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1. What is a stoma?
a) A type of surgical drain.
b) A surgically created opening between a hollow organ and the body surface.
c) A medical device used for irrigation.
d) A method of closing surgical wounds.
2. Stoma creations are commonly performed for:
a) Cosmetic reasons.
b) Only permanent solutions.
c) Either temporary or permanent solutions.
d) Primarily for pediatric patients.
3. The most frequent complication observed with all stoma types is:
a) Stoma necrosis.
b) Skin irritation.
c) Parastomal hernia.
d) Stoma prolapse.
4. A high-output stoma is defined as a stoma with daily output of more than:
a) 500 ml.
b) 1000 ml.
c) 1500 ml.
d) 2000 ml.
5. Which of the following is NOT a risk associated with high-output stomas?
a) Dehydration
b) Acute kidney injury
c) Electrolyte abnormalities
d) Increased appetite
6. Stoma necrosis is most commonly caused by:
a) Infection.
b) Ischemia.
c) Poor hygiene.
d) Allergic reaction to the stoma bag.
7. Parastomal hernias are defined as:
a) A type of skin infection around the stoma.
b) Incisional hernias associated with an abdominal wall stoma.
c) A prolapse of the stoma.
d) Blockage of the stoma.
8. A stoma prolapse happens when:
a) The stoma becomes infected.
b) A proximal segment of bowel intussuscepts and protrudes through the stomal orifice.
c) The stoma retracts into the abdomen.
d) The stoma changes color.
9. Stenosis in stomas is reported in:
a) 0-2% of stomas
b) 2-15% of stomas
c) 20-30% of stomas
d) 40-50% of stomas
10. Signs and symptoms of stomal obstruction includes all EXCEPT:
a) Nausea
b) Vomiting
c) Increased output
d) Abdominal distension
11. One of the metabolic complications of having a diverting stoma includes, because the ileum is responsible for the absorption of vitamins, minerals, and bile salts:
a) Vitamin A deficiency
b) Vitamin C deficiency
c) Vitamin B12 deficiency
d) Vitamin D deficiency
12. What are the main indications for using chyme reinfusion (CR)?
a) high-output double enterostomies (DES) and enteroatmospheric fistulas (EAFs) of the small bowel
b) low-output double enterostomies (DES) and enteroatmospheric fistulas (EAFs) of the small bowel
c) high-output of large bowel double enterostomies (DES) and enteroatmospheric fistulas (EAFs)
d) low-output of large bowel double enterostomies (DES) and enteroatmospheric fistulas (EAFs)
13. Compared to low-output EAFs, what is the mortality for high-output EAFs?
a) Mortality has been reported to be as high as 30%
b) Mortality has been reported to be as high as 6%
c) There is no difference in mortality rate
d) Mortality has been reported to be as high as 50%
14. One of the benefits of chyme reinfusion is:
a) Decreased kidney function
b) Central line infection
c) Metabolic derangements
d) Improvement in liver function
15. The common methods for chyme reinfusion are:
a) Manual collection and mechanical reinfusion
b) Novel closed-loop system
c) Both A and B
d) A and B with additional help of a registered dietitian
16. One of the most common technical issues with chyme reinfusion is:
a) Redness or infection
b) Backflow of effluent and tube migration
c) There are no complications
d) Dryness around site
17. Complications due to high-output include all EXCEPT:
a) electrolyte disturbances
b) dehydration
c) renal impairment
d) weight gain
18. The main contraindication for chyme reinfusion is:
a) A distal bowel stenosis or obstruction
b) Short gut syndrome
c) Ulcerative colitis
d) Lack of registered dietitian
19. One of the benefits of chyme reinfusion is that it is able to wean patients from parenteral nutrition in at least how many cases?:
a) <25%
b) >50%
c) >85%
d) 100%
20. What has been identified as a marker of absorptive small bowel capacity?
a) Plasma chloride
b) Plasma sodium
c) Plasma albumin
d) Plasma citrulline
21. What is one of the reasons chyme reinfusion has not been widely adopted?
a) Due to an efficient, reliable and user-friendly method
b) To standardize reporting of variable
c) It is an easy and quick process
d) Lack of an efficient, reliable, and user-friendly method
22. The Insides System is indicated for which of the following conditions?
a) Enteroatmospheric fistula
b) High-output enterostomy (with Accessible Distal Limb)
c) Diverting ileostomy patients requiring bowel rehabilitation prior to reversal
d) All of the above
23. In a person with intact GI anatomy, where is salt absorbed from?
a) Duodenum
b) Colon
c) Jejunum
d) Ileum
24. What must an enteroatmospheric patient do before starting The Insides System?
a) Stabilise and optimise nutrition
b) Contrast image the fistula tract
c) Wound and ostomy appliance management
d) All of the above
25. What must a patient with a colonic anastomosis do before starting The Insides System?
a) Contrast study of the anastomosis
b) Hope for the best
c) Endoscopic inspection
d) Perform an enema
26. Are there any dietary recommendations for chyme reinfusion?
a) Low residue diet
b) FODMAP diet
c) Vegetarian diet
d) High caloric diet
27. How often does a patient use The Insides System per day?
a) Patient should be reinfusing as much of their output as they can, once the distal gut has been rehabilitated
b) Once a week
c) Whenever the patient leaves their home
d) Prior to each outpatient/home visit
28. What are the potential side effects when first commencing chyme reinfusion?
a) Discomfort
b) Nausea
c) Bloating
d) All of the above
29. What patients may not be suitable for chyme reinfusion?
a) No accessible distal limb
b) Patient's enterostomy or fistula is not contained in one stoma bag
c) Patient has downstream stenosis, obstruction or an anastomotic leak
d) All of the above
30. Why does chyme reinfusion need automating?
a) Automation allows patients to manage their own condition at home
b) Automating it allows it to be performed in a closed system, meaning the user does not come into contact with chyme
c) Automation makes chyme reinfusion viable, which frees up nurses needing to perform manual reinfusion
d) All of the above
31. Who is the key clinical decision maker or prescriber of The Insides System?
a) Colorectal Surgeon & Gastroenterologist
b) Procurement
c) Patient caregiver
d) Stoma Nurses & Colorectal Nurse Specialists
32. Where are the key financial savings of chyme reinfusion from?
a) Reduced Parenteral Nutrition
b) Reduced length of stay in hospital
c) Reduced readmissions and complication costs
d) All of the above
33. What is the average duration of care for a type 2 intestinal failure patient, from initial presentation to closure
a) 12 months
b) 2 months
c) 6-8 months
d) 24 months
Please attempt the quiz again to get 100% correct for your certificate.
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