A new nurse reads a client has a wound "healing by second intention" and asks what that means.
Which description by the charge nurse is most accurate?
"The wound edges have been approximated and stitched together.”.
"The wound was stapled together after an infection was cleared up.”.
"The wound is an open cavity that will fill in with granulation tissue.”.
"The wound was contaminated by debris and cannot be closed at all.”.
The Correct Answer is C
Choice A rationale
Healing by primary intention, also known as primary union, occurs when a wound has clean edges that are approximated and sutured, stapled, or glued together. This process minimizes tissue loss and results in a fine scar. The wound's integrity is re-established with minimal granulation tissue formation.
Choice B rationale
This describes a form of delayed primary closure or tertiary intention healing. The wound is initially left open to allow for drainage and to clear infection. Once the wound is considered clean and free of infection, the edges are then approximated and closed, often with staples, to promote healing.
Choice C rationale
Healing by secondary intention, or secondary union, occurs in large, open wounds with significant tissue loss and non-approximated edges. The wound heals from the base up. This process involves the formation of new connective tissue and capillaries, called granulation tissue, to fill the defect before epithelialization can occur.
Choice D rationale
While contaminated wounds can heal by secondary intention, this description is not a complete definition. Secondary intention healing is a specific biological process involving granulation tissue, not just a description of a wound that is open due to contamination or debris. The defining characteristic is the formation of granulation tissue.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["3.5"]
Explanation
Step 1 is to convert the child's weight from pounds to kilograms: 55 lb ÷ 2.2 lb/kg = 25 kg.
Step 2 is to calculate the total daily dosage in milligrams: 7 mg/kg × 25 kg = 175 mg/24h.
Step 3 is to calculate the dosage per dose: 175 mg ÷ 2 doses = 87.5 mg per dose.
Step 4 is to calculate the volume per dose in mL: 87.5 mg ÷ (125 mg/5 mL) = 87.5 mg ÷ 25 mg/mL = 3.5 mL per dose. The final calculated dosage for this child is 3.5 mL per dose.
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
An elevated low-density lipoprotein (LDL-C) level is a significant risk factor for atherosclerosis because LDL-C is the primary carrier of cholesterol to the tissues. High levels lead to the deposition of cholesterol within the arterial walls, forming atherosclerotic plaques. These plaques narrow arteries, impede blood flow, and can rupture, leading to thrombosis and acute cardiovascular events. A normal LDL-C level is typically less than 100 mg/dL.
Choice B rationale
Decreased levels of high-density lipoprotein cholesterol (HDL-C) are concerning because HDL-C plays a protective role in the cardiovascular system. HDL-C is responsible for reverse cholesterol transport, a process where it removes excess cholesterol from the arterial walls and transports it back to the liver for excretion. Low levels impair this protective mechanism, allowing cholesterol accumulation and plaque formation. A normal HDL-C level is typically above 40 mg/dL for men and 50 mg/dL for women.
Choice C rationale
Asian ethnicity is not considered an independent risk factor for atherosclerosis. While certain populations may have varying risk profiles due to genetic and lifestyle factors, ethnicity alone does not directly predispose an individual to the condition in the same manner as modifiable factors like dyslipidemia or smoking. A comprehensive risk assessment relies on established clinical and lifestyle factors, not solely on a person’s racial background.
Choice D rationale
A history of smoking is a major, modifiable risk factor for atherosclerosis. The chemicals in cigarette smoke damage the endothelium, the inner lining of blood vessels, making it more permeable to cholesterol. Smoking also increases inflammation, promotes platelet aggregation, and lowers HDL-C levels. These combined effects accelerate the formation and progression of atherosclerotic plaques, significantly increasing the risk of cardiovascular events like myocardial infarction and stroke.
Choice E rationale
A single blood pressure reading of 142/92 mm Hg, while elevated, is not sufficient for a diagnosis of hypertension or to be considered a definitive risk factor. Hypertension is diagnosed based on multiple elevated readings over time. While this reading is concerning, a single measurement can be influenced by various factors. The finding warrants further monitoring, but it does not represent a chronic risk factor until a pattern of sustained high blood pressure is established
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