ATI LPN
Skin Integrity and Wound Care NCLEX Questions Quizlet Questions
Question 1 of 5
You assume care of a patient with active pulmonary tuberculosis. Appropriate management includes:
Correct Answer: C
Rationale: TB spreads via droplets. Standard Precautions plus airborne precautions e.g., N95 masks, negative pressure rooms control transmission, per CDC. Special rooms are part but incomplete. Face shield/gown fits contact, not airborne. Antimicrobials treat, not manage spread. Airborne precautions are the core, an LPN duty, making it the correct management.
Question 2 of 5
A 25-year-old patient complains of moderate incision pain post-morphine IV. The most appropriate action after injection is:
Correct Answer: B
Rationale: Post-IV morphine (peak 20-30 min), encouraging rest enhances relief, per pain protocols, calming the patient. Evaluating in 2 hours delays 30 min is standard. Distraction is adjunct, not primary. Ibuprofen overlaps unnecessarily. Rest leverages morphine's effect, an LPN step, making it the correct action.
Question 3 of 5
How should the nurse document a healing Stage III pressure ulcer with healthy tissue observed?
Correct Answer: C
Rationale: A Stage III pressure ulcer involves full-thickness skin loss with visible fat. When healing with healthy tissue, it's documented as 'Healing Stage III' (Choice C), per staging guidelines, retaining its original stage while noting progress. Stage I is nonblanchable redness, not applicable. Healing Stage II implies partial-thickness, underrepresenting depth. Stage III without 'healing' ignores improvement. Accurate documentation reflects the wound's history and current state, aiding care continuity and reimbursement, making 'Healing Stage III' the correct choice for this scenario.
Question 4 of 5
For which type of healing will the nurse focus the care plan for a patient who has experienced a laparoscopic appendectomy?
Correct Answer: D
Rationale: A laparoscopic appendectomy, with small, clean incisions, heals by primary intention (Choice D), per the text, where edges are approximated, minimizing infection risk and scarring. Partial-thickness repair is for shallow wounds. Secondary intention suits open, tissue-loss wounds. Tertiary intention delays closure. Primary intention's quick healing guides nurses to monitor for infection and support closure, making this the correct focus for care planning.
Question 5 of 5
Which assessment data will be most important for the nurse to gather with regard to wound healing?
Correct Answer: B
Rationale: Pulse oximetry measures oxygen saturation, vital for wound healing, per the text, as oxygen fuels cellular repair. Muscular strength and sensation assess mobility and nerve function, not healing directly. Sleep aids recovery but isn't specific. Adequate oxygenation (e.g., >90%) prevents hypoxia-related delays, making this the correct priority data for nurses to gather.