When giving a hot soak treatment, what is most important to ensure?

Soak only the affected area.

Position the patient comfortably.

Monitor the temperature of the water.

Check the patient’s skin integrity.

Answer and Explanation

The Correct Answer is C

Choice A rationale
When administering a hot soak treatment, it is crucial to soak only the affected area to provide targeted heat therapy. This localized approach helps to increase blood flow, reduce pain, and promote healing in the specific area that requires treatment. Soaking only the affected area also minimizes the risk of overheating and potential burns to other parts of the body.

Choice B rationale
While positioning the patient comfortably is important for any treatment, it is not the most critical aspect of a hot soak treatment. Comfort should always be considered, but the primary goal of the hot soak is to apply heat to the affected area to aid in healing. Therefore, ensuring that only the affected area is soaked takes precedence over general patient comfort in this context.

Choice C rationale
Monitoring the temperature of the water is the most important aspect of a hot soak treatment. The water must be warm enough to be therapeutic but not so hot as to cause burns or discomfort. This ensures the treatment is both safe and effective1.

Choice D rationale
Checking the patient’s skin integrity is important, especially if the patient has a condition that affects skin sensitivity, such as diabetes. However, the immediate concern during a hot soak treatment is to monitor the temperature to prevent injury.

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Correct Answer is A

Explanation

Choice A rationale
Vacuum-assisted closure (VAC) therapy aids in wound healing primarily by applying negative pressure to draw the wound edges together. This not only helps reduce the size of the wound but also promotes blood flow to the area, which can accelerate healing.

Choice B rationale
While VAC therapy does support the underlying structures of the wound, its primary function is not to strengthen the wall of the wound. The negative pressure assists in removing excess fluid and reducing edema, which indirectly supports the wound structure.

Choice C rationale
VAC therapy does have an impact on bacterial levels within the wound by helping to remove infectious materials. However, its main purpose is not to interrupt bacteria proliferation; this is more directly achieved through antibiotic therapy and proper wound care techniques.

Choice D rationale
While VAC does create a cover over the wound, its main purpose is to apply negative pressure to the wound area. This negative pressure helps to draw the wound edges together, promotes the removal of exudate and potentially infectious material, and stimulates the growth of new tissue, which aids in the healing process12. The occlusive cover is part of the system that allows the negative pressure to be maintained, but it is the negative pressure itself, not the cover, that provides the therapeutic benefit.

A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

Correct Answer is B

Explanation

Choice A rationale
Stage 1 wounds are characterized by non-blanchable redness of intact skin. The presence of partial-thickness skin loss indicates that the wound has progressed beyond stage 1, making this choice incorrect.

Choice B rationale
Stage 2 wounds involve partial-thickness loss of dermis presenting as a shallow open ulcer with a red-pink wound bed, without slough. This description matches the nurse’s assessment of the patient’s wound, confirming that it is indeed a stage 2 wound.

Choice C rationale
Stage 3 wounds exhibit full-thickness tissue loss. Subcutaneous fat may be visible, but bone, tendon, or muscle are not exposed. The patient’s wound, with partial-thickness skin loss and no mention of exposed subcutaneous structures, does not fit the criteria for stage 3.

Choice D rationale
Stage 4 wounds involve full-thickness tissue loss with exposed bone, tendon, or muscle. Slough or eschar may be present on some parts of the wound bed. The patient’s wound does not have these characteristics, ruling out stage 4.

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When giving a hot soak treatment, what is most important to ensure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse clarifies that a vacuum-assisted closure supports the healing of a wound by:

Correct Answer is A

Explanation

The nurse is caring for a 48-year-old female patient with diabetes mellitus (DM), hypertension (HTN), and limited mobility. Upon assessment, she notes that there is a pink, viable wound bed with partial-thickness skin loss. Which stage of wound healing does this describe?

Correct Answer is B

Explanation

When the patient complains of worsening due to increased swelling at the wound site on his leg, the nurse explains that the swelling indicates:

When giving a hot soak treatment, what is most important to ensure?

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The nurse clarifies that the second stage of wound healing is:

A nurse is planning care for a client who has multiple wounds. During the initial stage of wound healing, which of the following should the nurse include in the plan of care?

When preparing to change a sterile dressing over an incision, it is most important to remember to: