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What type of wound heals by delaying the suturing until the infection is resolved?
- A. Remodeling phase
- B. Primary intention
- C. Tertiary intention
- D. Secondary intention
Correct Answer: C
Rationale: Tertiary intention delays suturing until infection clears, allowing controlled closure.
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Many factors aid in healing. You can assist the patient in improving their healing ability by encouraging the following (Select all that apply):
- A. Keeping skin and surrounding tissue clean and dry.
- B. Proper nutrition with adequate protein and vitamins.
- C. Resting as much as possible and keeping the incisional area still.
- D. Increasing fluid intake to at least 4000 mL per day.
- E. Exercise and deep breathing to increase oxygen.
Correct Answer: A,B,C,E
Rationale: A: Reduces infection risk. B: Supports tissue repair. C: Minimizes tension on the wound. E: Oxygen aids healing. 4000 mL (D) is excessive unless specified.
What type of wound heals by edges approximating with a suture?
- A. Secondary intention.
- B. Remodeling phase.
- C. Primary intention.
- D. Tertiary intention.
Correct Answer: C
Rationale: Primary intention healing occurs when wound edges are brought together with sutures, minimizing scarring. Secondary intention heals open wounds, tertiary delays closure, and remodeling is a phase, not a type.
When changing the dressing on the patient's right arm, you see that the dressing has a moist yellow-red stain on it. How would you document this drainage?
- A. Sanguineous
- B. Serous
- C. Serosanguineous
- D. Purulent
Correct Answer: C
Rationale: Yellow-red drainage indicates serosanguineous (serum and blood mix), not purulent (pus) or sanguineous (blood only).
A patient is incontinent on the first day after surgery. This is a risk factor for the development of skin breakdown and infection primarily because:
- A. The moisture creates an environment suitable for the growth of microorganisms in a wound.
- B. Greater pressure is exerted by a wet bed.
- C. Shearing is more likely from wet sheets.
- D. The patient has to be repositioned for the bed to be changed.
Correct Answer: A
Rationale: Moisture from incontinence fosters microbial growth, increasing infection risk.
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.