ATI LPN
Skin Integrity and Wound Care Questions Questions
Question 1 of 5
Which nursing observation will indicate the wound healed by secondary intention?
Correct Answer: D
Rationale: Secondary intention, per the flashcards, results in severe scarring as open wounds fill with scar tissue, often impairing function. Options A-C are missing, but minimal scarring or redness don't fit. Nurses observe this in burns or ulcers, noting prolonged healing and infection risk, making this the correct indicator.
Question 2 of 5
The nurse caring for a patient with a healing Stage III pressure ulcer notes that the wound is clean and granulating. Which health care provider's order will the nurse question?
Correct Answer: B
Rationale: Dakin's solution , per the flashcards, is cytotoxic, harming clean granulation tissue, and should be questioned. Low-air-loss , hydrogel , and dietitian consults support healing. Nurses advocate for saline, making this the correct order to challenge.
Question 3 of 5
The nurse is caring for a patient who is immobile and wants to decrease the formation of pressure ulcers. Which action will the nurse take first?
Correct Answer: C
Rationale: Prevention starts with assessment. Determining risk factors , per the flashcards, identifies vulnerabilities for tailored care. Fluids and nutrition support later. Turning follows risk ID. This ensures effective planning, making it the correct first action.
Question 4 of 5
A patient at risk for skin impairment is able to sit up in a chair. How long should the nurse schedule the patient to sit in the chair?
Correct Answer: A
Rationale: Sitting over 2 hours risks ischemia on ischial tuberosities. Less than 2 hours at a time , per the flashcards, balances mobility and safety. Total daily limits or 30-minute caps are impractical. Comfort-based ignores objective risk. This standard prevents ulcers, making it the correct duration.
Question 5 of 5
The nurse is caring for a postoperative patient recovering from a medial meniscus repair of the right knee. Which action should the nurse take to assist with pain management?
Correct Answer: D
Rationale: Ice (implied Choice D), per nursing practice, reduces pain and swelling post-knee repair. Options are missing, but vital signs or pulses don't relieve pain directly. This evidence-based action, making it the correct choice.