The nurse is alert to the indication of possible dehiscence of an abdominal surgical wound, which would be evidenced by:

Increased pallor of the surgical site.

Increased serosanguineous drainage from the wound.

Excessive gas.

Complaint of constipation.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Increased pallor of the surgical site is not a typical sign of wound dehiscence. It could indicate poor blood flow to the area, but it’s not directly related to dehiscence.

Choice B rationale:

Increased serosanguineous drainage from the wound is a common sign of wound dehiscence. This type of drainage is a mixture of blood and serum, and an increase could indicate that the wound edges are separating.

Choice C rationale:

Excessive gas is not a typical sign of wound dehiscence. It could be related to other postoperative complications, such as ileus or bowel obstruction, but not specifically to dehiscence.

Choice D rationale:

Complaint of constipation is not a typical sign of wound dehiscence. It could be related to other postoperative complications, such as side effects of pain medication or decreased mobility, but not specifically to dehiscence.

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Correct Answer is A

Explanation

Choice A rationale:

The goal of wound irrigation is to clean the wound, so the nurse should continue to irrigate until the drainage is clear.

Choice B rationale:

The irrigant should be at room temperature, not chilled.

Choice C rationale:

The syringe should be held 1 inch (not 0.5 inch) from the wound.

Choice D rationale:

The wound should be flushed from the cleanest area to the most contaminated, not the other way around.

A. Wet-to-dry dressings. B. Negative pressure treatment. C. NPWT therapy. D. Hydrocolloid dressings. E. Promoting protein in the diet.

Correct Answer is ["B","C","D","E"]

Explanation

Choice A rationale:

Wet-to-dry dressings are not typically used for chronic wounds as they can cause tissue damage.

Choice B rationale:

Negative pressure treatment can promote healing by removing excess fluid and promoting blood flow to the wound.

Choice C rationale:

NPWT therapy, or Negative Pressure Wound Therapy, can help heal chronic wounds by removing excess fluid and promoting blood flow.

Choice D rationale:

Hydrocolloid dressings maintain a moist wound environment, which can promote healing.

Choice E rationale:

Protein is essential for wound healing as it is needed for the growth and repair of tissues.

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The nurse is alert to the indication of possible dehiscence of an abdominal surgical wound, which would be evidenced by:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to assist with irrigating a wound for a client.Which of the following actions should the nurse plan to take?

Correct Answer is A

Explanation

Chronic wounds that are not healing well may benefit from (Select all that apply.)

Correct Answer is ["B","C","D","E"]

Explanation

When the patient complains that he feels he is getting worse because of the increased swelling at his wound site on his leg, the nurse's most helpful response would be that swelling indicates that:

A nurse performing a right eye irrigation will position the patient:

A nurse is collecting data on a client.Which of the following findings increase the client's risk of a pressure injury?

Because the patient with an abdominal dressing requires frequent dressing changes, the abdomen is beginning to show skin irritation from repeated tape removal.The nurse would change the dressing procedure in order to use:

A patient has a pooling of blood under unbroken skin of the hip after a fall.The nurse should document that this patient has a(n):

The nurse is performing a dry sterile dressing change for an abdominal wound.The nurse should use a swab to clean:

When changing the dressing on the patient's right arm, you see that the dressing has a moist yellow-red stain on it. You would document this as drainage.