A nurse cares for a patient who has a deep wound that is being treated with a wet to-damp (used to be dry) dressing. Which intervention would the nurse include in this patient’s plan of care?

Change the dressing when it is saturated.

Assess the wound bed once a day.

Contact the provider when the dressing leaks.

Change the dressing every 6 hours.

Answer and Explanation

The Correct Answer is A

A. Change the dressing when it is saturated:

This intervention is the most appropriate for managing a deep wound with a wet to-damp dressing. Wet to-damp dressings are designed to maintain a moist environment conducive to wound healing. Changing the dressing when it becomes saturated with wound exudate helps prevent excessive moisture accumulation, which can lead to skin maceration and potential infection. It ensures that the wound bed remains in an optimal healing environment and reduces the risk of complications.

B. Assess the wound bed once a day:

Assessing the wound bed is an essential part of wound care, as it allows the nurse to monitor healing progress, assess for signs of infection, and evaluate the effectiveness of the chosen dressing. However, the frequency of wound bed assessment may vary depending on the specific patient's needs and the type of dressing being used. While daily assessment is generally recommended, it does not directly dictate the timing of dressing changes for wet to-damp dressings, which are primarily changed based on saturation levels.

C. Contact the provider when the dressing leaks:

Contacting the provider when the dressing leaks or when there are concerns or complications is an important step in patient care. Leaking dressings can indicate issues with the dressing application, excessive wound exudate, or potential complications such as infection. It's crucial to inform the provider promptly so that appropriate interventions can be implemented, but this instruction is more reactive and does not specifically address the timing of dressing changes.

D. Change the dressing every 6 hours:

Changing the dressing every 6 hours is not typically recommended for wet to-damp dressings unless specifically indicated based on the patient's condition and the amount of wound exudate. Frequent dressing changes can disrupt the healing process, cause unnecessary trauma to the wound bed, and increase the risk of infection. Dressing change frequency should be based on the assessment of wound exudate and the dressing's ability to maintain a moist environment.

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Correct Answer is C

Explanation

A. “All preoperative patients get this medication.” This statement is too broad and not entirely accurate. While many preoperative patients do receive famotidine (Pepcid), it’s not a standard for all. Medications are prescribed based on individual patient needs and medical history.

B. “The physician prescribed this medication for you.” While this is technically true, it doesn’t provide the patient with an understanding of why the medication is necessary. As a nurse, part of your role is to educate patients about their medications.

C. “It helps prevent ulcers from the stress of the surgery.” This is the correct answer. Famotidine (Pepcid) is given to decrease the amount of acid produced in the stomach, which can help prevent stress ulcers that can occur due to the physical stress of surgery.

D. “Since you don’t have ulcers, I will have to ask.” This statement suggests uncertainty and a lack of knowledge about the medication’s purpose. It’s important for healthcare professionals to understand the medications they administer and be able to explain them to patients.

A. Evidence based practice B. Informatics C. quality improvement D. Safety

Correct Answer is D

Explanation

A. Evidence-based practice:

Evidence-based practice (EBP) involves integrating the best available evidence from research, clinical expertise, and patient preferences and values to inform nursing practice. In perioperative nursing, EBP is important for making informed decisions about preoperative, intraoperative, and postoperative care protocols. For example, using evidence-based guidelines for surgical site infection prevention, pain management strategies, and postoperative care protocols can improve patient outcomes and safety.

B. Informatics:

Informatics refers to the use of information technology and data management systems to support nursing practice, education, research, and patient care. In perioperative nursing, informatics plays a crucial role in managing electronic health records (EHRs), accessing patient data, documenting care, and communicating with interdisciplinary team members. It also includes utilizing perioperative information systems for surgical scheduling, anesthesia records, and tracking patient progress during surgery.

C. Quality improvement:

Quality improvement (QI) involves systematic processes to monitor, assess, and improve the quality of healthcare services. In perioperative nursing, QI initiatives focus on enhancing patient safety, optimizing surgical outcomes, reducing complications, and improving efficiency in perioperative processes. Nurses participate in QI projects by analyzing data, identifying areas for improvement, implementing evidence-based practices, and evaluating the impact of interventions on patient care and outcomes.

D. Safety:

Safety is a fundamental QSEN competency, particularly critical in perioperative nursing care. Perioperative nurses are responsible for ensuring the safety of patients during all phases of surgery, including preoperative assessment, intraoperative care, and postoperative recovery. This includes measures such as verifying patient identity and surgical site, preventing surgical errors (e.g., wrong-site surgery), maintaining aseptic techniques to prevent infections, preventing falls and injuries, managing anesthesia safely, and adhering to protocols for safe medication administration and equipment use.

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A nurse cares for a patient who has a deep wound that is being treated with a wet to-damp (used to be dry) dressing. Which intervention would the nurse include in this patient’s plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is giving a preoperative patient a dose of famotidine ( Pepcid). The patient asks why the nurse is giving this drug when the patient has no history of ulcers. What response by the nurse is best?

Correct Answer is C

Explanation

A nurse working in the perioperative area is reviewing the Quality and Safety Education in Nursing (QSEN) competencies. Which of the foIIowing competencies should the nurse identify as the priority when caring for a client during the perioperative period?

Correct Answer is D

Explanation

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