NURS 5354 FINAL (2024/2025) EXAM
QUESTIONS WITH CORRECT
DETAILED ANSWERS || ALREADY
GRADED A+ <LATEST VERSION>
What needs to be documented/coded when suturing? - ANSWER ✔ Lesion
location, lesion size, benign/malignant (discuss path report), and closure.
What needs to be documented for wound repair? - ANSWER ✔ laceration length
and location, any neurovascular damage distal to the injury, laceration clean or
contaminated, anesthetic medication used, how the wound was cleansed, suture
size, number and layer sutured (skin, dermis, fascia) and discussion of potential for
infection or impaired function.
What should be considered for post procedural care? - ANSWER ✔ Cleansing,
antibiotics (if needed), use of steri-strips after suture removal to decrease wound
tension and applying sunscreen to the area for at least 6 months to reduce scarring.
What history should be obtained with laceration injuries? - ANSWER ✔ When
did it occur (greater than 12-24 hours)?
Where did it occur (dirty vs. clean)?
Any foreign body?
What was the mechanism of injury (sharp, blunt, animal bite, human bite,
puncture?)
What are present symptoms and care prior to arrival?
,Any history of impaired healing (HIV, DM, PVD, allergies, tetanus exposure,
malnutrition, chemo, alcoholism, chronic steroid use, obesity)?
What should ALWAYS be checked distal to the injury? - ANSWER ✔
Movement, circulation and sensation.
With hand injuries, what should always be documented? - ANSWER ✔ Hand
dominance and occupation.
What are the goals of laceration/incision repair? - ANSWER ✔ Achieve
hemostasis, prevent infection, preserve function, preserve cosmetic appearance,
minimize discomfort.
What is primary closure/intention? - ANSWER ✔ Direct approximation of the
wound edges by suture, tape, adhesives, etc.
What is secondary closure/intention? - ANSWER ✔ Wound is left open to heal by
the formation of granulation tissue and contraction.
What is delayed primary closure or tertiary intention? - ANSWER ✔ Wound is
left open and would benefit from closure in a few days. Irrigation, packings and/or
may be done while wound is left open and then by the 3rd day, definitive closure
occurs.
What is the main reason not to use primary closure? - ANSWER ✔ Infection.
What is the equipment needed for wound closure? - ANSWER ✔ Forceps,
anesthetic, needle holder, suture.
, What are the two types of forceps? - ANSWER ✔ Locking-Ex: needle holder,
hemostat and Kelly clamps. These are typically used for suturing, hemostasis and
extraction.
Non-locking-Ex: DeBakey or Cooley. These are typically used for
grasping/handling delicate tissue.
What type of forcep is used for the skin? - ANSWER ✔ The Adson forceps (non-
locking forcep)
What hand are forceps held in? - ANSWER ✔ The non-dominant hand. They are
typically help between the thumb and the first finger. Imagine holding a pencil or
pen.
What are needle holders used for? - ANSWER ✔ They hold the curved needle
while suturing. The tip of a needle holder is straight.
What are the three aspects of a curved needle? - ANSWER ✔ The needle point,
the needle body and the swaged eye.
What is the swaged eye of a curved needle? - ANSWER ✔ The point of the needle
closest to the suture.
Where should the needle be grasped with needle holders for suturing? - ANSWER
✔ Grasp on the furthest end of the body; approximately 1-2 cm from the swaged
eye.
