Chapter 26: Dressings, Bandages, and Binders

Chapter 26: Dressings, Bandages, and Binders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse applies a circumferential gauze dressing to a patient’s amputated leg. Which method should the nurse use to decrease edema in the extremity?

ANS:  C

The nurse applies a dressing around the extremity using the figure-eight method to avoid restriction of blood flow and main venous return. This allows the dressing to be anchored by wrapping gauze in alternating directions that ascend and descend with oblique, overlapping turns. The terminal end of the dressing is secured with a short piece of tape, taking care not to restrict blood flow in any manner. Montgomery straps are contraindicated for dressing an extremity because the circumference is usually too small to make them practical. Adhesive tape potentially constricts blood flow to the extremity if it is wrapped tightly over itself in a circumferential manner. Circular turns dressings are used on small parts like fingers or toes, but are too constricting to use on larger body parts.

DIF:    Cognitive Level: Apply                   REF:   Page 703-705

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Planning

2. The nurse assigns patient care to nursing assistive personnel (NAP). Which wound care tasks should the nurse assign to this staff member?

ANS:  C

The nurse assigns reporting visible drainage on the dressing to the NAP because this individual is trained to perform this wound care task. It is essential to review what needs to be looked for and what to report back to the nurse. The remaining wound care tasks require critical thinking and nursing judgment, assessment, and evaluation skills that the nurse cannot delegate because he or she owes these duties to the patient. In addition, the nurse avoids delegating the first postoperative dressing change because it is a sterile procedure requiring the same nursing skills and judgment.

DIF:    Cognitive Level: Apply                   REF:   Page 688

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Planning

3. The nurse plans care for the patient’s wound that requires a moist-to-dry dressing. Which should the nurse use for an expected patient outcome several hours after applying a new dressing?

ANS:  B

The nurse uses a moist-to-dry dressing for wound débridement and exudate collection because cellular debris and exudate in a wound bed delay healing. The nurse expects the dressing to absorb wound drainage and to be dry and intact. The dressing should feel cold as the nurse applies the moist gauze, not later. It should absorb drainage, not cause drainage to increase and penetrate the layers of dressing material. Pain rated as 8 on a scale of 1 to 10 is severe and warrants further investigation by the nurse because a dressing should provide patient comfort.

DIF:    Cognitive Level: Apply                   REF:   Page 691-692

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Evaluation

4. The wound care nurse prepares to dress the wounds of four patients. Which wound should receive a transparent film dressing?

ANS:  A

An indication for a transparent film dressing includes a clean, superficial laceration because transparent dressings adhere to wounds and are nonabsorbent. A transparent dressing is contraindicated for a deep ulcer because the dressing is adherent; in addition, a deep ulcer most likely drains exudate or requires débridement, contraindicating the use of the dressing. The nurse avoids using the transparent dressing for the bleeding puncture wound because he or she first applies a pressure dressing to stop the bleeding and then dresses the wound with an absorbent dressing to collect subsequent drainage. Because the dressing is adherent, the nurse avoids using a transparent dressing over a large laceration. The laceration is likely to require sutures or Steri-Strips to close the wound; thus the nurse avoids using a dressing that can pull on the fragile wound edges.

DIF:    Cognitive Level: Apply                   REF:   Page 684-685

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Planning