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The nurse assesses the large raised scar on the African American patient.
The nurse documents the lesion as a:

Laceration.

Contusion.

Keloid.

Hematoma.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

A laceration is a cut or tear in the skin, not a raised scar.

Choice B rationale:

A contusion is a bruise caused by an impact to the skin, not a raised scar.

Choice C rationale:

A keloid is a thick, raised scar that can develop at the site of an injury or inflammation. It’s more common in people with darker skin tones.

Choice D rationale:

A hematoma is a collection of blood outside of the blood vessels, not a raised scar.

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Correct Answer is A

Explanation

Choice A rationale:

The goal of wound irrigation is to clean the wound, so the nurse should continue to irrigate until the drainage is clear.

Choice B rationale:

The irrigant should be at room temperature, not chilled.

Choice C rationale:

The syringe should be held 1 inch (not 0.5 inch) from the wound.

Choice D rationale:

The wound should be flushed from the cleanest area to the most contaminated, not the other way around.

A. Moisten it with povidone iodine. B. Pull it off using slow, steady pressure. C. Add normal saline to loosen it. D. Leave it in place and cover it with new, wet dressings.

Correct Answer is C

Explanation

Choice A rationale:

Moistening the dressing with povidone iodine could cause irritation and is not the best method for removing a dressing stuck to the wound bed.

Choice B rationale:

Pulling off the dressing using slow, steady pressure could cause trauma to the wound bed and increase pain.

Choice C rationale:

Adding normal saline to loosen the dressing minimizes trauma to the wound bed and reduces pain during dressing removal.

Choice D rationale:

Leaving the old dressing in place and covering it with new, wet dressings could lead to infection and is not the best method for managing a dressing stuck to the wound bed.

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The nurse assesses the large raised scar on the African American patient.The nurse documents the lesion as a:

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to assist with irrigating a wound for a client.Which of the following actions should the nurse plan to take?

Correct Answer is A

Explanation

The nurse changing a wet to dry normal saline dressing for a patient with an ulcer on the heel finds that the old dressing is stuck to the wound bed.The nurse's most beneficial intervention would be to:

Correct Answer is C

Explanation

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The nurse assesses the large raised scar on the African American patient.
The nurse documents the lesion as a: