FREE AND STUDY GAMES ABOUT FOUNDATION CH.32

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FREE AND STUDY GAMES ABOUT FOUNDATION CH.32

EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -63 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation Question 1: A client comes to the emergency department after falling off a skateboard onto the sidewalk. Which assessment data, consistent with an abrasion, would the nurse expect to see?

Answer:

scraping off of surface layers of skin Question 2: A nurse is cleaning the wound of a client who has been injured by a gunshot. Which guideline is recommended for this procedure?

Answer:

Clean the wound from the top to the bottom and from the center to outside.Question 3: A client has developed blisters around the tape securing a dressing. What nursing action would be appropriate to prevent further damage to the tissues?

Answer:

applying the dressing with a binder

Question 4: The nurse is changing the dressing of a client with a gunshot wound. What nursing action would the nurse provide?

Answer:

The nurse selects a dressing that absorbs exudate, if it is present, but still maintains a moist environment.Question 5: Adequate blood flow to the skin is necessary for healthy, viable tissue. Adequate skin perfusion requires four factors. Which is not one of these factors?

Answer:

Local capillary pressure must be lower than external pressure.Question 6: The nurse is caring for a Penrose drain for a client post-abdominal surgery. What nursing action reflects a step in the care of a Penrose drain that needs to be shortened each day?

Answer:

The nurse pulls the drain out a short distance using sterile scissors and a twisting motion, then cuts off the end of the drain with sterile scissors.Question 7: The nurse and client are looking at the client's heel pressure injury. The client asks, "Why does my heel look black?" What is the nurse's appropriate response?

Answer:

"That is necrotic tissue, which must be removed to promote healing." Question 8: The nurse is caring for a client with a sacral wound. Upon assessment, the wound is noted to be intact, reddened, and unblanchable. How will the nurse categorize this pressure injury?

Answer:

stage I Question 9: Upon review of a postoperative client's medication list, the nurse recognizes that which medication will delay the healing of the operative wound?

Answer:

corticosteroids

Question 10: The nurse has removed the sutures and is now planning to apply wound closure strips. What should the nurse do before applying the strips?

Answer:

Apply a skin protectant to the skin around the incision.Question 11: The nurse is caring for a client who has a wound to the right forearm following a motor vehicle accident. The primary care provider has ordered culture of the wound. Which action should the nurse perform in obtaining a wound culture?

Answer:

Keep the swab and the inside of the culture tube sterile.Question 12: Which activity should the nurse implement to decrease shearing force on a client's stage II pressure injury?

Answer:

preventing the client from sliding in bed Question 13: A full-thickness or third-degree burn develops a leathery covering called a(an):

Answer:

eschar.Question 14: The nurse is assessing the wounds of clients in a burn unit. Which wound would most likely heal by primary intention?

Answer:

a surgical incision with sutured approximated edges Question 15: The nurse is assessing a client's surgical wound after abdominal surgery and sees viscera protruding through the abdominal wound opening. Which term best describes this complication?

Answer:

evisceration Question 16: For which client would the application of a hydrocolloid dressing be most appropriate?

Answer:

A client who has a partial-thickness venous ulcer with moderate drainage

Question 17: Which is not considered a skin appendage?

Answer:

Connective tissue Question 18: A client reports acute pain while negative pressure wound therapy is in place.What should the nurse do first?

Answer:

Assess the client's wound and vital signs.Question 19: The nurse just completed a dressing change and returned the client to a comfortable position. What should the nurse do next?

Answer:

Document the color, odor, amount, and type of wound drainage.Question 20: The nurse observes the client for signs of stage I pressure injury development, which most likely will include which finding?

Answer:

nonblanchable redness Question 21: Collection of a wound culture has been ordered for a client whose traumatic hand wound is showing signs of infection. When collecting this laboratory specimen, which action should the nurse take?

Answer:

Rotate the swab several times over the wound surface to obtain an adequate specimen.Question 22: A nurse is documenting on a client who has had an appendectomy. During a dressing change of the surgical site, the nurse observed a watery pink drainage on the dressing. Which drainage type should the nurse document?

Answer:

serosanguineous Question 23: The nurse is teaching a client about healing of a large wound by primary intention.What teaching will the nurse include? Select all that apply.

Answer:

"Very little scar tissue will form." "This is a simple reparative process." "Your wound edges are right next to each other."