SEM580 Final Exam Review 1: Wound, Ostomy, and Continence Nursing, Exams of Nursing

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SEM580 Final Exam Review 1 Questions with Answers

1.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.: D) the origin of the specialty began with a

patient who had a stoma.

2.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.: b. use the title, WOC nurse

3.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.: b. implements, coordinates, and evaluates spe- cialty care.

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4.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: d. randomized clinical trials

5.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.: d. clinical guidelines are derived from the current literature and summarize state of the art for specific healthcare issues.

6.What are the major layers of the skin?

a. hypodermis and muscle

b. epidermis and dermis

c. keratinocytes and fibroblasts

d. macrophages and platelets: b. epidermis and dermis

7.What is the benefit in the skin maintaining an acid mantle

a. promotes skin hydration

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a. hypodermis

b. subcutaneous

c. dermis

d. muscle: d. muscle (inside out damage)

12.what is the definition of MASD?

a. skin damage caused by prolonged exposure to various sources of moisture.

b. skin damage that is due to stripping action while cleansing the skin with soap and water

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c. skin damage due to radiation dermatitis.

d. skin damage due to infiltration of medication.: a. skin damage caused by prolonged exposure to various

sources of moisture.

13.understanding the physiology of skin when it is injured by MASD is impor- tant. skin that is occluded by an

absorptive type of product (i.e. adult brief) results in what altered skin barrier effect?

a. decrease in TEWL and skin pH

b. increase in TEWL and skin pH

c. less perspiration

d. reduced friction: b. increase in TEWL and skin pH

14.intertriginous dermatitis (ITD) is differentiated from incontinence associ- ated skin damage (IAD) in that:

a. IAD only occurs in skin folds

b. IAD may be complicated by bacterial or fungal infection

c. ITD only occurs between the buttocks

d. the source of moisture and location are different: d. the source of moisture and location are different

15.select the statement that is most true regarding IAD (incontinence associ- ated dermatitis) management

a. skin barrier pastes should be removed entirely following fecal incontinent episodes

b. petroleum based products may reduce the absorbency of disposable un- dergarments.

c. humectants are an important ingredient in incontinence skin care products

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d. balsam of peru: b. silicone

19.which of the following statements is true regarding MARSI (medical adhe- sive 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: b. partial thickness skin injury due to

friction or moisture

20.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 prod- uct

d. wheal (raised edema of skin) anywhere on the body.: c. well defined vesicles (small blisters) found upon removal

of adhesive product.

21. 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: b. skin tear, type 1

22.which of the following treatments would be most appropriate for the man- agement of a wound with a fully

8 / 16 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: a. reapproximate edges and

apply a non adherent dressing.

23.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 applica- tion 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.-

: c. excessive hair is removed with a clipper or scissors rather than shaved.

24.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: d. use the push-pull technique and support the skin

25.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

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c.

d. : a. administrators, nurses and providers can utilize a full range of your services.

29.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 conti- nence issue

b. identify support systems to assist the patient at discharge

c. documentation of events to report to risk management

d. documentation to support referral to a dietician: a. gather clues regarding the potential etiology of a wound,

ostomy, or continence issue

30.as you obtain your past medical history, your patient with metastatic colon cancer divulges he is having

problems with keeping his skin from getting sore between his buttocks. which of the following may contribute to his skin problem?

a. history of radiation

b. use of skin care products with pH 7.

c. use of a colostomy pouch

d. good blood sugar control: a. history of radiation

31.You have a patient in acute care who has multiple risk factors for skin breakdown. which of the following

statements are true regarding frequency of skin assessments?

a. a head to toe assessment should be done only upon initial admission

b. patients at risk for skin breakdown should have at least a daily skin inspec- tion.

c. skin inspection should be performed twice an eight-hour shift for those at risk

d. skin inspections should only be done daily if the patient has a wound.: b. patients at risk for skin breakdown

11 / 16 should have at least a daily skin inspection.

32.which of the following is an example of a patient centered goal?

a. use of compression stockings in a patient with severe hand arthritis who

lives alone

b. setting weekly wound center visits in a patient with limited finances who lives 70 miles from the center.

c. reviewing written education materials with patient and family and asking for questions or clarifications.

d. inform the patient that they must stop smoking or the wound will not heal.: c. reviewing written education

materials with patient and family and asking for questions or clarifications.

33.which of the following reflect a short term goal in a patient with an ostomy?

a. patient can empty pouch independently

b. patient is able to manage simple peristomal skin problems.

c. patient is independent in ostomy care

d. patient performs a return demonstration on pouch change.: a. patient can empty pouch independently

34.your patient is being discharged to home. you have assessed the following barriers to care for this patient but

note one issue that is unresolved. which of the following represents an unresolved barrier to care?

a. the patient has meals delivered to the home.

b. the patient is continuing to take his medications for hypertension and anxiety.

c. the family has helped to develop strategies for managing the patient's poor dexterity.

d. the patient is intermittently using a walker but has an unstable gait.: d. the patient is intermittently using a

walker but has an unstable gait.

35.Define a Macule: Flat, circumscribed skin discoloration <1 cm; E.g., freckle, flat mole, petechia

13 / 16 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 indi- cator), 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

50.Define a Fissure: Linear crack in epidermis, may be moist or dry; E.g., athlete's foot, dry heels

51.erosion of skin: Loss of epidermis

52.Define scaling of skin: Heaped up, keratinized cells; flaky skin, irregular; thick or thin; E.g. dry skin, seborrheic

dermatitis

53.Define a crust: Dried serum, blood, or exudate which varies in color; E.g., scab on abrasion

54.Define a scab: A dry, protective crust that forms over a cut or wound. Not to be confused with eschar.

55.Define a Hemosiderin: Brownish pigment caused by the breakdown of blood hemoglobin in red blood cells. Iron

and other byproducts are released from hemo- globin 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.

56.Define a lipodermatosclerosis: 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.

57.Define atrophie blanche: 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

58.Define a Lichenification: Rough, thicken epidermis due to chronic rubbing, itching; E.g., chronic dermatitis

59.Define a atrophy: Thinning of skin surface with loss of landmarks, skin is paper like; E.g., thinned, aged skin

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60.Define a hypertrophic scar: Thicken, wide, raised scar due to over production of collagen; E.g., surgical incision

61.Define a keloid: Irregular-shaped, grossly & progressively elevated scar that grows beyond boundary of wound

62.Define a abcess: Collection of pus in a localized area of tissue surrounded by inflammation

63.Define a dermatitis: 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

64.Define denuded: Loss of epidermis due to exposure to urine, feces, body fluids, wound exudate or friction.

Superficial erosions

65.Define maceration: 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

66.Define a callus: Thickening of the epidermis in response to friction or pressure

67.Define a Granulation: New vascular tissue in a wound healing by secondary intention that appears beefy red,

velvety and cobblestone appearance.

68.Define a hypergranulation: Overgrowth of granulation tissue that is often ap- pears pale or deep red, boggy, and

friable (bleeds easily).

69.Define a epithelialization: Process of epithelial cells migrating from wound margin or from hair follicles to

complete wound healing causing a pink to lavender color.

70.Define a slough: Non-viable tissue that is soft, moist, that can vary in color (white, yellow, tan, gray, or

green), may be loose or firmly adherent.

71.Define a eschar: Black or brown non-viable tissue, can be loose or firmly adherent, hard, soft, or soggy.

72.Define a epibole: Rolled under edges, premature closure, often in a longstand- ing wound. Contact inhibition-

wound thinks it is closed.

73.as a specialist, the mini-nutritional assessment tool is useful primarily because it:

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d. liver, lean meat, or poultry high in iron.: a. whole grains and foods fortified with b vitamins

remember that vitamin b12 is absorbed in the ileum (most distal section of small intestine). Also good for those following a vegan diet.