A client is receiving negative pressure wound therapy (NPWT) for a diabetic foot ulcer. Which action should the nurse take when changing the dressing?

Correct Answer: A

Rationale: Applying sterile saline to moisten the foam dressing before removal is the correct action during an NPWT dressing change for a diabetic foot ulcer. The foam can adhere to the wound bed, and moistening it with saline prevents trauma, pain, or bleeding upon removal, protecting fragile granulation tissue common in diabetic wounds. Cutting the foam loosely is incorrect; it should fit snugly to ensure even pressure distribution. Securing the film with tape risks air leaks; an adhesive drape extending beyond the edges is standard to maintain the seal. Disconnecting tubing from the foam first disrupts suction prematurely; it should detach from the device first to avoid pressure issues. Moistening with saline is a precise, evidence-based step to safeguard the wound, especially critical in diabetic patients with impaired healing.

Correct Answer: C

Rationale: Moistening the new dressing with sterile water, wringing it out, and applying it is the correct technique for a wet-to-dry dressing. This method mechanically debrides necrotic tissue as the dressing dries and adheres, lifting debris upon removal. Sterile water is preferred over saline to avoid sodium crystal formation, and wringing prevents maceration while ensuring contact with the wound bed. Soaking the old dressing reduces debridement by softening adhered tissue. Antibiotic ointment interferes with adhesion and risks resistance, countering the dressing's purpose. An occlusive cover traps moisture, promoting infection rather than drying for debridement. Proper technique with moistening and wringing balances efficacy and safety, optimizing chronic wound care.

Correct Answer: D

Rationale: Elimination,' as this function describes the skin's role in excreting water, electrolytes, and nitrogenous wastes through sweat. Sweat glands produce sweat, a mixture containing these substances, aiding in waste removal and electrolyte balance, albeit in small amounts compared to kidneys. 'Protection' refers to the skin's barrier against pathogens and injury, not excretion. 'Sensation' involves nerve endings detecting stimuli, unrelated to waste. 'Regulation' covers temperature control via sweating or vasoconstriction, but the question specifies excretion, not thermoregulation. Elimination uniquely fits, as it's a recognized skin function in physiology, crucial for nursing knowledge in fluid balance and patient assessment e.g., excessive sweating might signal electrolyte loss. This specificity distinguishes 'Elimination' as the precise answer, aligning with the skin's excretory role.

Correct Answer: B

Rationale: Delayed primary intention,' as it fits Mr. Griffin's case: a large wound left open initially to heal naturally (allowing granulation and infection control), then sutured later. This method delays primary closure until the wound bed is stable, common for contaminated or traumatic injuries. 'Primary intention' involves immediate suturing, not waiting days. 'Tertiary intention' implies prolonged openness with later closure after significant healing, often for deeper wounds, but the question suggests a shorter delay. 'B and C' is incorrect only one process applies here. In nursing, delayed primary intention balances infection risk and closure, critical for trauma care. The sequence of open healing then suturing pinpoints B as the accurate description.

Correct Answer: A

Rationale: Hemostasis,' as it's the phase where blood vessels constrict to stop bleeding via clotting, then dilate to enhance permeability, leaking plasma and blood components into the injury site. Hemostasis, the first wound healing stage, begins instantly post-injury vasoconstriction forms a clot, followed by vasodilation to initiate inflammation. 'Inflammatory phase' follows, focusing on immune response (e.g., neutrophil influx), not initial clotting. 'Proliferation phase' involves tissue rebuilding, not vessel dynamics described here. 'A and B' is incorrect constriction and dilation are hemostasis-specific, not inflammatory. In nursing, recognizing hemostasis aids early wound assessment e.g., excessive bleeding signals issues. The question's vessel behavior pinpoints A, distinguishing it from later phases.