Nokea
After closing the curtain around the client's bed and lifting his gown to expose the horizontal abdominal wound, which of the following positions should you assist the client into for comfortable wound irrigation?
- A. High-Fowler's
- B. Side-lying
- C. Supine
- D. Dorsal Recumbent
Correct Answer: D
Rationale: Dorsal recumbent position allows access to the abdominal wound while keeping the client comfortable and stable.
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The nurse is taking care of a post-surgical patient and notes the incision is clean and dry, with sutures intact. The nurse further assesses that the wound is healing by:
- A. Second intention.
- B. Fourth intention.
- C. Third intention.
- D. First intention.
Correct Answer: D
Rationale: First intention healing occurs with clean, sutured incisions, minimizing scarring.
When preparing to change a sterile dressing over an incision, it is most important to remember to:
- A. Prepare a discard bag next to the wound.
- B. Remain very still during the procedure.
- C. Restrain from moving the patient.
- D. Change gloves after removing the old dressing.
Correct Answer: D
Rationale: Changing gloves after removing the old dressing maintains sterility, as the old dressing is contaminated.
A nurse is ambulating a patient in the hall a few days after abdominal surgery when the patient says, "I think something just let go." What should be the nurse's initial intervention?
- A. Ask someone to quickly get an abdominal binder.
- B. Seat the patient in a nearby chair.
- C. Instruct the patient to pant to reduce abdominal tension.
- D. Assist the patient into a supine position.
Correct Answer: D
Rationale: Assisting to a supine position reduces strain on the abdominal wound, preventing further dehiscence.
When giving a hot soak treatment, what is most important to ensure?
- A. Soak only the affected area.
- B. Position the patient comfortably.
- C. Monitor the temperature of the water.
- D. Check the patient's skin integrity.
Correct Answer: C
Rationale: Monitoring water temperature prevents burns, the primary safety concern with hot soaks.
What is the physiological effect of moist heat on the treated area?
- A. Numbing the area treated.
- B. Drawing fluid to the site of application.
- C. dilating the blood vessels
- D. Constricting the blood vessels.
Correct Answer: C
Rationale: Moist heat dilates blood vessels, increasing blood flow and promoting healing.