All of the following are correct regarding stoma formation; EXCEPT:

Appeared in: AIIMS Delhi NO- 2019

Explanation

The correct answer identifies the one incorrect statement among the options.
Creating a stoma near a bony prominence is a direct contradiction of proper surgical and nursing practice for stoma siting.
A bony prominence creates an uneven surface, making it impossible for an ostomy appliance to achieve a secure, leak-proof seal.
This incorrect placement leads to complications such as leakage of stool onto the skin, peristomal skin excoriation, pain, and difficulty in patient self-care.

Option B: This is a true and fundamental principle of stoma siting. Stomas must be placed away from bony prominences to ensure a flat surface for the appliance.
Option C: This is a true statement. Stomas are typically created on the abdomen, within the rectus abdominis muscle, which is a fleshy/fatty area suitable for creating a viable stoma.
Option D: This statement is false, as stoma placement is a highly selective and precise process. However, the option stating that a stoma is created near a bony prominence is a more specific and critically incorrect action.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Principles of surgical stoma site selection as background academic context rather than a clinical decision trigger.
Proper stoma siting is one of the most important factors affecting a patient's long-term adjustment and quality of life after ostomy surgery.
A poorly sited stoma can lead to chronic leakage, painful skin complications, social isolation, and depression.
Nursing responsibility includes preoperative assessment and patient education, often in collaboration with a Wound, Ostomy, and Continence (WOC) nurse, to mark the optimal site.

How to Approach the Question

First, identify the negative keyword "EXCEPT". This tells you to look for the single false statement among the options.
Read each option and evaluate it as either a 'true' or 'false' principle of stoma formation.
Recall the key principles of stoma siting: place on a flat surface (rectus muscle), away from bones, folds, and scars.
Option A directly violates a core principle (avoiding bony prominences). Option B and C state correct principles.
Option D is also false, but Option A describes a more specific and critical error in the procedure.
Select the statement that is definitively incorrect based on established standards of care.

Concept Tested & Keywords

Concept Tested: Principles of surgical stoma site selection.
Stem keywords: stoma formation, correct, EXCEPT
Lead-in keywords: EXCEPT
Negative lead-in flag: The question asks for the exception, meaning you must identify the incorrect statement about stoma formation.

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