A client with venous insufficiency has a venous stasis ulcer on the lower leg. Which instruction should the nurse give to the client to promote wound healing?

Correct Answer: D

Rationale: All of the above,' is correct, as all listed instructions applying compression stockings or bandages , avoiding crossing legs or tight clothing , and keeping the leg elevated promote healing of a venous stasis ulcer. Venous insufficiency causes blood pooling, edema, and pressure, impairing wound recovery. Compression therapy enhances venous return, reducing swelling and supporting circulation. Avoiding leg crossing or tight garments prevents vessel constriction, maintaining blood flow. Elevation above heart level uses gravity to drain fluid, alleviating edema and pressure. Each action targets a facet of venous ulcer pathology, and together, they form a comprehensive strategy to improve oxygenation, reduce inflammation, and accelerate healing, making D the most inclusive and effective choice for patient education in this chronic condition.

Correct Answer: A

Rationale: Integument,' as the skin is commonly referred to as the integument or integumentary system, encompassing the external covering of the body that shields it from environmental harm. This term includes the skin itself along with its appendages like hair, nails, and glands, forming a comprehensive protective barrier. 'Epidermis' is incorrect because it's only the outermost layer of the skin, not the whole system. 'Dermis' refers to the middle layer beneath the epidermis, containing connective tissue and blood vessels, but it doesn't represent the entire skin. 'Subcutaneous' is the deepest layer, also called the hypodermis, providing insulation and fat storage, but it's distinct from the skin's broader designation. The integumentary system's holistic role in protection, sensation, and regulation distinguishes 'Integument' as the precise term, aligning with anatomical definitions and nursing fundamentals where understanding the skin's full scope is critical for patient care and wound management.

Correct Answer: B

Rationale: Acute wound,' as it describes a wound that heals quickly (days to weeks) with well-approximated edges and reduced infection risk. Acute wounds, like cuts or surgical incisions, follow a predictable healing trajectory due to minimal tissue loss and prompt repair, often via primary intention. 'Abrasion wound' is a type of injury (scraping), not a healing classification, and may heal slower if extensive. 'Chronic wound' persists beyond weeks, often due to underlying conditions like diabetes, contradicting quick healing. 'Unintentional wound' defines cause (accidental), not healing speed or edge alignment. In nursing, identifying acute wounds guides timely interventions e.g., suturing versus chronic wounds needing prolonged care. B aligns with the description's focus on healing dynamics, distinguishing it as the accurate classification over specific wound types or causation.

Correct Answer: C

Rationale: Pain,' as it's a physical, not psychological, effect of wounds. Pain results from nerve stimulation at the injury site, a sensory response, whereas psychological effects impact mental state. 'Anxiety' is psychological, reflecting worry about healing or outcomes. 'Fear' involves emotional dread, perhaps of complications. 'Changes in body image' affect self-perception, a mental shift. In nursing, distinguishing these aids holistic care pain requires analgesics, while anxiety might need counseling. The question's focus on psychological effects excludes C, as pain's physical nature contrasts with the emotional impacts of A, B, and D, aligning with wound care's mind-body framework.

Correct Answer: D

Rationale: B and C,' as 'pressure ulcers' and 'bedsores' synonymous terms are among the most common skin and tissue disruptions, especially in immobile or elderly patients. They result from sustained pressure impairing blood flow, leading to tissue necrosis, with high prevalence in hospitals and long-term care. 'Maceration' is skin softening from prolonged moisture (e.g., incontinence), common but less frequent than pressure-related issues in broader statistics. 'Pressure ulcers' and 'bedsores' overlap, reinforcing their dominance. 'A and B' excludes bedsores' synonymy, underrepresenting the category. In nursing, preventing pressure ulcers via repositioning is a priority due to their frequency and complications (e.g., infection). E correctly pairs B and C, aligning with clinical data on skin disruption prevalence.