A WOCN is reviewing the wound healing process with a group of nurses on a unit. The WOCN should include in the information which of the following alterations for wound healing by secondary intention? (Select all that apply)

Laceration sealed with adhesive

Skin tear on the forearm

Stapled hip incision

Stage 4 pressure injury

Infected re-opened abdominal incision

Answer and Explanation

Correct Answer : B,D,E

A. Laceration sealed with adhesive: This wound is healing by primary intention, where the wound edges are approximated and closed using sutures, staples, or adhesive. Healing is typically faster with minimal scarring and reduced risk of infection.

B. Skin tear on the forearm: A skin tear often involves partial loss of skin integrity and may not have edges that can be approximated. When left open to heal naturally, it undergoes secondary intention, which involves granulation tissue formation, contraction, and epithelialization.

C. Stapled hip incision: This wound is healing by primary intention because the edges have been brought together and secured using staples. There is minimal tissue loss and faster healing with less scarring compared to secondary intention.

D. Stage 4 pressure injury: A stage 4 pressure injury involves full-thickness tissue loss that often exposes muscle, tendon, or bone. Due to extensive tissue damage and inability to approximate wound edges, it heals by secondary intention through granulation and scar tissue formation.

E. Infected re-opened abdominal incision: If a surgical incision becomes infected and dehisces, it can no longer heal by primary intention. It must be managed as an open wound, healing by secondary intention, involving a longer healing process and greater risk of scarring.

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

Explanation

A. 33-year-old client with chronic pain: While chronic pain requires ongoing medication management, this client is not inherently at increased risk for toxic effects without additional factors such as organ dysfunction or polypharmacy.

B. 43-year-old client with end stage renal (kidney) disease: Renal impairment reduces the body’s ability to excrete drugs, increasing the risk of drug accumulation and toxicity. Dosage adjustments and close monitoring are essential to prevent adverse effects.

C. 36-year-old client with chronic liver disease: Liver disease impairs drug metabolism, leading to prolonged drug action and higher risk of toxic effects. Careful selection and dosing of medications are necessary to avoid toxicity.

D. 84-year-old client with congestive heart failure: Older adults and those with heart failure often have altered pharmacokinetics and pharmacodynamics, making them more susceptible to drug toxicity. Age-related changes and reduced cardiac output can affect drug metabolism, distribution and elimination.

A. Present the information in small segments B. Dim the lights in the client's room C. Provide reading material using blue-colored ink D. Avoid repeating information to the client

Correct Answer is A

Explanation

A. Present the information in small segments: Older adults often process information more effectively when it is delivered in manageable portions. Breaking content into smaller segments allows for better understanding and retention, especially when learning new material like medication instructions.

B. Dim the lights in the client’s room: Dim lighting can impair visibility, particularly for older adults who may already have age-related vision changes. Adequate lighting is essential for promoting alertness and supporting clear reading and communication.

C. Provide reading material using blue-colored ink: Blue ink can be difficult to read for individuals with visual impairments or age-related vision decline. High-contrast colors, such as black print on a white background, are generally easier for older adults to see.

D. Avoid repeating information to the client: Repetition reinforces learning and helps with memory retention, particularly in older adults who may experience mild cognitive changes. Avoiding repetition can lead to misunderstanding or noncompliance with instructions.

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A WOCN is reviewing the wound healing process with a group of nurses on a unit. The WOCN should include in the information which of the following alterations for wound healing by secondary intention? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When administering a medication, the nurse would identify which of the following clients at risk for toxic effects? (SELECT ALL THAT APPLY)

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

Explanation

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Correct Answer is A

Explanation

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