ATI LPN
NCLEX Questions Skin Integrity and Wound Care Questions
Question 1 of 5
The nurse identifies which syringe to use when irrigating a patient's deep wound?
Correct Answer: D
Rationale: A 30- to 50-mL syringe with an 18-gauge catheter provides the recommended 4-15 psi for deep wound irrigation.
Question 2 of 5
Which patient will the nurse see first?
Correct Answer: C
Rationale: Priority follows acuity. Appendicitis with a heating pad , per the flashcards, risks rupture an emergency outweighing a chronic Stage IV ulcer . A Braden score of 18 is low risk. An approximated incision is normal. Heat exacerbates inflammation, per nursing principles, demanding immediate nurse action to prevent peritonitis, making this the correct first patient.
Question 3 of 5
Which finding will alert the nurse to a potential wound dehiscence in a postoperative patient?
Correct Answer: C
Rationale: Dehiscence wound layer separation often presents with a patient feeling something has given way' , per the flashcards, especially post-strain (e.g., coughing). Options A, B, and D are incomplete, but organ protrusion (evisceration) or drainage differ. This report triggers urgent nurse assessment, making it the correct alert.
Question 4 of 5
The nurse is caring for a patient on the medical-surgical unit with a wound that has a drain and a dressing that needs changing. Which action should the nurse take first?
Correct Answer: A
Rationale: Dressing changes hurt. Providing analgesics first , per the flashcards, eases pain 30 minutes prior, aiding cooperation. Avoiding drain removal , gloves , and supplies follow. Pain management sets the stage, making this the correct first action.
Question 5 of 5
The nurse is completing a skin risk assessment using the Braden Scale. The patient has slight sensory impairment, has skin that is rarely moist, walks occasionally, and has slightly limited mobility, along with excellent intake of meals and no apparent problem with friction and shear. Which score will the nurse document for this patient?
Correct Answer: C
Rationale: Braden scores (6-23) assess risk; higher is better. Per the flashcards: slight sensory (3), rarely moist (4), walks occasionally (3), slight mobility (3), excellent intake (4), no friction/shear (4) = 20 . This is moderate risk, making it the correct score.