the nurse assesses a deep wound the area is covered by black and necrotic tissue what term would the nurse use when documenting this wound
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Nursing Elites

ATI RN

Multi Dimensional Care | Exam | Rasmusson

1. The nurse assesses a deep wound. The area is covered by black and necrotic tissue. What term would the nurse use when documenting this wound?

Correct answer: B

Rationale:

2. A client has sustained an open fracture. How can the nurse best prevent osteomyelitis in this client?

Correct answer: B

Rationale:

3. The nurse is assessing a client who had a cast placed 4 hours ago. What assessment finding is cause for concern?

Correct answer: B

Rationale: Inability to insert a finger between the cast and skin indicates the cast is too tight, risking circulation problems.

4. The nurse Is teaching the client how to administer eye drops. Which of these actions indicates the need for further client education?

Correct answer: D

Rationale: Touching the dropper to the eye contaminates it and can lead to infection.

5. Which finding is not typically associated with inflammation in a client?

Correct answer: C

Rationale: Polyuria is excessive urination and is not a typical assessment finding in inflammation. Inflammation commonly presents with pain (A), heat (B), and erythema (D) which are classic signs of an inflammatory response. Pain results from the release of inflammatory mediators, heat is due to increased blood flow, and erythema is caused by vasodilation and increased blood flow to the area. Polyuria is more likely associated with conditions such as diabetes or renal issues, rather than inflammation.

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