# A postoperative client with a new colostomy has several stoma appearances shown. Click the finding that requires immediate reporting for possible ischemia.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397552&lang=en  
> language: en  
> subject: Mobility/Immobility  
> category: BCC

## Question

A postoperative client with a new colostomy has several stoma appearances shown. Click the finding that requires immediate reporting for possible ischemia.

![](https://mymerci.kr/data/nclex/hotspot/v5/v5_stoma_comparison.svg)

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## Explanation

Dusky black stoma is the best answer. A dusky, purple, brown, or black stoma suggests impaired perfusion or necrosis. Other marked areas do not best match the cue in this item.

## In-depth explanation

Quick answer
Dusky black stoma is the best answer. A dusky, purple, brown, or black stoma suggests impaired perfusion or necrosis. Other marked areas do not best match the cue in this item.

Why this is correct
A healthy stoma is expected to be moist and pink to red because it is well perfused. Dusky, purple, brown, or black tissue suggests impaired blood flow and possible necrosis, making color change a priority postoperative finding.

Easy analogy or mental picture
Use a perfusion color check: moist pink-red supports blood flow, while progressive darkening signals that oxygenated blood may not be reaching the tissue. Color is a warning sign and must be interpreted with the full assessment.

Memory hook
Dusky or black means possible loss of perfusion and requires prompt reporting.

NCLEX decision rule
When a new stoma becomes dusky or black, think impaired perfusion; compare with the prior appearance and report the change promptly according to postoperative protocol.

Why the other choices are wrong
Prolapse and retraction require assessment, but the dark ischemic appearance represents the most immediate perfusion threat in this image set.References

- [1]UOAA: Nursing care after ostomy surgery

## Clinical scenario

Clinical situation
A postoperative client with a new colostomy has several stoma appearances shown.

What the nurse should notice
Dusky black stoma is the best answer. A dusky, purple, brown, or black stoma suggests impaired perfusion or necrosis. Other marked areas do not best match the cue in this item.

Transfer to practice
When a new stoma becomes dusky or black, think impaired perfusion; compare with the prior appearance and report the change promptly according to postoperative protocol.

## Key concepts

- **Stoma** — Surgically created opening.
- **Stoma ischemia** — Reduced blood flow to the surgically created bowel opening.
- **Necrosis** — Tissue death.

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