A nurse is contributing to the plan of care for a client who has a superficial skin tear with no exudate. Which of the following dressings should the nurse recommend to cover the wound?
Hydrofiber dressing
Transparent-film dressing
Alginate dressing
Foam dressing
The Correct Answer is B
A. Hydrofiber dressing:
Hydrofiber dressings are designed for moderate to heavy exudate, not dry or non-exudative wounds.
B. Transparent-film dressing:
Transparent-film dressings are ideal for superficial, non-draining wounds like skin tears. They protect the area while allowing for oxygen exchange and visualization of the wound.
C. Alginate dressing:
Alginate dressings are highly absorbent and used for moderate to heavy exudating wounds, not for dry superficial tears.
D. Foam dressing:
Foam dressings are best for wounds with exudate. They are thicker and may not adhere well to superficial skin tears without drainage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Place a gauze pad around the drain:
Penrose drains are open and passive. A gauze pad absorbs drainage and prevents skin irritation or maceration around the site.
B. Connect the drain to continuous low-pressure suction:
Penrose drains are not connected to suction. They allow drainage to passively exit the wound.
C. Clean the skin near the drain in a circular motion from the outside to the inside:
The correct method is to clean from the drain outward, to prevent contaminating the site.
D. Empty the drainage device when it is half full:
Penrose drains do not have a collection device to empty; instead, drainage is absorbed into gauze.
Correct Answer is B
Explanation
A. Provide the client a sip of warm water and wait 5 min before measuring his oral temperature:
This does not reliably normalize oral temperature and can still affect the accuracy.
B. Wait 30 min and return to measure the client's oral temperature:
Eating or drinking cold or hot substances can alter the oral temperature reading. Waiting 15–30 minutes allows for an accurate measurement.
C. Proceed to measure the client’s oral temperature:
This can result in an inaccurate (falsely low) reading due to recent ice chips.
D. Document the inability to obtain an accurate reading of the client’s oral temperature:
This step would be appropriate only if the nurse was unable to return or use an alternative method, which is not the case here.
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