Certified Ostomy Care Nurse (COCN) Test Review
The Certified Ostomy Care Nurse is a licensed Registered Nurse who has completed certification by the Wound, Ostomy, and Continence Nursing Certification Board (WOCNCB) and, additionally, successfully passed the exam enabling them to use the title of Certified Continence Care Nurse. The specialized certification provides the extra training necessary to adequately care for and treat patients who have an ostomy or ostomies along with the physical, psychological, and potential safety concerns associated with this.
In order to be eligible to take the Certified Ostomy Care Nurse exam, the applicant must be a licensed Registered Nurse who has a Baccalaureate Degree. Initially, the RN must obtain WOCNCB certification. At least 1,500 hours of employment engaged in the care of ostomy patients must have been completed within the past 5 years, with 375 of those hours obtained during the past year. In addition, at least 50 continuing education hours in ostomy care should be completed in the past 5 years.
The Certified Ostomy Care Nurse exam is offered quarterly at various testing centers across the United States. The fee to take the exam is $300 with discounts applied if more than one WOCNCB certification exam is taken at a time.
The exam questions focus on testing the RN's knowledge of care of the patient with at least one ostomy. These can address the physiological processes involved with elimination, along with the psychosocial and behavioral needs of the patient. The exam also contains questions pertaining to the devices used with an ostomy and educating the patient on self-care.
Certification as a Certified Ostomy Care Nurse is valid for 5 years. At that time, the RN can retake the exam to recertify, or requirements for the Professional Growth Program are met to qualify for recertification. This program utilizes a mixture of direct patient care and continuing education activities to meet specific requirements necessary to maintain certification.
Certified Ostomy Care Nurse (COCN) Practice Questions
1. A 57-year-old male is diagnosed with stage III cancer of the bladder with invasion of the muscle tissue. Which primary treatment is MOST common?
- Partial or segmental cystectomy
- Interstitial radiation only
- Radical cystectomy with urinary diversion and chemotherapy
- Chemotherapy only
2. Which of the following stomal complications indicates a need for surgical intervention?
- Slight bleeding when changing stomal appliance
- Slow oozing at one area of the mucocutaneous juncture
- Slow bleeding at mucocutaneous juncture and caput medusa
- Frank bleeding from the mucocutaneous juncture
3. Within what period of time postoperatively should an ileostomy begin to excrete stool?
- 24 to 48 hours
- 2 to 3 days
- 4 to 5 days
4. male patient develops painful red pustular lesions about the peristomal area. The most likely diagnosis is:
- Contact dermatitis
5. A patient with a colostomy develops herpes zoster with lesions in the peristomal area. The draining lesions are interfering with pouch adhesion. The BEST solution is to
- Apply hydrocolloid dressing to lesions
- Apply barrier paste to lesions
- Leave appliance off until the lesions heal
- Mechanically debride lesions by washing and drying
Certified Ostomy Care Nurse (COCN) Answer Key
1. Answer: C
The most standard treatment for cancer that has invaded the muscle is radical cystectomy with urinary diversion. Chemotherapy may be done prior to or after surgery to improve survival rates, because recurrence rates are about 50%. In males, the bladder, prostate, seminal vesicles, and perivesical tissues are removed; in females, the bladder, uterus, ovaries, fallopian tubes, urethra, and anterior vaginal wall are removed. Urinary diversions may include an ileal conduit or an internal pouch, such as the Indiana pouch or neobladder (formed from part of the intestine).
2. Answer: D
Frank bleeding from the mucocutaneous juncture may indicate bleeding from a mesenteric artery, requiring surgery to open the incision and ligate the artery. A slight bleeding when changing of stomal appliance relates to mechanical trauma to the mucosa and is normal, unless it continues. Slow oozing usually stops, but may require cauterization. Oozing of blood may be caused by antiplatelet drugs, such as salicylates. Slow bleeding along with caput medusa (distention of veins about the umbilicus) is a complication related to portal hypertension.
3. Answer: A
An ileostomy should begin to function and excrete stool by 24 to 48 hours postoperatively, because digested food passes quickly into the small intestine in liquid form. A colostomy, however, may not pass stool for 4 to 5 days, varying somewhat with the position of the colostomy, which affects reabsorption of liquids. Because kidneys constantly produce urine, an ureterostomy should immediately produce urine. Stomas should be observed carefully to ensure that they are functioning properly. Delayed function may indicate obstruction or other complications.
4. Answer: B
Folliculitis is inflammation of the hair follicles by staphylococcus aureus. The lesions are often pustular, red, and painful. Folliculitis usually results from slight nicks in the skin from shaving with a razor, from friction, or from occlusion. Candidiasis is a fungal infection that causes inflammation with burning and itching and red patches, related to prolonged moisture on skin, usually from secretions or leakage under the pouch. Contact dermatitis may result from a hypersensitivity reaction to a particular chemical or product in the pouching system. Skin may be red, draining, and painful. Chemical trauma from secretions may look similar: red, draining, and painful.
5. Answer: A
Hydrocolloid dressing may be used to prevent fluid from herpetic lesions from interfering with the pouching system. Herpes zoster and herpes simplex, both viral illnesses, remain dormant, but can be triggered by illness or stress and can erupt in the peristomal area. Antiviral treatments may be used to speed healing. Herpetic lesions in the peristomal area may be irritated by pouch adhesive. While cool moist compresses may provide some relief from discomfort, the lesions should be allowed to open and dry on their own (usually within 2 to 3 weeks).
Last Updated: 04/18/2018