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A nurse is assessing a client's wound in the stages of healing. Which of the following areas of the wound represents granulation tissue? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)

Answer and Explanation

The Correct Answer is "{\"xRanges\":[333.4270782470703,393.4270782470703],\"yRanges\":[222.1666259765625,282.1666259765625]}"

Granulation tissue is a key component of the healing process for wounds and appears as new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process. It typically appears red or pink, indicating the presence of new blood vessels (capillaries). It has a moist, bumpy, or grainy texture. The tissue might look uneven or pebbled. It progressively covers the wound bed, starting from the edges and moving toward the center, eventually filling the wound cavity.

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Correct Answer is A

Explanation

A. Compile a list of the client's current medications to compare with new medications. Medication reconciliation is a key component of The Joint Commission's National Patient Safety Goals. It helps prevent medication errors by ensuring that all medications are reviewed and documented.
B. Label syringes, but not medicine cups or basins, during a procedure. All medications and solutions should be labeled to prevent medication errors, including those in syringes, medicine cups, and basins. Not labeling all items can lead to confusion and errors.
C. Use one client identifier for treatments, care, and services. Using at least two identifiers (e.g., name and date of birth) is recommended to ensure correct patient identification and reduce the risk of errors.
D. Perform a daily assessment of wounds using the Braden scale. The Braden scale is used for assessing pressure ulcer risk, not for daily wound assessment. While regular assessment of wounds is important, the Braden scale is not the correct tool for this purpose.

A. Log off the computer before he leaves the nurses' station. B. Turn off the monitor so others cannot view the client's data. C. Position the computer's screen so no one else can view it. D. Ask another nurse to complete the documentation.

Correct Answer is A

Explanation

A. Log off the computer before he leaves the nurses' station: This is correct. Logging off ensures that no unauthorized person can access the client's electronic health records, maintaining privacy and security.
B. Turn off the monitor so others cannot view the client's data. This action alone does not provide sufficient security, as the computer might still be logged in.
C. Position the computer's screen so no one else can view it. While this helps with privacy, it does not secure the computer from unauthorized access in the nurse’s absence.
D. Ask another nurse to complete the documentation. This is not appropriate as it may lead to incomplete or inaccurate documentation. Each nurse should document their own care.

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A nurse is assessing a client's wound in the stages of healing. Which of the following areas of the wound represents granulation tissue? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An acute care nurse is teaching a group of newly licensed nurses about The Joint Commission's National Patient Safety Goals. Which of the following information should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is documenting data in a client's electronic health record at a computer terminal in the nurses' station when he has to leave the area to answer a client's call light. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse manager is planning an in-service for a group of staff nurses about documentation guidelines in The Joint Commission's National Patient Safety Goals. Which of the following examples should the nurse manager include when discussing error-prone abbreviations?

A nurse overhears two staff members in a public hallway discussing the diagnosis of a client on another unit. Which of the following actions should the nurse take to promote HIPAA regulations?

A nurse is preparing a teaching program for the parents of a toddler who has a new diagnosis of cystic fibrosis. From which of the following sources should the nurse obtain information?

A nurse is assessing a client who has a Clostridium difficile infection. The nurse should monitor for which of the following complications during the early stages of this infection?

A nurse is preparing to administer a liquid oral medication to a client. Which of the following actions should the nurse take?

A charge nurse is reviewing hand hygiene guidelines with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

A nurse is teaching the parents of a preschooler who is experiencing urinary incontinence at night. The nurse should instruct the parents that which of the following interventions is most effective in treating enuresis?

A nurse is planning care for a client who has a Clostridium difficile infection. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)