The new nurse reads a client has a wound “healing by second intention” and ask what that means. Which description by the charge nurse is most accurate?
“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 edges have been approximated and stitched together.”
“The wound was contaminated by debris and can’t be closed at all.”
The Correct Answer is B
A. “The wound was stapled together after an infection was cleared up”: Wounds that are closed after infection resolution heal by tertiary (delayed primary) intention, not second intention. In tertiary healing, the wound is initially left open and later closed surgically once infection or contamination subsides.
B. “The wound is an open cavity that will fill in with granulation tissue.”: Healing by second intention occurs when the wound is left open and allowed to heal naturally from the inside out. Granulation tissue gradually fills the wound bed, followed by epithelialization. This process is common in large, infected, or pressure wounds and results in more noticeable scarring.
C. “The wound edges have been approximated and stitched together.”: When wound edges are brought together and sutured, it is healing by first intention. This type of healing occurs in clean surgical incisions with minimal tissue loss, allowing faster recovery and minimal scarring.
D. “The wound was contaminated by debris and can’t be closed at all.”: While contaminated wounds may initially be left open, the statement is inaccurate because such wounds can still heal by second or tertiary intention once cleaned. Complete inability to close the wound is not characteristic of any specific healing process.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Fecal Occult test: Esomeprazole reduces gastric acid secretion, which helps prevent stress-related gastrointestinal bleeding, a common complication in clients with extensive burns. Monitoring for occult blood in the stool is the most direct way to evaluate the drug’s effectiveness in preventing GI bleeding.
B. Stool frequency: Changes in stool frequency may indicate bowel function or diarrhea but are not related to the effectiveness of proton pump inhibitors in preventing stress ulcers or GI bleeding.
C. Abdominal distention: Abdominal distention may suggest ileus, obstruction, or fluid accumulation, but it does not provide information about the efficacy of acid suppression therapy.
D. Bowel sounds: Bowel sounds reflect gastrointestinal motility but do not indicate whether esomeprazole is effectively preventing stress ulcers or gastrointestinal bleeding in burn clients.
Correct Answer is C
Explanation
A. “I should drink wine occasionally instead of every night”: Reducing alcohol consumption is appropriate since alcohol irritates the gastric mucosa and can worsen gastritis. Occasional, moderate intake may be tolerated, but complete avoidance is preferable during healing.
B. “I should decrease my intake of caffeinated drinks, especially coffee”: Caffeine stimulates gastric acid secretion, aggravating gastritis symptoms and delaying mucosal recovery. Recognizing the need to limit coffee and other caffeinated beverages demonstrates correct understanding of preventive self-care measures.
C. “I can continue smoking cigarettes which is better than chewing tobacco”: Smoking, regardless of form, impairs gastric mucosal blood flow and interferes with healing of gastritis. It also increases gastric acid secretion and delays epithelial repair.
D. “I will take acetaminophen instead of aspirin when I have a headache”: Aspirin is a known gastric irritant that can worsen gastritis and cause ulcer formation. Choosing acetaminophen, which has minimal gastric irritation, reflects correct understanding of medication safety.
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