Chapter 13 - Surgical Wound care

98 Questions | Total Attempts: 2509

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Chapter 13 - Surgical Wound care

From Foundations of Nursing by Christensen and Kockrow, pages 310-342. For any questions, email [email protected] Com


Questions and Answers
  • 1. 
    After an abdominal surgery, abdominal muscles contract and cause intraabdominal pressure. If the incisional area is weak, what is possible to happen?
    • A. 

      Dehiscence

    • B. 

      Evisceration

    • C. 

      Decubitus

    • D. 

      Shearing

  • 2. 
    How are wounds classified? Select all the apply:
    • A. 

      Cause

    • B. 

      Severity of injury

    • C. 

      Amount of contamination

    • D. 

      Skin's integrity

    • E. 

      Color and shape

  • 3. 
    A cut produced surgically by a sharp instrument creating an opening into an organ or space in the body
    • A. 

      Puncture

    • B. 

      Incision

    • C. 

      Stoma

    • D. 

      Abrasion

  • 4. 
    Stab wound for a drainage system 
    • A. 

      Puncture

    • B. 

      Incision

    • C. 

      Stoma

    • D. 

      Abrasion

  • 5. 
    Classification of wound according to the CDC. Select all that apply:
    • A. 

      Clean

    • B. 

      Clean-contaminated

    • C. 

      Contaminated

    • D. 

      Dirty or infected

    • E. 

      Aseptic or sterile

  • 6. 
    Which of the following four phases of wound healing are arranged accordingly
    • A. 

      Hemostasis, inflammatory phase, maturation, reconstruction

    • B. 

      Hemostasis, inflammatory phase, reconstruction, maturation

    • C. 

      Hemostasis, reconstruction, maturation, inflammatory phase

    • D. 

      Inflammatory phase, hemostasis, maturation, reconstruction

  • 7. 
    During hemostasis, termination of bleeding begins and blood clots are formed.  What is in the blood clot that helps hold the wound together?
    • A. 

      Granulation

    • B. 

      Hemes

    • C. 

      Fibrin

    • D. 

      Leucocytes

  • 8. 
    When does wound dehiscence primarily take place?
    • A. 

      Maturation phase

    • B. 

      Reconstruction phase

    • C. 

      Inflammatory phase

    • D. 

      Mitotic phase

  • 9. 
    Definition of a Keloid
    • A. 

      A painful disease involving tissue damage

    • B. 

      This is another phase of wound healing

    • C. 

      Same as an eschar only with a lighter color

    • D. 

      Overgrowth of a collagenous scar tissue at the site of the wound

  • 10. 
    Best Definition of EXUDATE
    • A. 

      Exactly the same as Drainage

    • B. 

      It is a noun derived from the verb "to exude"

    • C. 

      Fluid, cells, or other substances that have been slowly exuded or discharged, from cells or blood through small pores or breaks in cell membranes.

    • D. 

      That which emerges from an injured tissue

  • 11. 
    What is granulation tissue?
    • A. 

      Composed of small microscopic grains of epithelial cells

    • B. 

      A group of cells that form a grain

    • C. 

      The tissue that remains after a scar is healed

    • D. 

      Soft, pink, fleshy projections consisting of capillaries surrounded by fibrous collagen.

  • 12. 
    • A. 

      The stages for wound healing provide a model for acute wound healing and not necessarily chronic.

    • B. 

      The stages of wound healing are not necessarily linear

    • C. 

      The least amount of scar after healing would be in the primary intention wound

    • D. 

      Tertiary intention healing produces the smallest scar

  • 13. 
    A patient who had an appendicitis removed early in the morning is having a hard time going to sleep because of coughing. What is the best non-pharmacological intervention that a nurse could provide him?
    • A. 

      Apply a pillow, rolled blanket, or the palms of the hands to the incisional area to lessen intraabdominal pressure

    • B. 

      Administer a PRN pain medication

    • C. 

      Call the surgeon and tell him to intervene

    • D. 

      Bind the wound with a Montgomery wrap

  • 14. 
    The process of applying a pillow, rolling a bath blanket, or the palms of the hands to an incisional area to decrease intraabdominal pressure is called what?. 
    • A. 

      Binding

    • B. 

      Wrapping

    • C. 

      Splinting

    • D. 

      Dressing

  • 15. 
    It is a factor that impairs wound healing by interfering with normal cellular mechanisms that promote release of oxygen to tissues. It reduces the amount of functional hemoglobin in blood. 
    • A. 

      Obesity

    • B. 

      Radiation

    • C. 

      Smoking

    • D. 

      Malnutrition

  • 16. 
    A chronic disease that impairs wound healing because it causes hemoglobin to have greater affinity for oxygen, so it fails to release oxygen to tissues. An effect of this disease alters ability of leukocytes to perform phagocytosis needed for wound healing. This same effect will also support overgrowth of fungal and yeasts infection which are both contraindicated for wound healing
    • A. 

      Multiple sclerosis

    • B. 

      Diabetes insipidus

    • C. 

      Diabetes mellitus

    • D. 

      Myocardial infection

  • 17. 
    Which of the following groups are not a factor that could impair wound healing?
    • A. 

      Obesity, malnutrition and age

    • B. 

      Impaired oxygenation, radiation and smoking

    • C. 

      Height, weight and body mass

    • D. 

      Drugs, diabetes mellitus and wound stress

  • 18. 
    During the first day after surgery, how often would you inspect the dressings? 
    • A. 

      Every 2 to 4 hours for the first 24 hours

    • B. 

      Every 8 to 10 hours for the first 42 hours

    • C. 

      Every 6 to 8 hours for the first 30 hours

    • D. 

      Every 2 to 4 hours for the first 12 hours

  • 19. 
    Which of the following is not an evidence of infection?
    • A. 

      Elevated WBC

    • B. 

      Purulent drainage

    • C. 

      Primary intention

    • D. 

      Increased leukocytes

  • 20. 
    When doing wound care, which of the following should be the first thing to do?
    • A. 

      Introduce yourself

    • B. 

      Explain the procedure

    • C. 

      Refer to medical record, care plan or kardex

    • D. 

      Identify patient

  • 21. 
    When are dressings over closed wound usually removed?
    • A. 

      The day after surgery

    • B. 

      On the third day

    • C. 

      A week after surgery

    • D. 

      When the physician gives the order

  • 22. 
    What kind of dressings promote healing by keeping wounds moist yet sterile? 
    • A. 

      Binders and steri-strips

    • B. 

      Transparent and permeable dressings

    • C. 

      Occlusive and semi-occlusive dressings

    • D. 

      Wet and dry dressings

  • 23. 
    When using an occlusive dressing, where will the tape strips be attached?  
    • A. 

      Several inches apart

    • B. 

      On all sides of the dressing

    • C. 

      One on top of the other

    • D. 

      On the four corners

  • 24. 
    When Montgomery straps are soiled, when do they get replaced? 
    • A. 

      Every 2 hours

    • B. 

      Once every shift

    • C. 

      At least once a week

    • D. 

      Every 2 to 3 days

  • 25. 
    A method and a trend that allows atmospheric oxygen to circulate above the wound, aiding in the healing process
    • A. 

      Use Montgomery straps without binders

    • B. 

      Protect sutured, clean wounds with occlusive dressing after surgery.

    • C. 

      Leave sutured, clean wounds undressed after surgery or use loose dressings

    • D. 

      Allow dry to dry dressings using occlusive gauze