The nurse is caring for a client one week postsurgery. Which finding should the nurse expect to see if the surgical incision is healing properly?
A well approximated Incision site.
Erythema and serosanguineous exudate.
Eschar and slough in the wound.
Beefy red granulation tissue.
The Correct Answer is A
A. A well approximated incision site:
A properly healing surgical incision typically appears well approximated, meaning the wound edges are closely aligned and held together with sutures or staples. This indicates that the wound is healing as expected and that the risk of infection and complications is minimized.
B. Erythema and serosanguineous exudate:
Erythema (redness) and serosanguineous exudate (pinkish fluid composed of serum and blood) can be normal findings in the early stages of wound healing, but they may also indicate inflammation or infection if they persist or worsen over time.
C. Eschar and slough in the wound:
Eschar (dead tissue) and slough (yellow or white necrotic tissue) are signs of tissue necrosis or delayed wound healing. They indicate that the wound is not healing properly and may require intervention such as debridement to remove dead tissue and promote healing.
D. Beefy red granulation tissue:
Beefy red granulation tissue is a sign of the proliferative phase of wound healing and indicates that the wound is healing from the bottom up. While granulation tissue is a positive sign of healing, it typically appears later in the healing process rather than one week post-surgery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Withdraw the medication into a syringe and label it with the client's name:
This is not necessary for the remainder of the medication. The medication should not be withdrawn into a syringe for future use or left labeled, as it could lead to errors or contamination.
B. Throw the vial into the trash in the presence of another nurse:
Discarding the vial into the trash is not appropriate, as it does not ensure proper documentation, accountability, or safe storage of the remaining medication. Additionally, the presence of another nurse does not address these concerns.
C. Place the vial with the remainder of the medication into a locked drawer:
While storing the vial in a locked drawer may prevent unauthorized access, it does not address the need for proper documentation and labeling of the remaining medication. Additionally, the vial should not be stored with the medication still in it after withdrawal.
D. Ask another nurse to witness the medication being discarded:
This is the appropriate action. Many facilities require that the disposal of unused or remaining medications, especially controlled substances, be witnessed by another nurse to ensure accountability and compliance with regulations.
Correct Answer is ["1"]
Explanation
To determine how many tablespoons the client should take with each dose, we need to first calculate the dosage in tablespoons based on the concentration of the oral suspension.
Given:
Dextromethorphan oral suspension concentration: 30 mg per 15 mL
To find out how many milliliters the client should take per dose:
The prescribed dose is 30 mg.
So, if 15 mL contains 30 mg, then 1 mL contains:
30 mg / 15 mL = 2 mg/mL
To find out how many milliliters the client should take for the prescribed dose:
30 mg / 2 mg/mL = 15 mL
Now, we know that the prescribed dose is 15 mL. To convert this to tablespoons, we can use the fact that 1 tablespoon (tbsp) is equal to 15 milliliters.
So, the client should take:
15 mL / 15 mL/tbsp = 1 tablespoon
Therefore, the nurse should instruct the client to take 1 tablespoon with each dose.
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