The nurse documenting an acute open wound should include which characteristics? Select all that apply.

Wound size.

Wound bed.

Periwound skin.

Pattern of eruption.

Answer and Explanation

Correct Answer : A,B,C

Choice A rationale

Documenting wound size includes measuring the length, width, and depth of the wound to track the healing process and plan appropriate interventions.

Choice B rationale

The wound bed should be assessed for tissue type (granulation, slough, or eschar), color, and the presence of any exudate or infection.

Choice C rationale

The periwound skin is the area around the wound which should be assessed for color, temperature, swelling, and signs of maceration or excoriation.

Choice D rationale

Pattern of eruption is more relevant to dermatological conditions such as rashes or lesions, and not a primary focus for documenting acute open wounds.

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Correct Answer is C

Explanation

Choice A rationale

The peripheral nervous system (PNS) consists of all the nerves outside the brain and spinal cord. It transmits signals to and from the central nervous system but does not specifically regulate energy expenditure.

Choice B rationale

The parasympathetic nervous system is part of the autonomic nervous system that promotes "rest and digest" functions, conserving energy by slowing the heart rate and increasing intestinal and gland activity.

Choice C rationale

The sympathetic nervous system is responsible for the "fight or flight" response, which prepares the body to expend energy rapidly in response to perceived threats. It increases heart rate, dilates airways, and mobilizes energy stores.

Choice D rationale

The central nervous system (CNS) consists of the brain and spinal cord. It is responsible for processing information and coordinating bodily functions but does not specifically regulate energy expenditure.

A. Exercise in a dark room. B. Sleep no more than 5 hours at a time. C. Use St. John's Wort. D. Keep a food diary. E. Maintain a headache diary.

Correct Answer is ["D","E"]

Explanation

Choice A rationale

Exercise is important but should be done in a well-lit, comfortable environment. Exercising in a dark room is not specifically beneficial for migraine management and may not address trigger factors effectively.

Choice B rationale

Adequate sleep is crucial for migraine management. Advising to sleep no more than 5 hours at a time is incorrect; sufficient rest is necessary to prevent migraines.

Choice C rationale

St. John's Wort is commonly used for depression and anxiety but has no proven efficacy for migraine management. It may also interact with other medications.

Choice D rationale

Keeping a food diary helps identify dietary triggers that can lead to migraines. Tracking food intake can reveal patterns and specific triggers to avoid.

Choice E rationale

Maintaining a headache diary is important for tracking migraine frequency, duration, and potential triggers. It helps in managing and understanding the condition better.

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The nurse documenting an acute open wound should include which characteristics? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When learning about the nervous system, students learn that which nervous system regulates the expenditure of energy?

Correct Answer is C

Explanation

The nurse is educating a group of people newly diagnosed with migraine headaches. What information should the nurse include in the educational session?

Correct Answer is ["D","E"]

Explanation

Which cerebral lobe is the largest and controls abstract thought?

What should the nurse suspect when hourly assessment of urine output on a client post craniotomy exhibits a urine output from a catheter of 1,500 mL for two consecutive hours?

The critical care nurse is giving end-of-shift report on a client. The nurse uses the Glasgow Coma Scale (GCS) to assess the level of consciousness (LOC) of a female client and reports to the oncoming nurse that the client has an LOC of 6. What does an LOC score of 6 in a client indicate?

An older adult client has come to the clinic for a regular check-up. The nurse's initial inspection reveals an increased thoracic curvature of the client's spine. The nurse should document the spinal disorder as which of the following?

A critical care nurse is caring for a client diagnosed with acute pancreatitis. The nurse knows this client should be started on parenteral nutrition (PN) after what indications?

The nurse is caring for a client whose recent health history includes an altered LOC. What should be the nurse's first action when assessing this client?

A nurse practitioner prescribes a therapeutic bath for a client with an exacerbation of psoriasis. The nurse tells the client to make sure the bath area is well ventilated. Which of the following is the therapeutic bath solution prescribed by the nurse?

Which term describes the fibrous connective tissues that cover the brain and spinal cord?