CWOCN Practice Questions (2026) — Free Sample Questions with Answers

Answer: A

Overflow incontinence from incomplete emptying: Correct. Neuropathy can cause an underactive detrusor; a large post-void residual with dribbling indicates retention with overflow.

Stress incontinence from sphincter weakness: Stress leakage occurs with coughing or exertion and is not associated with a large residual volume.

Urge incontinence from detrusor overactivity: Urge incontinence causes sudden urgency with leakage, usually with low residual volumes.

Functional incontinence from limited mobility: Functional incontinence results from barriers to reaching the toilet in a person whose lower urinary tract works normally.

Large PVR + frequent dribbling/weak stream = overflow (retention) incontinence; management focuses on bladder emptying (e.g., intermittent catheterization), not anticholinergics.

Answer: C

0.51: This divides by the right brachial pressure (70 ÷ 138); the ABI denominator is the higher of the two brachial pressures.

0.42: This uses the lower ankle pressure (62 ÷ 146); the numerator is the higher of the two ankle pressures on that leg.

0.48: Correct. Highest ankle pressure on the right (70) ÷ highest brachial pressure of either arm (146) = 0.48, which indicates significant arterial disease.

0.46: This averages the ankle pressures (66) and the brachial pressures (142); ABI uses the highest values, not averages.

ABI = highest ankle pressure for that leg ÷ highest brachial pressure of both arms. Values below 0.5 mean severe arterial disease (no compression; refer). Values above 1.3 suggest noncompressible vessels, so obtain a TBI.

Answer: B

At the belt line, where clothing helps hold the pouch: The belt line puts pressure on the pouch and disrupts the seal.

Within the rectus muscle, visible to the patient: Correct. A site within the rectus abdominis lowers hernia and prolapse risk, and the patient must be able to see the site to do self-care.

In a skin crease that flattens when the patient lies down: Creases and folds that appear when sitting cause leaks; sites must be checked lying, sitting and bending.

Directly beside a healed scar to protect healthy skin: Scars and their uneven contours undermine the pouch seal and should be avoided.

Stoma site: within the rectus muscle, on a flat surface clear of creases, scars, bony prominences and the belt line, visible to the patient, and checked in several positions.

Answer: D

Switch to an indwelling catheter for convenience: Indwelling catheters carry higher infection and complication risks; intermittent catheterization is preferred when feasible.

Limit fluids to 1 liter per day to reduce volumes: Severe fluid restriction concentrates urine and raises infection risk.

Change to sterile technique for every catheterization: Clean technique is acceptable in the home and does not address bladder overdistension.

Catheterize more often to keep volumes below ~500 mL: Correct. Bladder volumes should usually stay below about 400–500 mL to prevent overdistension and lower UTI risk, so the frequency should increase.

CIC: schedule catheterization so volumes stay below about 400–500 mL (often 4–6 times a day). Clean technique is acceptable at home, with adequate fluid intake.

Answer: C

Sharp debridement of necrotic tumor tissue each week: Debriding friable tumor risks serious bleeding and pain and does not fit palliative goals.

Negative pressure therapy to promote wound closure: Healing is not a realistic goal, and NPWT is contraindicated with malignancy in the wound.

Topical metronidazole, absorbent nonadherent dressings: Correct. Palliative wound care targets odor (topical metronidazole, charcoal), exudate, bleeding (nonadherent dressings, gentle removal) and pain.

Wet-to-dry gauze dressings changed three times a day: Wet-to-dry dressings cause pain and bleeding on removal and increase the care burden.

Palliative wound goals are symptom control (odor, exudate, bleeding, pain, appearance), not healing; choose gentle, nonadherent, absorbent and odor-controlling products.

Answer: D

Drink large amounts of plain water whenever thirsty: Large volumes of plain (hypotonic) water can increase ileostomy output and sodium loss.

Limit fluids so the pouch needs emptying less often: Restricting fluids with high ileostomy losses quickly causes dehydration and kidney injury.

Avoid salty foods to protect the kidneys: People with an ileostomy lose sodium in their output and generally need more salt, not less.

Sip oral rehydration solution; report scant urine: Correct. Glucose-electrolyte solutions improve absorption, and early signs such as thirst, dark or scant urine, dizziness and cramps should be reported.

Ileostomy patients lose water and sodium: encourage fluids including oral rehydration solutions, salt intake, and recognition of dehydration signs, especially when output is high.