A nurse is caring for a client with a chronic wound and is discussing smoking cessation. The client does not understand how smoking may impact wound healing. Which of the following would be the best nurse response?
Smoking causes you to cough frequently and the wound might get infected by sputum.
Nicotine causes vasoconstriction so your wound might not get enough blood flow to heal.
Nicotine causes tar to build up in the wound and it will impair healing.
Smoking is bad and you should stop right away.
The Correct Answer is B
A. Smoking causes you to cough frequently, and the wound might get infected by sputum.
While smoking can indeed contribute to respiratory issues like coughing, linking this directly to wound infection by sputum is not the most accurate explanation of how smoking affects wound healing. The primary concern with smoking and wound healing lies in its effects on circulation and tissue oxygenation rather than the risk of infection due to coughing.
B. Nicotine causes vasoconstriction, so your wound might not get enough blood flow to heal.
This is the best response among the options provided. Nicotine, a major component of cigarette smoke, is known to constrict blood vessels (vasoconstriction). This constriction reduces blood flow to the wound site, leading to decreased delivery of oxygen and nutrients necessary for proper wound healing. It addresses the direct physiological impact of smoking on wound healing and provides a clear explanation for the client.
C. Nicotine causes tar to build up in the wound, and it will impair healing.
While nicotine and other components of tobacco smoke can have detrimental effects on healing, particularly through vasoconstriction, the explanation about tar building up in the wound is not entirely accurate. Tar is more associated with lung damage from smoking rather than direct buildup in external wounds. Therefore, this response is less specific and may confuse the client about the actual mechanism of how smoking affects wound healing.
D. Smoking is bad, and you should stop right away.
While this response emphasizes the importance of smoking cessation, it lacks specificity in explaining how smoking impacts wound healing. Providing specific information about vasoconstriction due to nicotine, as mentioned in option B, would be more helpful in helping the client understand the direct effects of smoking on their chronic wound and why cessation is crucial.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
A serum potassium level of 3.2 mEq/L indicates hypokalemia, which is a potential complication of inhibiting aldosterone secretion and release. Aldosterone plays a key role in potassium regulation in the body by promoting potassium excretion in the kidneys. When aldosterone secretion is inhibited, potassium excretion decreases, leading to an accumulation of potassium in the bloodstream and resulting in hypokalemia. Symptoms of hypokalemia may include muscle weakness, cramping, irregular heartbeat, and fatigue.
B. Urine output of 1,200 mL in the last 2 hours:
This option does not directly relate to complications of inhibiting aldosterone secretion. A urine output of 1,200 mL in the last 2 hours indicates adequate urine production, which is generally a positive sign. However, in the context of inhibiting aldosterone secretion, the nurse would be more concerned about decreased urine output due to potential renal effects.
C. Blood osmolality of 250 mOsm/kg (250 mmol/kg):
Blood osmolality within the normal range (usually around 275-295 mOsm/kg) is not directly associated with complications of inhibiting aldosterone secretion. Blood osmolality reflects the concentration of solutes in the blood and is regulated by various factors, including water balance, electrolyte levels, and hormonal regulation. Inhibiting aldosterone secretion primarily affects electrolyte balance rather than blood osmolality.
D. Urine output of 25 mL/hr:
A urine output of 25 mL/hr is considered low and may indicate decreased renal perfusion or impaired kidney function. Inhibiting aldosterone secretion can affect renal function and urine output, leading to decreased urine production. Reduced urine output can contribute to fluid and electrolyte imbalances and may be a concern in patients with inhibited aldosterone secretion.
E. Serum potassium level of 5.4 mEq/L:
A serum potassium level of 5.4 mEq/L indicates hyperkalemia, which is another potential complication of inhibiting aldosterone secretion. Aldosterone helps regulate potassium levels by promoting potassium excretion in the kidneys. When aldosterone secretion is inhibited, potassium excretion decreases, leading to an accumulation of potassium in the bloodstream and resulting in hyperkalemia. Symptoms of hyperkalemia may include muscle weakness, irregular heartbeat, nausea, and numbness or tingling.
Correct Answer is B
Explanation
A. Loose connective tissue:
Melanocytes are not typically found in loose connective tissue. Their primary location is within the epidermis, specifically in the basal layer, where they interact with keratinocytes to produce melanin and contribute to skin color. Loose connective tissue contains collagen and elastin fibers, as well as fibroblasts, but it does not house melanocytes.
B. Epidermis:
This is the correct answer. Melanocytes are primarily located in the basal layer of the epidermis, which is the deepest layer of the epidermis. These cells produce melanin, a pigment that helps protect the skin from UV radiation and determines skin color. Melanocytes are interspersed among keratinocytes in the epidermis and transfer melanin to keratinocytes to provide skin pigmentation.
C. Dermis:
The dermis is the layer of skin beneath the epidermis and consists of connective tissue, blood vessels, nerves, hair follicles, and sweat glands. While the dermis plays a crucial role in supporting and nourishing the epidermis, melanocytes are not primarily located in the dermis. They are confined to the basal layer of the epidermis.
D. Superficial fascia:
The superficial fascia, also known as the subcutaneous tissue or hypodermis, lies beneath the dermis and consists of adipose (fat) tissue and connective tissue. It provides insulation, energy storage, and cushioning for underlying structures. However, melanocytes are not typically found in the superficial fascia. They are restricted to the epidermis, specifically the basal layer, where they carry out their function of melanin production.

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