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NUR 155 EXAM 3 GALEN (UNITS 6 (11-13) ,7 (24-26) ,8(11-13))
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NUR 155 EXAM 3 GALEN (UNITS 6 (11-13) ,7 (24-26) ,8(11-13))
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NUR 155 EXAM 3 GALEN (UNITS 6 (11-13) ,7 (24-26) ,8(11-13))
T/F, When collecting a culture from a wound, do not use pus or pooled exudates. -
Answers -True
The nurse is admitting an older patient from a nursing home. During the assessment,
the nurse notes a shallow open reddish, pink ulcer without slough on the right heel of
the patient. How will the nurse stage this pressure ulcer?
A
Stage I
B
Stage II
C
Stage III
D
Stage IV - Answers -Stage II
The nurse is caring for a patient who is experiencing a full-thickness repair. Which type
of tissue will the nurse expect to observe when the wound is healing?
A
Eschar
B
Slough
C
Granulation
D
Purulent drainage - Answers -Granulation
A patient has developed a pressure ulcer. Which laboratory data will be important for
the nurse to check?
A
Vitamin E
B
Potassium
C
Albumin
D
Sodium - Answers -Albumin
A nurse is caring for a patient with a wound. Which assessment data will be most
important for the nurse to gather with regard to wound healing?
A
Muscular strength assessment
B
, Pulse oximetry assessment
C
Sensation assessment
D
Sleep assessment - Answers -Pulse oximetry assessment
The nurse is caring for a patient on the medical-surgical unit with a wound that has a
drain and a dressing that needs changing. Which action should the nurse take first?
A
Provide analgesic medications as ordered.
B
Avoid accidentally removing the drain.
C
Don sterile gloves.
D
Gather supplies. - Answers -Provide analgesic medications as ordered.
The nurse is caring for a patient with a pressure ulcer on the left hip. The ulcer is black.
Which next step will the nurse anticipate?
A
Monitor the wound.
B
Document the wound.
C
Debride the wound.
D
Manage drainage from wound. - Answers -Debride the wound.
The nurse is completing a skin risk assessment using the Braden Scale. The patient
has slight sensory impairment, has skin that is rarely moist, walks occasionally, and has
slightly limited mobility, along with excellent intake of meals and no apparent problem
with friction and shear. Which score will the nurse document for this patient?
A
15
B
17
C
20
D
23 - Answers -20
A patient is asking for a heating pad who has a sprained ankle. What would you teach?
- Answers -24 hours after trauma, heat increases bleeding and swelling
When cleaning a sutured wound, the nurse would wipe in what order? - Answers -
sutures, distal, proximal
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