Chapter 38: Providing Wound Care and Treating Pressure Ulcers

DeWit's Fundamental Concepts and Skills for Nursing, 5th Edition By Patricia A. Williams

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Chapter 38: Providing Wound Care and Treating Pressure Ulcers

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. The nurse clarifies that the first stage of wound healing is:
a. proliferation.
b. maturation.
c. reconstruction.
d. inflammation.

 

 

ANS:  D

Inflammation is the first stage of wound healing, followed by the proliferation, maturation, and reconstruction stages.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 761             OBJ:   Theory #1

TOP:   Inflammatory Process                      KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse is taking care of a postsurgical patient and notes the incision is clean and dry, with sutures intact. The nurse further assesses that the wound is healing by:
a. fourth intention.
b. third intention.
c. second intention.
d. first intention.

 

 

ANS:  D

A wound with minimal tissue loss, such as a surgical incision, heals by closure, which is first, or primary, intention. Wounds that are not closed heal by either second (secondary) or third (tertiary) intention.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 762             OBJ:   Theory #1

TOP:   Wound Healing Stages                    KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse gives an example of a wound that heals by second (secondary) intention as a:
a. laceration with edges that do not approximate.
b. surgical incision closed with staples.
c. chest wound left open for a closed system.
d. puncture wound sutured with silk suture.

 

 

ANS:  A

A secondary intention healing occurs when there is a jagged wound whose edges do not approximate.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 762             OBJ:   Theory #1

TOP:   Wound Types                                 KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. When the patient complains that he feels he is getting worse because of the increased swelling at his wound site on his leg, the nurse’s most helpful response would be that swelling indicates that:
a. an infection is in progress at the wound site.
b. vessels have dilated and allowed plasma to leak into the wound site.
c. he has lain in one position for such a long time that swelling has occurred.
d. there is probably a deeper injury than what appears on the surface.

 

 

ANS:  B

As part of the healing process, histamines and prostaglandins have caused small vessels to dilate and leak plasma and electrolytes into the wound site causing swelling, which causes the wound to become reddened and swollen as the phagocytosis cleans up the microorganisms.

 

DIF:    Cognitive Level: Application           REF:   p. 761             OBJ:   Theory #3

TOP:   Swelling and Inflammation              KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse warns the patient that one of the patient’s habits has caused the reduction of functional hemoglobin, which limits the hemoglobin’s oxygen carrying ability. To improve this situation, the nurse suggests that the patient quit:
a. drinking.
b. using marijuana.
c. smoking cigarettes.
d. eating excessive fats.

 

 

ANS:  C

Smoking reduces the functional hemoglobin which, in turn, reduces the amount of oxygen carried to the cells of the body.

 

DIF:    Cognitive Level: Analysis                REF:   p. 762             OBJ:   Theory #2

TOP:   Smoking         KEY:  Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

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