A new nurse is delegating care of a chronic, nonsterile wound to a UAP. What action by the new nurse causes the preceptor to intervene?

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NCLEX Practice Questions Skin Integrity and Wound Care Questions

Question 1 of 5

A new nurse is delegating care of a chronic, nonsterile wound to a UAP. What action by the new nurse causes the preceptor to intervene?

Correct Answer: A

Rationale: Wound assessment is a nursing responsibility and cannot be delegated to UAP.

Question 2 of 5

The nurse identifies which skin layer that delivers the blood supply to the dermis, provides insulation, and has a cushioning effect?

Correct Answer: C

Rationale: The subcutaneous layer supplies blood to the dermis and provides insulation and cushioning.

Question 3 of 5

The nurse is caring for a patient with a Stage IV pressure ulcer. Which type of healing will the nurse consider when planning care for this patient?

Correct Answer: B

Rationale: Stage IV ulcers, exposing bone or muscle, heal via full-thickness repair , per the text, involving four phases (hemostasis, inflammatory, proliferative, maturation) due to extensive loss. Partial-thickness suits shallow wounds. Primary intention is for closed incisions. Tertiary intention delays closure. Nurses plan debridement and grafting for full-thickness, per evidence-based care, making this the correct healing type.

Question 4 of 5

The nurse is caring for a patient who has experienced a total abdominal hysterectomy. Which nursing observation related to the incision will indicate the patient is experiencing a complication of wound healing?

Correct Answer: D

Rationale: A swollen, bluish incision suggests a hematoma a healing complication, per the flashcards, from blood pooling under tissues, risking vascular pressure. Pain and itching are normal post-op. Approximation is expected. Nurses intervene for hematomas, making this the correct observation.

Question 5 of 5

A patient presents to the emergency department with a laceration of the right forearm caused by a fall. After determining that the patient is stable, what is the next best step for the nurse to take?

Correct Answer: A

Rationale: Post-stabilization, bleeding , per the flashcards, is the next focus, as lacerations may hemorrhage, requiring control. Options B-D are missing, but bleeding precedes foreign body checks or tetanus. Nurses ensure hemodynamic stability, making this the correct step.

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