The nurse is caring for a client one week post-surgery. Which finding should the nurse expect to see if the surgical incision is healing properly?

Eschar and slough in the wound.

A well-approximated incision site.

Beefy red granulation tissue.

Erythema and serosanguineous exudate.

Answer and Explanation

The Correct Answer is B

Choice A reason: Eschar and slough in the wound are not signs of proper healing. They are necrotic tissue that impairs wound healing and increases the risk of infection. They should be removed by debridement to promote wound closure.

Choice B reason: A well-approximated incision site is a sign of proper healing. It means that the edges of the wound are close together and aligned, without gaps or separation. It indicates that the wound is healing by primary intention, which is the fastest and most desirable method of wound healing.

Choice C reason: Beefy red granulation tissue is a sign of healing, but not of proper healing for a surgical incision. It is new tissue that fills the wound bed and consists of blood vessels and connective tissue. It indicates that the wound is healing by secondary intention, which is a slower and less desirable method of wound healing.

Choice D reason: Erythema and serosanguineous exudate are not signs of proper healing. They are signs of inflammation and possible infection. Erythema is redness of the skin around the wound, and serosanguineous exudate is a mixture of blood and serum that drains from the wound. They should be monitored and reported to the health care provider.

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Correct Answer is A

Explanation

Choice A reason: Using simulation activities is the most useful action for the nurse to include during the teaching session. It allows the clients to practice and apply their problem-solving skills in realistic and relevant scenarios. It also enhances their motivation, engagement, and feedback.

Choice B reason: Offering positive reinforcement is a helpful action for the nurse to include during the teaching session, but not the most useful one. It can increase the clients' confidence and self-efficacy, but it does not directly teach them how to solve problems.

Choice C reason: Incorporating verbal analogies is a creative action for the nurse to include during the teaching session, but not the most useful one. It can help the clients to understand complex or abstract concepts by relating them to familiar or simpler ones, but it does not necessarily improve their problem-solving skills.

Choice D reason: Providing physical demonstrations is a clear action for the nurse to include during the teaching session, but not the most useful one. It can show the clients how to perform a specific task or procedure, but it does not encourage them to think critically or independently.

A. Assess the position of the mask on the client's face. B. Release and reinsert the flowmeter in the wall outlet. C. Attach the flowmeter to a humidification canister. D. Adjust the flow rate to the prescribed liters per minute.

Correct Answer is B

Explanation

Choice A reason: Assessing the position of the mask on the client's face is not the priority action. The mask may be well-fitted, but the oxygen delivery may be compromised by the faulty connection of the flowmeter.

Choice B reason: Releasing and reinserting the flowmeter in the wall outlet is the best action as it may correct the problem of the loose or misaligned connection. The nurse should ensure that the flowmeter is securely attached and that the oxygen is flowing properly.

Choice C reason: Attaching the flowmeter to a humidification canister is not necessary for oxygen delivery per mask. Humidification is usually added for high-flow oxygen devices such as nasal cannula or face tent.

Choice D reason: Adjusting the flow rate to the prescribed liters per minute is not the appropriate action. The flow rate may be correct, but the oxygen delivery may be impaired by the hissing sound indicating a leak or obstruction.

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The nurse is caring for a client one week post-surgery. Which finding should the nurse expect to see if the surgical incision is healing properly?

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Naxlex Comprehensive Predictor Exams

The nurse plans to encourage a group of young adult clients to engage in problem-solving strategies. Which action is most useful for the nurse to include during the teaching session?

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When initiating oxygen per mask to a client who is short of breath, the nurse hears a loud hissing sound after inserting the flowmeter into the wall outlet. Which should the nurse do next?

Correct Answer is B

Explanation

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