Wound, Ostomy, and Continence Nursing (WOCN) Exam Review: Questions and Answers, Exams of Social Sciences

Download Wound, Ostomy, and Continence Nursing (WOCN) Exam Review: Questions and Answers and more Exams Social Sciences in PDF only on Docsity! 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. - Answers- D) the origin of the specialty began with a patient who had a stoma. 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 - Answers- 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. - Answers- d. Clinical guidelines are derived from the current literature and summarize state of the art for specific healthcare issues. SEM580 FINAL EXAM REVIEW # 1 QUESTIONS AND ANSWERS What are the major layers of the skin? A. Hypodermis and muscle B. Epidermis and dermis C. Keratinocytes and fibroblasts D. Macrophages and platelets - Answers- 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 - Answers- 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 - Answers- a. Prolongs the rate of cell turnover (>28 days) Intertriginous dermatitis (ITD) is differentiated from incontinence associated 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 - Answers- d. The source of moisture and location are different Select the statement that is most true regarding IAD (incontinence associated dermatitis) management A. Skin barrier pastes should be removed entirely following fecal incontinent episodes B. Petroleum based products may reduce the absorbency of disposable undergarments. C. Humectants are an important ingredient in incontinence skin care products D. Soap and water should be used for incontinence skin care management. - Answers- b. Petroleum based products may reduce the absorbency off disposable undergarments. Which statement about incontinence related skin damage is true? A. Exposure to a mixture of urine and feces is more irritating than feces alone. B. The area of skin damaged by incontinent episodes is characterized by pinpoint satellite lesions along the periphery. C. Containment garments alone are the most effective way to protect the skin from liquid stool D. Urine with an acidic ph is more damaging to the skin than urine with an alkaline ph. - Answers- a. Exposure to a mixture of urine and feces is more irritating than feces alone. 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 - Answers- 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. - Answers- 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 - Answers- 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 - Answers- 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. - Answers- 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 - Answers- 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. - Answers- 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 D. Documentation to support referral to a dietician - Answers- a. Gather clues regarding the potential etiology of a wound, ostomy, or continence issue 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 7.0 C. Use of a colostomy pouch D. Good blood sugar control - Answers- a. History of radiation 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 inspection. 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. - Answers- b. Patients at risk for skin breakdown should have at least a daily skin inspection. 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. - Answers- c. Reviewing written education materials with patient and family and asking for questions or clarifications. 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. - Answers- a. Patient can empty pouch independently 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. - Answers- d. The patient is intermittently using a walker but has an unstable gait. Define a Macule - Answers- Flat, circumscribed skin discoloration <1 cm; E.g., freckle, flat mole, petechia Define a patch - Answers- Flat, nonpalpable, irregular-shaped macule >1cm; E.g., vitiligo, port-wine stain Define a papule - Answers- Elevated, firm, circumscribed palpable area of skin <1 cm; E.g., wart, elevated mole Define a Nodule - Answers- Elevated, firm circumscribed, palpable area deeper in dermis than a papule 1-2 cm; tumor if > 2cm Define Plaque - Answers- Elevated, firm, rough lesion with flat top surface >1 cm; E.g., Psoriasis, seborrheic keratosis Define a vesicle - Answers- Elevated, circumscribed serous fluid beneath the epidermis <1cm; E.g., chicken pox, herpes zoster Define a pustule - Answers- Elevated, superficial lesion like a vesicle but filled with purulent fluid; E.g., Acne, impetigo Define a cyst - Answers- Elevated, circumscribed, encapsulated lesion in dermis or subcutaneous layer; filled with liquid or semisolid material; E.g., Sebaceous cyst, cystic acne Define a wheal - Answers- circumscribed, irregular-shaped, elevated area of cutaneous edema; solid, transient; E.g., insect bite, allergic reaction, TB test Define a Bulla - Answers- Vesicle >1 cm; E.g., Large blister, bullous pemphigus