ATI LPN
Fundamentals of Nursing Medication Administration Practice Questions Questions
Question 1 of 5
A client has a wound on the lower leg that is covered with dry, yellow crusts. The nurse recognizes this as an indication of:
Correct Answer: A
Rationale: Slough is dead tissue that is shed from the surface of the wound. It may be white, yellow, green, or brown in color and may have a soft, moist, or dry texture. It should be removed to promote wound healing.
Question 2 of 5
A client with diabetes mellitus has a diabetic foot ulcer on the left heel. The nurse is preparing to apply a hydrocolloid dressing to the wound. What is an advantage of using this type of dressing?
Correct Answer: D
Rationale: Hydrocolloid dressings are occlusive or semi-occlusive dressings that adhere to the skin and form a gel-like substance over the wound. This creates a moist environment that stimulates autolytic debridement, which is the natural breakdown of necrotic tissue by enzymes in the wound fluid.
Question 3 of 5
A nurse is preparing to change a dressing on a client's surgical incision. Which type of dressing should the nurse use to promote autolytic debridement of the wound?
Correct Answer: D
Rationale: The nurse should use a hydrogel dressing to promote autolytic debridement of the wound. Autolytic debridement is a natural process that uses the body's own enzymes and moisture to liquefy and remove necrotic tissue from a wound. Hydrogel dressings provide hydration and moisture to dry wounds and facilitate autolytic debridement.
Question 4 of 5
A nurse is assessing a client with a pressure ulcer on the sacrum. Which finding should the nurse report to the provider immediately?
Correct Answer: A
Rationale: The wound with a foul odor and purulent drainage indicates an infection, which can delay healing and cause systemic complications, such as sepsis. The nurse should report this finding to the provider immediately and obtain a wound culture and sensitivity test.
Question 5 of 5
A nurse is planning care for a client who has a surgical incision with staples. Which intervention should the nurse include in the plan to prevent wound dehiscence?
Correct Answer: B
Rationale: Splinting the incision when coughing or sneezing helps to reduce tension and stress on the wound edges and prevent wound dehiscence, which is the partial or total separation of the wound layers. The nurse should also instruct the client to avoid lifting heavy objects or straining during bowel movements.