A nurse is caring for a client who has a wound infection. Which of the following actions should the nurse take when obtaining a wound-drainage specimen for culture?
Irrigate the wound with an antiseptic prior to obtaining the specimen.
Include intact skin at the wound edges in the culture.
Swab an area of skin away from the wound to identify the usual flora.
Cleanse the wound with 0.9% sodium chloride saline irrigation before obtaining the specimen.
The Correct Answer is D
A. Irrigating the wound with an antiseptic prior to obtaining the specimen can introduce substances that may interfere with the accuracy of the culture results. Sterile saline is the preferred solution for wound irrigation.
B. Intact skin at the wound edges should not be included in the culture. The specimen should be obtained directly from the wound bed or drainage.
C. Swabbing an area of skin away from the wound to identify the usual flora is not appropriate for obtaining a wound drainage specimen. The culture should be taken directly from the wound site.
D. Before obtaining a wound-drainage specimen for culture, it is important to cleanse the wound with a sterile solution, such as 0.9% sodium chloride saline irrigation. This helps remove debris and contaminants from the wound site, providing a more accurate specimen for culture.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
A. Coordinator: This role involves organizing and integrating the group's activities to achieve the goals effectively. The coordinator helps ensure that tasks are assigned, deadlines are met, and resources are utilized efficiently.
B. Self-confessor: This role involves expressing personal feelings, thoughts, or concerns.
While open communication is important in a team, this role may not always be considered a "necessary task performance role" in the same sense as the others listed. It's more about interpersonal communication rather than task-related functions.
C. Evaluator: This role involves assessing the group's progress toward its goals and providing feedback on performance. The evaluator helps the group identify areas for improvement and make necessary adjustments.
D. Energizer: This role involves motivating and energizing the group members to
maintain their enthusiasm and commitment to the task at hand. The energizer helps boost morale and keeps the group focused on achieving its objectives.
Correct Answer is A
Explanation
A. Gloves should be removed first. This is because the gloves are the items most likely to be contaminated. To remove gloves, grasp the outside edge near the wrist and peel them off, turning them inside out as you go.
B. The gown should be removed next. The gown protects the nurse's clothing from contamination. Untie or unfasten the gown, and then carefully remove it, taking care to avoid touching the outside of the gown.
C. Face shields or goggles should be removed next if used. This helps protect the eyes and face. Handle the shield or goggles by the headband or earpieces and remove them without touching the front.
D. Mask should be removed last. The mask helps protect the respiratory system. Untie or unhook the mask from behind the ears or head and discard it.
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