A nurse is caring for a client with a chronic wound. Which of the following is a systemic cause of chronic wounds?
Infection
Malnutrition
Continued pressure
Venous insufficiency
The Correct Answer is B
A. Infection: While infection can certainly delay wound healing and contribute to the development of chronic wounds, it is more of a local factor rather than a systemic cause. Infections can hinder the normal healing process and lead to tissue damage, inflammation, and prolonged wound healing.
B. Malnutrition
A chronic wound is a wound that fails to progress through the normal stages of healing in an orderly and timely manner. Systemic factors can significantly impact wound healing, and malnutrition is one such systemic cause. Malnutrition, which refers to an inadequate intake or absorption of nutrients essential for healing, can impair the body's ability to repair tissues, fight infection, and generate new cells.
C. Continued pressure: Prolonged pressure, such as that experienced in pressure ulcers, can lead to tissue ischemia (lack of blood flow) and tissue necrosis, resulting in chronic wounds. However, this is considered a local factor related to the specific site of the wound and pressure-related damage.
D. Venous insufficiency: Venous insufficiency can cause chronic wounds, particularly venous ulcers, due to impaired venous return leading to increased pressure in the veins of the lower extremities. This pressure can result in tissue damage and poor wound healing. While venous insufficiency is a systemic condition, it primarily affects specific areas of the body (such as the lower legs) and is more directly related to the development of localized chronic wounds in those areas.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The transfusion will begin after the administration of 650 mg of acetaminophen (Tylenol).
This option suggests that the nurse would administer acetaminophen to lower the client's temperature and then proceed with the blood transfusion. While acetaminophen can be used to reduce fever, the decision to administer medication should be made by the healthcare provider after assessing the client's overall condition and determining the cause of the fever. Administering medication without proper evaluation and orders from the healthcare provider is not appropriate.
B. The blood will be held, and the health care provider will be notified.
This option is the correct choice. When a client has an elevated temperature before a blood transfusion, it is standard practice to hold the transfusion and notify the healthcare provider. An elevated temperature could indicate an underlying infection or another condition that needs to be evaluated before proceeding with the transfusion to ensure the client's safety.
C. The transfusion will begin after the administration of an antihistamine.
Administering an antihistamine would not be the appropriate action in response to an elevated temperature before a blood transfusion. Antihistamines are typically used to treat allergic reactions, not fevers. Holding the transfusion and notifying the healthcare provider to assess the situation would be the correct course of action.
D. The transfusion will begin as prescribed.
This option is not appropriate because starting the transfusion without addressing the elevated temperature could pose risks to the client's health. Elevated temperatures may indicate an underlying infection or other conditions that need to be evaluated before proceeding with the transfusion. Holding the transfusion and seeking further guidance from the healthcare provider is the recommended action in this scenario.
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.
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