacity
nary incontinence er: A
nation: Infection is a significant risk in the early postoperative phase, requiring vigilant moni ompt intervention if symptoms arise.
ion: 716
ent with acute diverticulitis has experienced recurrent episodes and is now considering surgi ention. What is the recommended surgical procedure for a patient with recurrent diverticulitis
pendectomy ula repair
onic resection with anastomosis moid colectomy
er: D
nation: Sigmoid colectomy is recommended for patients with recurrent diverticulitis to preve episodes and complications.
ion: 717
the most common cause of peristomal dermatitis in ostomy patients?
Electrolyte imbalance
3. Uri Answ
Expla toring
and pr
Quest
A pati cal
interv ?
1. Ap
2. Fist
3. Col
4. Sig Answ
Expla nt
further Quest What is
1. Allergic reaction to the adhesive
2. Stoma size changes
3. Infection
4. Excessive moisture Answer: D
Explanation: Excessive moisture from output can lead to skin breakdown and dermatitis, making it the most common cause of peristomal skin issues.
ion: 718
iscussing modifications to lifestyle post-ostomy, which of the following is a critical point to regarding physical activity?
oid all forms of exercise for six months.
y walking is recommended post-operatively. enuous activities can be resumed after one week.
ht exercise is encouraged immediately after surgery. er: D
nation: Light exercise is encouraged soon after surgery to promote healing and Improve over eing, but patients should avoid strenuous activities initially.
Quest
When d address
1. Av
2. Onl
3. Str
4. Lig Answ
Expla all
well-b
Question: 719
Which of the following types of skin barriers for ostomy management provides flexibility and conforms well to irregular skin surfaces?
1. Flexible skin barriers
2. Rigid skin barriers
onvex skin barriers wer: A
anation: Flexible skin barriers provide flexibility and conform well to ular skin surfaces. They are designed to move with the body and prov ortable fit. Rigid skin barriers, on the other hand, are more rigid and m uitable for individuals with well-formed stomas or to provide addition ort. Flat skin barriers have a flat surface and are suitable for individua
lat or flush stomas. Convex skin barriers have a convex shape and ar gned to help manage stomas that are retracted or flush with the skin ce.
stion: 720
ch healthcare professional plays a role in providing support and educat tients undergoing fecal and urinary diversion surgery?
Flat skin barriers
3. C
Ans Expl
irreg ide a
comf ay
be s al
supp ls
with f e
desi surfa
Que
Whi ion
to pa
1. Surgeon
2. Pharmacist
3. Physical therapist
4. Radiologist
Explanation: The surgeon has a primary role in the surgical management of fecal and urinary diversion. They are responsible for performing the surgery and providing post-operative care, including support and education to the patients.
Question: 721
eostomy lavage edication administration ouching fistulas olostomy irrigation
wer: A
anation: In the case of food blockage in an ileostomy, ileostomy lavag mmended treatment. It involves the gentle instillation of warm water i toma to help dislodge the blockage and facilitate its passage.
stion: 722
ch type of dermatitis is caused by exposure to irritants such as stool, u hesive products?
What is the recommended treatment for food blockage in an ileostomy?
1. Il
2. M
3. P
4. C
Ans
Expl e is a
reco nto
the s
Que
Whi rine,
or ad
1. Peristomal candidiasis
2. Allergic contact dermatitis
3. Psoriasis
4. Irritant contact dermatitis
Explanation: Irritant contact dermatitis is a common skin condition that occurs when the skin comes into direct contact with irritant substances. In the context of ostomy management, it can be caused by exposure to stool, urine, or adhesive products used to secure the pouching system.
Question: 723
opical antifungal creams ral antibiotics
urgical intervention mmunosuppressive therapy
wer: A
anation: Peristomal candidiasis is a fungal infection that affects the sk nd the stoma. The recommended treatment is the use of topical antifu ms or ointments to control the infection.
stion: 724
ch of the following is a characteristic of pyoderma gangrenosum in th ext of ostomy management?
seudoverrucous lesions
What is the recommended treatment for peristomal candidiasis?
1. T
2. O
3. S
4. I
Ans
Expl in
arou ngal
crea
Que
Whi e
cont
1. P
2. Folliculitis
3. Suture granulomas
4. Skin trauma Answer: A
Explanation: Pyoderma gangrenosum is a rare inflammatory skin disease that
can occur in the peristomal area. It is characterized by the development of pseudoverrucous lesions, which are raised, wart-like growths on the skin.
Question: 725
seudoverrucous lesions yoderma gangrenosum uture granulomas soriasis
wer: B
anation: Pyoderma gangrenosum is a non-infectious inflammatory ski ition that can occur around the stoma and is often associated with rlying inflammatory bowel disease. It is characterized by the develop inful, necrotic ulcers with undermined borders. Pseudoverrucous lesio to wart-like growths that can occur around the stoma. Suture granulo nflammatory reactions that can occur in response to sutures used durin ery. Psoriasis is a chronic skin condition characterized by the develop d, scaly patches on the skin.
stion: 726
Which of the following is a non-infectious inflammatory skin condition that can occur around the stoma and is often associated with underlying inflammatory bowel disease?
1. P
2. P
3. S
4. P
Ans
Expl n
cond
unde ment
of pa ns
refer mas
are i g
surg ment
of re
Que
Which type of skin barrier is recommended for irregular or uneven peristomal areas?
1. Flat skin barrier
2. Convex skin barrier
Answer: B
Explanation: A convex skin barrier is recommended for irregular or uneven peristomal areas. It helps create a secure seal around the stoma, preventing leakage and protecting the surrounding skin.
stion: 727
ch of the following is a common complication associated with peristo a?
eristomal candidiasis olliculitis
uture granulomas eristomal fistula
wer: D
anation: Peristomal hernia refers to the protrusion of an organ or tissu ugh the abdominal wall around the stoma. It can lead to the formation tomal fistula, which is an abnormal connection between the stoma an cent organs or tissues.
stion: 728
Que
Whi mal
herni
1. P
2. F
3. S
4. P
Ans
Expl e
thro of a
peris d
adja
Que
Which type of ostomy system is designed as a single unit combining the skin barrier and pouch?
1. One-piece system
2. Two-piece system
Answer: A
Explanation: A one-piece system is an ostomy system that combines the skin barrier and pouch into a single unit. It is convenient and easy to use, as the entire system is replaced when necessary.
stion: 729
ch of the following is a type of peristomal complication characterized rowth of abnormal tissue that resembles a wart or verruca?
eristomal hernia eristomal fistula seudoverrucous lesions yoderma gangrenosum
wer: C
anation: Pseudoverrucous lesions are a type of peristomal complicatio acterized by the growth of abnormal tissue that resembles a wart or ve can occur around the stoma and may require treatment to prevent fur plications. Peristomal hernia refers to the protrusion of abdominal con ugh a weak area in the abdominal wall around the stoma. Peristomal fi abnormal connection between the stoma and adjacent organs or tissu
Que
Whi by
the g
1. P
2. P
3. P
4. P
Ans
Expl n
char rruca.
They ther
com tents
thro stula
is an es.
Pyoderma gangrenosum is a non-infectious inflammatory skin condition characterized by the development of painful, necrotic ulcers.
Question: 730
1. Stoma site marking
2. Colostomy irrigation
3. Quality of life
anation: The psychosocial effects of fecal and urinary diversion surge e influenced by various factors, including the individual's quality of l djustment to living with a stoma can have a significant impact on a on's psychological well-being and overall satisfaction with life.
stion: 731
ch complication is characterized by the narrowing or constriction of th a opening?
eristomal hernia oma prolapse oma necrosis toma stenosis
wer: D
Nasogastric tube management Answer: C
Expl ry
can b ife.
The a pers
Que
Whi e
stom
1. P
2. St
3. St
4. S
Ans
Explanation: Stoma stenosis refers to the narrowing or constriction of the stoma opening, making it difficult for effluent to pass through. It can be caused by various factors, including tissue inflammation or scarring.
Question: 732
1. Stoma cap
2. Skin barrier sealant
3. Stoma paste
anation: Ostomy belts are used to secure the pouching system and pro ional support and protection. They can help prevent accidental detach ovement of the pouching system, especially during physical activities. ma caps are small, lightweight pouches used for temporary use when th pouching system is not needed. Skin barrier sealants and stoma paste to fill in gaps or crevices between the skin barrier and the skin surfac
reate a more secure seal.
stion: 733
ch of the following ostomy systems is specifically designed for fecal sion?
ne-piece systems wo-piece systems losed-end pouches rainable pouches
Ostomy belt Answer: D
Expl vide
addit ment
or m
Sto e
main are
used e to
help c
Que
Whi diver
1. O
2. T
3. C
4. D
Answer: B
Explanation: Two-piece systems are specifically designed for fecal diversion. They allow for easy attachment and detachment of the pouch, making it convenient for emptying and changing the pouch as needed. One-piece systems have the pouch and skin barrier permanently attached to each other and are
suitable for both fecal and urinarydiversions. Closed-end pouches are typically used for one-time use and are suitable for individuals with predictable bowel movements. Drainable pouches have an opening at the bottom that can be opened to empty the contents and are suitable for individuals with unpredictable bowel movements.

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