Alt of Tissue Integrity & Mobility Study Test

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Alt of Tissue Integrity & Mobility

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Kay

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Alt of Tissue Integrity & Mobility Study Test


Alt of Tissue Integrity & Mobility Study TestOnline version Alt of Tissue Integrity & Mobility by Kay 1 Which of the following is an example of a first-degree burn? a Sunburn b Blistering from flames c Blackened dead skin d Excessive scaring 2 Which of the following is a potential complication of a chronic wound? a Fluid volume overload b Altered hemoglobin c Electrolyte abnormalities d Psychological distress 3 Which of the following interventions would reduce the risk for skin injury? a Utilize adult diapers to manage incontinence b Apply moistening dressing to wounds with exudate c Use water or adhesive remover to take off medical adhesive d Disinfect the skin with alcohol-based wound cleasers 4 The skin has a large abrasion that is warm, darker than the surrounding skin and edematous. Which of the following states of healing is the wound in? a Hemostasis and inflammation b Tissue remodeling c Proleration d Calcification 5 Which of the following pairing represents the correct skin layer and function? a Dermis - contains hair folicles b Epidermis - contains sweat glands c Hypodermis - contains a moisture barrier d Epidermis - contains adipose lobules 6 Which of the following pairings reflect the correct wound infection state with the description? a Colonization - Replicating microorganisms; not yet infected b Contaminated - infection beyond the wound c Systemic infection - wound is darker than the surrounding skin with noted drainage present d 7 The client does not understand how smoking may impact wound healing. Which of the following would be the best nurse response? a Nicotine causes vasoconstriction so your wound might not get enough blood flow to heal b Smoking is bad and you should stop right away. c Nicotine causes tar build up d 8 Which of the following clients is most prone to skin infections? a A 35 yr old receiving chemotherapy b A 60-yr old with gastritis c A 20 yr old with a closed tibia fracture d A 55 yr old take an ACE inhibitor 9 Which of the following practices will decrease friction injuries? a Assist the client with a trapeze to raise their body while staff assists with repositioning b Have 2 or 3 staff pull the client up in bed when needed c Elevate the head of the bed 90 degrees for bedridden patients d 10 Which of the following cultural considterations should the nurse consider when making the plan of care for wounds? a Food preferences when making a nutrition plan b The cost of wound dressings c The time it will take to complete the dressing changes d 11 A patient with a stress foot fracture, which of the following explanations by the nurse is appropriate? a I suspect you do a lot of the routines repeatedly which can cause a lot a stress on the bones b Did you fall off a balance beam c You will have to ask the provider about this d 12 Strategies to hep keep low back pain from becoming chronic. Which of the following is appropriate for the nurse to make at this time? a Try to maintain good posture and strengthen your core b Try to get plenty of rest every night c There is nothing you can do d 13 Which of the following are most likely to become chronic wounds? a Abdominal surgical incision b Posterior scalp wound c Diabetic foot ulcer d Cluster of oral herpes sores 14 The client states that since the wound is small the burn must not be too bad. Which of the following is the best response by the nurse? a Electrical burns can have small amounts of skin damage, but more extensive damage beneath the skin b Electrical burns are typically minor c d 15 A patient with osteoporosis in the vertebral bones of the thoracic spine. Which of the following assessments should the nurse be alert to? a Limited range of motion in the arms b Stiff joints especially in the morning c Shortness of breath d Chronic pain 16 A patient is at risk for complications of immobility, which of the following interventions should the nurse include to prevent complications? a Encourage the patient to sit in the chair for all meals b Have the patient remain in bed for self-care activities c Elevate the head of the bed 3-040 degrees d 17 The nurse identifies that which of the following factors associated with aging may impact the ability for the ulcer to heal? a Decreased protein level b Elevated hemoglobin c Increased muscle mass d Low bone density 18 A painful blistery rash that has occurred on the left side of the chest, the nurse identifies that it is most likely which of the following? a Shingles b Impetigo c Cellulitis d Yeast infection 19 Which of the following patients is most likely to have a moisture related skin condition? a A patient in the ICU in a coma b A patient who recently delivered a baby c A patient in the ER for asthma d A patient who is post off day 1 for an appendectomy 20 A patient with Peripheral artery disease who has an arterial ulcer. Which of the following best describes the mechanism for developing the clinical problem? a Decreased blood flow to the area can cause the wound and decrease healing b Swelling of the lower extremity can create a wound c d 21 Which layer of skin contains collagen, blood vessels, and nerve endings? a Dermis b Epidermis c Subcutaneous layer d Keratin layer 22 The epidermis primarily functions to: a Provide protection b Store fat c Produce blood cells d Cushion bones 23 The subcutaneous layer is responsible for: a Insulation and cushioning b Pigmentation c Blood supply d Nerve transmission 24 Which best describes contamination? a Bacteria present but not multiplying b Infection spreading systemically c Bacteria multiplying with no infection response d Redness and drainage present 25 Colonization occurs when: a Bacteria multiply without infection response b Infection enters bloodstream c Skin is intact and sterile d Tissue is necrotic 26 Select all that apply: Signs of local infection include: Choose one or more answers a Redness b Pain c Drainage d Sepsis e Cellulitis beyond wound 27 Which indicates spreading infection? a Cellulitis around wound b Redness only at wound c No symptoms d Dry wound bed 28 Systemic infection involves: a Bacteria in bloodstream b Local redness c No symptoms d Wound healing 29 Which condition is most likely to become chronic? a Pressure injury b Acne c Sunburn d Bruise 30 Systemic Causes of Chronic Wounds - Select all that apply: Choose one or more answers a Diabetes b Malnutrition c Rheumatoid arthritis d Minor cuts 31 A major complication of psoriasis is: a Psoriatic arthritis b Osteoporosis c Lung disease d Kidney failure 32 Which patient is seen first? a Acute infection b Healing wound c Chronic ulcer d Old scar 33 Stage 1 Pressure Injury - Characteristic finding: a Non-blanchable redness b Open wound c Bone exposure d Blister rupture 34 Nurse Factor in Wound Care - Select all that apply: Choose one or more answers a Experience level b Stress level c Cognitive load d Patient age 35 Thoracic Osteoporosis Findings: a Kyphosis b Increased height c Enlarged joints d Fever 36 PAD Symptom - Select all that apply: Choose one or more answers a Cool skin b Weak pulses c Swelling d Claudication 37 Burn 50% TBSA Complication - Select all that apply: Choose one or more answers a Infection risk b Fluid loss c Hyperkalemia d Increased strength 38 Infection Priority Wound - Which client is highest priority? a Wound with purulent drainage b Chronic venous ulcer c Healing wound d Dry scar 39 Which findings indicate urinary retention? - Select All that Apply Choose one or more answers a Distended abdomen b Inability to void c Frequent urination d Low back pressure 40 Select all that apply as causes of early hyperkalemia in burns: Choose one or more answers a Cell destruction b Potassium release into bloodstream c Kidney failure immediately d Tissue breakdown

Alt of Tissue Integrity & Mobility Study Test

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Alt of Tissue Integrity & Mobility Study TestOnline version

by Kay

Which of the following is an example of a first-degree burn?

Which of the following is a potential complication of a chronic wound?

Which of the following interventions would reduce the risk for skin injury?

The skin has a large abrasion that is warm, darker than the surrounding skin and edematous. Which of the following states of healing is the wound in?

Which of the following pairing represents the correct skin layer and function?

Which of the following pairings reflect the correct wound infection state with the description?

The client does not understand how smoking may impact wound healing. Which of the following would be the best nurse response?

Which of the following clients is most prone to skin infections?

Which of the following practices will decrease friction injuries?

Which of the following cultural considterations should the nurse consider when making the plan of care for wounds?

A patient with a stress foot fracture, which of the following explanations by the nurse is appropriate?

Strategies to hep keep low back pain from becoming chronic. Which of the following is appropriate for the nurse to make at this time?

Which of the following are most likely to become chronic wounds?

The client states that since the wound is small the burn must not be too bad. Which of the following is the best response by the nurse?

A patient with osteoporosis in the vertebral bones of the thoracic spine. Which of the following assessments should the nurse be alert to?

A patient is at risk for complications of immobility, which of the following interventions should the nurse include to prevent complications?

The nurse identifies that which of the following factors associated with aging may impact the ability for the ulcer to heal?

A painful blistery rash that has occurred on the left side of the chest, the nurse identifies that it is most likely which of the following?

Which of the following patients is most likely to have a moisture related skin condition?

A patient with Peripheral artery disease who has an arterial ulcer. Which of the following best describes the mechanism for developing the clinical problem?

Which layer of skin contains collagen, blood vessels, and nerve endings?

The epidermis primarily functions to:

The subcutaneous layer is responsible for:

Which best describes contamination?

Colonization occurs when:

Select all that apply: Signs of local infection include:

Which indicates spreading infection?

Systemic infection involves:

Which condition is most likely to become chronic?

Systemic Causes of Chronic Wounds - Select all that apply:

A major complication of psoriasis is:

Which patient is seen first?

Stage 1 Pressure Injury - Characteristic finding:

Nurse Factor in Wound Care - Select all that apply:

Thoracic Osteoporosis Findings:

PAD Symptom - Select all that apply:

Burn 50% TBSA Complication - Select all that apply:

Infection Priority Wound - Which client is highest priority?

Which findings indicate urinary retention? - Select All that Apply

Select all that apply as causes of early hyperkalemia in burns: