Chapter 36. Skin Integrity and Wound Healing

Chapter 36. Skin Integrity and Wound Healing

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____       1.   What is the function of the stratum corneum?

1)

Provides insulation for temperature regulation

2)

Provides strength and elasticity to the skin

3)

Protects the body against the entry of pathogens

4)

Continually produces new skin cells

 

 

ANS:       3

The stratum corneum is the outermost layer of the epidermis and is composed of numerous thicknesses of dead cells. Functioning as a barrier to the environment, it restricts water loss, prevents entry of fluids into the body, and protects the body against the entry of pathogens and chemicals. The subcutaneous layer is composed of adipose and connective tissue that provide insulation, protection, and an energy reserve (adipose). The dermis is composed of irregular fibrous connective tissue that provides strength and elasticity to the skin. The stratum germinativum is the innermost layer of the skin that produces new cells, pushing older cells toward the skin surface.

 

PTS:    1                      DIF:    Moderate        REF:    p. 1223

KEY:   Nursing process: Assessment | Client need: PHSI | Cognitive level: Comprehension

 

 

 

____       2.   Skin integrity and wound healing are compromised in the client who takes blood pressure medications because antihypertensives:

1)

Can cause cellular toxicity.

2)

Increase the risk of ischemia.

3)

Delay wound healing.

4)

Predispose to hematoma formation.

 

 

ANS:       2

Blood pressure medications decrease the amount of pressure required to occlude blood flow to an area, creating a risk for ischemia. Chemotherapeutic agents delay wound healing because of their cellular toxicity. Anticoagulants can lead to extravasation of blood into subcutaneous tissue, predisposing to hematoma formation with minimal pressure or injury.

 

PTS:    1                      DIF:    Difficult          REF:    p. 1224

KEY:   Nursing process: Assessment | Client need: PHSI | Cognitive level: Comprehension

 

 

 

____       3.   What is the primary difference between acute and chronic wounds? Chronic wounds:

1)

Are full-thickness wounds, but acute wounds are superficial.

2)

Result from pressure, but acute wounds result from surgery.

3)

Are usually infected, whereas acute wounds are contaminated.

4)

Exceed the typical healing time, but acute wounds heal readily.

 

 

ANS:       4

The length of time for healing is the determining factor when classifying a wound as acute or chronic. Acute wounds are expected to be of short duration. Wounds that exceed the anticipated length of recovery are classified as chronic wounds.

 

PTS:    1                      DIF:    Easy                REF:    p. 1225

KEY:   Nursing process: Assessment | Client need: PHSI | Cognitive level: Analysis

 

 

 

____       4.   A patient with quadriplegia presents to the outpatient clinic with an ischial wound that extends through the epidermis into the dermis. When documenting the depth of the wound, how would the nurse classify it?

1)

Partial-thickness wound

2)

Penetrating wound

3)

Superficial wound

4)

Full-thickness wound

 

 

ANS:       1

Partial-thickness wounds extend through the epidermis into the dermis. Superficial wounds involve only the epidermal layer of skin. Full-thickness wounds extend into the subcutaneous tissue and beyond. Penetrating is a descriptor sometimes added to indicate that the wound includes internal organs.

 

PTS:    1                      DIF:    Easy                REF:    pp. 1226-1227

KEY:   Nursing process: Assessment | Client need: PHSI | Cognitive level: Application

 

 

 

____       5.   A patient underwent abdominal surgery for a ruptured appendix. The surgeon did not surgically close the wound. The wound healing process described in this situation is:

1)

Primary intention healing.

2)

Secondary intention healing.

3)

Tertiary intention healing.

4)

Approximation healing.

 

 

ANS:       2

Secondary intention healing occurs when a wound is left open, and it heals from the inner layer to the surface by filling in with beefy red granulation tissue. Primary intention healing occurs when a wound is surgically closed. Tertiary intention healing occurs when a wound that was previously left open to heal by secondary intention is closed by joining the margins of granulation tissue. Approximation is another word for the joining of wound edges.

 

PTS:    1                      DIF:    Moderate        REF:    p. 1227

KEY:   Nursing process: Assessment | Client need: PHSI | Cognitive level: Comprehension