Download SEM580 Final Exam Review and more Exams Community Corrections in PDF only on Docsity! SEM580 Final Exam review #1 questions with correct answers Which of the following statements accurately reflects the origins of the WOC nursing specialty? A) the first education programs were 8 weeks long and required the learner be in residence during that period. B) the 1st WOC nurse specialized in wound care C) the first education programs had no precepted clinical practicum D) the origin of the specialty began with a patient who had a stoma. - correct answer -D) the origin of the specialty began with a patient who had a stoma. Margaret is a graduate of a WOCN accredited nursing education program. Having just completed the full scope of practice. Prior to sitting for her certification exam/s, she can: a. debride wounds in her facility b. use the title, WOC nurse c. recommend and prescribe antifungal agents. d. use the credential, WOCN. - correct answer -b. use the title, WOC nurse An essential component of a WOC nursing practice is: a. establishing an outcomes program to measure results of care. b. implements, coordinates, and evaluates specialty care. c. establishing a clinic for outpatient follow up d. billing for services provided. - correct answer -b. implements, coordinates, and evaluates specialty care. Evidence based practice: the highest level of evidence comes from which of the following sources? a. case studies b. prospective studies c. expert opinions d. randomized clinical trials - correct answer -d. randomized clinical trials Which of the following statements about clinical practice guidelines is true? a. these are basically recommendations for care of a specific condition based on expert opinion and case studies b. the literature from which the clinical guidelines are derived should be reviewed prior to incorporating the guidelines into patient care. c. to avoid the appearance of self interest, the national government authors all clinical practice guidelines. d. clinical guidelines are derived from the current literature and summarize state of the art care for specific healthcare issues. - correct answer -d. clinical guidelines are derived from the current literature and summarize state of the art for specific healthcare issues. What are the major layers of the skin? a. hypodermis and muscle b. epidermis and dermis c. keratinocytes and fibroblasts d. macrophages and platelets - correct answer -b. epidermis and dermis What is the benefit in the skin maintaining an acid mantle a. promotes skin hydration b. increases TEWL (trans epidermal water loss) c. retards growth of skin pathogens d. promotes skin elasticity - correct answer -c. retards growth of skin pathogens How does age alter the skin's epidermal turnover or process of differentiation? a. prolongs the rate of cell turnover (>28 days) b. reduces the rate of cell turnover (<28 days) c. doesn't affect the rate of cell turnover d. accelerates turnover to 5 days or less - correct answer -a. prolongs the rate of cell turnover (>28 days) b. friction and moisture between skin folds. c. chemical injury to the skin d. occlusion used with skin barriers - correct answer -b. friction and moisture between skin folds You are called to the neonatal intensive care unit regarding appropriate products to use on the skin of neonates. which of the following products would be considered safe to use on the neonate's skin? a. triple antibiotic ointment b. silicone c. adhesive removers d. balsam of peru - correct answer -b. silicone which of the following statements is true regarding MARSI (medical adhesive related skin injury) damage? a. partial or full thickness skin injury due to mechanical force of pressure b. partial thickness skin injury due to friction or moisture c. MARSIs are not usually preventable d. shave all hair prior to the application of an adhesive product - correct answer -b. partial thickness skin injury due to friction or moisture medical adhesive products can produce allergic or contact dermatitis. which of the following statements best demonstrates a skin reaction from the medical adhesive: a. Erythema with macules lesions. b. pustules with a hair piercing the center after shaving. c. well defined vesicles (small blisters) found upon removal of adhesive product d. wheal (raised edema of skin) anywhere on the body. - correct answer -c. well defined vesicles (small blisters) found upon removal of adhesive product. 90 year old female in a nursing home has a wound with a fully approximated skin flap on her left forearm. identify the type of skin damage present: a. stage 2 pressure injury b. skin tear, type 1 c. skin tear, type 2 d. skin tear, type 3 - correct answer -b. skin tear, type 1 which of the following treatments would be most appropriate for the management of a wound with a fully approximated skin flap? a. re-approximate edges and apply a non adherent dressing b. apply transparent film dressing c. apply hydrocolloid dressing d. utilize antibiotic ointment with gauze and kerlix (gauze bandage wrap) roll - correct answer -a. reapproximate edges and apply a non adherent dressing. which of the following statements is true in effective skin preparation prior to application of an adhesive product? a. prep the skin with an adhesion promoter such as tincture of benzoin b. standard skin preparation should include skin cleansing, dry and application of liquid skin barrier film c. excessive hair is removed with a clipper or scissors rather than shaved. d. defat the skin prior to application of adhesives with an acetone or alcohol. - correct answer -c. excessive hair is removed with a clipper or scissors rather than shaved. educate the patient and nursing staff to properly remove adhesives by: a. quickly removing the adhesive at a 90 degree angle to generate a high peel force. b. always using an adhesive remover. c. removing adhesives at a 30 degree angle while supporting the skin. d. use the push-pull technique and support the skin - correct answer -d. use the push-pull technique and support the skin in the lower extremity, the skin may be very friable, necessitating an adhesive alternative for dressing securement. select the ideal alternative. a. tubular elastic dressing b. open weave gauze wrap c. ace wraps d. fabric tape - correct answer -a. tubular elastic dressing an important aspect of the WOC nurse's role is knowledge and implementation of risk reduction strategies. select the best example of a risk reduction strategy. a. have the new WOC nurse make round and discuss care plans for the patients on the unit. b. focus on prevention and early detection of potential complications. c. identify strategies to increase staff and patient satisfaction d. implement all WOC cares for the patients so that you can assure quality. - correct answer -b. focus on prevention and early detection of potential complications. you have identified that an ostomy outpatient clinic is necessary to follow patients after they leave the hospital. what type of customer will be targeted as you develop your plan? a. influencers: regulatory bodies and insurance companies. b. end users: ostomy patients and their families c. decision makers- administrators d. influencers and end users - correct answer -c. decision makers- administrators Why is it important to clearly delineate your products and services to the health care team and care setting administration? a. administrators, nurses and providers can utilize a full range of your services. b. marketing efforts in the care system can identify a broad range of patient services it provides. regulatory bodies can recognize the proper use of your services. c. d. - correct answer -a. administrators, nurses and providers can utilize a full range of your services. which of the following is the primary purpose of a comprehensive patient assessment across the scopes? a. gather clues regarding the potential etiology of a wound, ostomy, or continence issue b. identify support systems to assist the patient at discharge c. documentation of events to report to risk management Define a cyst - correct answer -Elevated, circumscribed, encapsulated lesion in dermis or subcutaneous layer; filled with liquid or semisolid material; E.g., Sebaceous cyst, cystic acne Define a wheal - correct answer -circumscribed, irregular-shaped, elevated area of cutaneous edema; solid, transient; E.g., insect bite, allergic reaction, TB test Define a Bulla - correct answer -Vesicle >1 cm; E.g., Large blister, bullous pemphigus Define Telangiectasia - correct answer -fine, irregular red lines produced by capillary; E.g., Rosacea around nose, spider veins Define purpura - correct answer -extravasation of blood in the skin causing macules and papules (about 2mm), larger spots-ecchymosis (bruise) Define petechiae - correct answer -Tiny 1-2 mm, red macules, result from tiny hemorrhages Define Excoriation - correct answer -Linear epidermal abrasion caused by scratching (term frequently confused with erosion). Define candidiasis - correct answer -Most common type of skin infection. • Intertriginous dermatitis (ITD) and Incontinence associated dermatitis (IAD) are more prone to secondary microbial/fungal skin infections. Both types of Moisture associated skin damage (MASD) are found in dark, warm, & moist environments that have higher levels of residential microbial flora! Description: Burning, itching (pruritus), erythema, & scaling, maculopapular rash with satellite lesions (key indicator), advancing border with central redness. clinical presentation yields your diagnosis. TREATEMENT- topical antifungal. antifungal powder OTC lightly dusted. Cream not good in an already moist area Define a Fissure - correct answer -Linear crack in epidermis, may be moist or dry; E.g., athlete's foot, dry heels erosion of skin - correct answer -Loss of epidermis Define scaling of skin - correct answer -Heaped up, keratinized cells; flaky skin, irregular; thick or thin; E.g. dry skin, seborrheic dermatitis Define a crust - correct answer -Dried serum, blood, or exudate which varies in color; E.g., scab on abrasion Define a scab - correct answer -A dry, protective crust that forms over a cut or wound. Not to be confused with eschar. Define a Hemosiderin - correct answer -Brownish pigment caused by the breakdown of blood hemoglobin in red blood cells. Iron and other byproducts are released from hemoglobin through leaking small blood vessels and converted into hemosiderin. This shows up as a brown stains or even bruise like staining on the skin and is a sign of chronic venous insufficiency. Define a lipodermatosclerosis - correct answer -Chronic inflammatory condition characterized by subcutaneous fibrosis and hardening of the skin on the lower legs. Causes a tapering of the leg to an inverted champagne bottle shape. Define atrophie blanche - correct answer -Atrophie blanche (white atrophy) is the name given to a particular type of angular scar arising on the lower leg or foot. Is a spontaneously developing lesion, often mistaken for a scar of previous ulceration Define a Lichenification - correct answer -Rough, thicken epidermis due to chronic rubbing, itching; E.g., chronic dermatitis Define a atrophy - correct answer -Thinning of skin surface with loss of landmarks, skin is paper like; E.g., thinned, aged skin Define a hypertrophic scar - correct answer -Thicken, wide, raised scar due to over production of collagen; E.g., surgical incision Define a keloid - correct answer -Irregular-shaped, grossly & progressively elevated scar that grows beyond boundary of wound Define a abcess - correct answer -Collection of pus in a localized area of tissue surrounded by inflammation Define a dermatitis - correct answer -Generic term meaning inflammation of the skin due to irritation (i.e. sun, products, meds, edema, etc.) evidenced by itching, redness, and various skin lesions Define denuded - correct answer -Loss of epidermis due to exposure to urine, feces, body fluids, wound exudate or friction. Superficial erosions Define maceration - correct answer -Softening and breaking down of the skin due to prolong exposure to moisture. Appears whiter or lighter in color than the skin next to it; often appears water-logged Define a callus - correct answer -Thickening of the epidermis in response to friction or pressure Define a Granulation - correct answer -New vascular tissue in a wound healing by secondary intention that appears beefy red, velvety and cobblestone appearance. Define a hypergranulation - correct answer -Overgrowth of granulation tissue that is often appears pale or deep red, boggy, and friable (bleeds easily). Define a epithelialization - correct answer -Process of epithelial cells migrating from wound margin or from hair follicles to complete wound healing causing a pink to lavender color. Define a slough - correct answer -Non-viable tissue that is soft, moist, that can vary in color (white, yellow, tan, gray, or green), may be loose or firmly adherent. Define a eschar - correct answer -Black or brown non-viable tissue, can be loose or firmly adherent, hard, soft, or soggy.