Wound Healing - Practice Questions

A client has limited mobility of the shoulders due to inadequate healing. Which complication of healing would have led to the limited mobility of the shoulders?

Contractures

What type of wound healing problem are inflexible shrinkage of wound tissue as the body closes the wound?

Contractures

Secondary intention wound healing

Large, open wounds, which require more tissue replacement and are often contaminated. - think bed sore - epithelialization, scar formation, and contracture takes longer

A patient is recovering from ankle surgery and states that his ankle "feels stuck" when he tries to move into some positions. The nurse is worried that the continued decreased mobility may be because of which of the following developments? 1. Adhesions 2. Primary intention 3. Keloid formation 4. Fistula

1. Adhesions

A nurse is explaining a tertiary intention healing to a patient. Which of the following characteristics are correct for the nurse to include in her explanation? 1. Common post-surgical wound 2. May require temporary packing with sterile gauze 3. May be left open for 4 to 5 days 4. May have extensive drainage 5. Wound that forms with stitching of incisions

2, 3, 4

What are abnormal bands of internal scar tissue that may form following surgery?

Adhesions

Which condition is an example of wound healing by secondary intention?

An infected burn of the arm

A patient underwent an open cholecystectomy 4 days ago and her incision is now in the proliferative phase of healing. The nurse knows that the next step in the process of wound healing is: A. Inflammation B. Maturation C. Remodeling D. Coagulation

C. Remodeling

When you examine the wound, you note the appearance of redness and warmth. Fluid appearing to contain cells and proteins, known as _________, is seeping from the edges of the wound.

Exudate

What may occur between different areas of tissue or different organs?

Fistulas

What is necessary to fill in the gap in secondary intention wound healing?

Granulation and fibrous tissue

John, age 37, appears at your clinic complaining of pain and soreness in his knee. Several days prior, John had undergone shoulder surgery to repair a tear in the medial meniscus. The surgical laceration is considered a _________________ intention.

Primary

A surgical wound/incision is what type of wound healing

Primary intention

What type of wound healing occurs with clear wound edges and no missing tissue?

Primary intention

Pressure ulcers and severe burns are examples of wounds that require what type of healing?

Secondary and tertiary

What type of wound healing occurs with an extensive loss of tissue (gap), prolonged healing, and scar tissue formation?

Secondary intention

When caring for a client with a wound that is healing by primary intention, the nurse recognizes which characterization best describes this type of wound?

Surgical incision

What type of wound healing occurs with missing a large amount of tissue that is contaminated?

Tertiary intention

The nurse is caring for a client with an infected wound that is left to heal by secondary intention. Which observation does the nurse expect to make during assessment of the wound area?

The wound is healing slowly with epithelial and scar tissues present.

Which stage of wound healing is characterized by increased vascular permeability and the migration of leukocytes into the extravascular space, vasodilation starts about 10-15 minutes after initial vasoconstriction a. inflammation b. hemostasis c. cellular migration d. protein synthesis

a (inflammation, vasodilation allows development of edema which leads to pain, this is why you wait a few minutes after you're done to check for bleeding)

When a nurse is asked which cell plays an active role in collagen deposition during wound healing, how should the nurse respond? a) mast cell b) elastase c) Fibroblast d) Osteocyte

c) Fibroblast

During which phase of wound healing does contraction occur? a) Epithelialization b) Inflammation c) Proliferation d) Remodeling

c) Proliferation

After abdominal surgery, an obese patient reports to the nurse that something has popped and now there is clear drainage coming from the wound. Which condition does the nurse realize the patient is experiencing? a) Keloid formation b) Excessive bleeding c) Contraction of the wound d) Wound dehiscence

d) Wound dehiscence

What is primary function of inflammation phase? a. allow re-establishment of epithelial surface as well as revascularization b. replace damaged tissue with scar tissue c. deposit proteins in the wound d. bring inflammatory cells to area to destroy bacteria and eliminate debris of dying cells and damaged matrix

d. bring inflammatory cells to area to destroy bacteria and eliminate debris of dying cells and damaged matrix

During which stage of wound healing is damaged tissue replaced with Scar tissue. Lots of collagen, less edema/inflammation. Granulation tissue is characteristic a. inflammation b. hemostasis c. cellular migration d. protein synthesis e. proliferation

e. proliferation

This stage of wound healing is characterized by erythema, edema, heat and pain. _______

inflammation

The plan of care for the patient with wound healing includes the prevention of contractures. The development of contractures can lead to:

limited movements at joints and impaired blood flow

Closure by ______ intention is when wound is closed by direct approximation of wound edges, involves immediate coverage with epithelial elements

primary (ideally wound has minimal edema, no infection, no separation of edges, Minimal scar formation)

The nurse is assessing the wound of a postoperative client. The client has a 6-inch abdominal wound that is well approximated and closed with surgical suture. The wound does not display any redness or drainage. The nurse would document the healing process as:

primary intention

Excessive granulation tissue build up is more likely in healing by (primary/secondary) intention

secondary

When the wound is left open and allowed to heal spontaneously this is closure by _____ intention

secondary

A patient has a large, deep (stage IV) pressure ulcer. The nurse will observe the wound heal through the process of

secondary intention

Wounds that are contaminated or dirty, infected traumatic wounds, and wounds that need debridement of nonviable tissues is done using _____ intention

tertiary (goal is low bacterial counts, this is the whole, cleaning from the bottom up thing)

After abdominal surgery, an obese patient reports to the nurse that something popped and now there is clear drainage coming from the wound. Which condition does the nurse realize the patient is experiencing?

wound dehiscence

Primary intention wound healing

wounds that heal under conditions of minimal tissue loss - think paper cut or sutured surgical wound (clean incision)