A nurse is providing care for a patient who is due for surgery.
The patient’s lab results and physical history are as follows: Prealbumin level is 13 mg/dL (normal range: 15 to 36 mg/dL), Cholesterol is 230 mg/dL (normal is less than 200 mg/dL), and Fasting glucose is 110 mg/dL (normal range: 70 to 110 mg/dL). The patient has a history of hyperlipidemia and diabetes mellitus.
Which of the following factors could potentially delay the patient’s wound healing process?

The patient’s medication history

The patient’s cholesterol level

The patient’s prealbumin level

The patient’s fasting glucose level

Answer and Explanation

The Correct Answer is C

Choice A rationale

While a patient’s medication history can impact wound healing, in this case, there is no specific information provided about the patient’s medications that would suggest a delay in wound healing.

Choice B rationale

Although the patient’s cholesterol level is elevated, hyperlipidemia is not typically associated with delayed wound healing.

Choice C rationale

Prealbumin is a marker of nutritional status. A low prealbumin level, like in this patient, could indicate malnutrition, which can delay wound healing. Adequate nutrition is essential for wound healing as it provides the necessary building blocks for tissue repair.

Choice D rationale

The patient’s fasting glucose level is within the normal range, so it is unlikely to impact wound healing. While poorly controlled diabetes can delay wound healing, this patient’s diabetes appears to be well-controlled.

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Correct Answer is B

Explanation

Choice A rationale

While gastric acid can cause dyspepsia, measuring gastric residual is not primarily done to remove gastric acid.

Choice B rationale

Measuring gastric residual is primarily done to identify delayed gastric emptying. This is important because delayed gastric emptying can lead to complications such as aspiration pneumonia.

Choice C rationale

Gastric residual does not directly determine the patient’s electrolyte balance.

Choice D rationale

While confirming the placement of the NG tube is important, it is not the primary purpose of measuring gastric residual.

A. Detecting the scent of a rose B. Observing the color of a flower C. Feeling the texture of a fabric D. Hearing the sound of a bell

Correct Answer is C

Explanation

Choice A rationale

Detecting the scent of a rose is primarily associated with the olfactory system, not the tactile system.

Choice B rationale

Observing the color of a flower is primarily associated with the visual system, not the tactile system.

Choice C rationale

Feeling the texture of a fabric is primarily associated with the tactile system. The tactile system, part of the somatosensory system, allows us to perceive touch, pressure, temperature, pain, and vibration.

Choice D rationale

Hearing the sound of a bell is primarily associated with the auditory system, not the tactile system.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who receives intermittent enteral feedings through an NG tube.Before administering a feeding, the nurse should measure the gastric residual for which of the following purposes?

Correct Answer is B

Explanation

A nurse is evaluating a patient’s sensory function.Which of the following sensory stimuli is primarily associated with the tactile system?

Correct Answer is C

Explanation

The same nurse is now preparing to clean the abrasion on the client’s right elbow. The provider has prescribed mechanical debridement for the wound. Exhibits Which of the following is a form of mechanical debridement that the nurse should expect to use?

A nurse is assessing a patient’s wound dressing and observes a watery red drainage. How should the nurse document this type of drainage?

The nurse notes that a patient has a black pressure ulcer on the left hip. Which event will the nurse anticipate when planning care for this patient?

Which of the following correctly describes the process of hearing?

A nurse is caring for a patient with a nasogastric (NG) tube and tests the pH of the secretions to verify correct placement of the tube. What pH reading should the nurse expect?

A nurse is preparing to irrigate a wound for a patient. What actions should the nurse plan to take?

A nurse is assessing a patient who has a wound that is healing by first intention. What findings should the nurse expect?

A nurse is about to replace a nearly depleted container of total parenteral nutrition (TPN) for a patient, but discovers a delay in the delivery of the new TPN solution from the pharmacy. Which solution should the nurse administer until the next TPN solution is available?