Author Question: A nurse is assessing the wound in the right hip of a client following surgery. The wound has clean ... (Read 109 times)

olgavictoria · **on:** Jul 17, 2018

A nurse is assessing the wound in the right hip of a client following surgery. The wound has clean edges. How should the nurse document the wound in the electronic medical record?

A) Incision
B) Abrasion
C) Laceration
D) Puncture

Question 2

The nurse has applied a bandage to a lower extremity on a client. The nurse has to evaluate the status of the extremity encased in the bandage by completing a peripheral neurovascular assessment with the RN.

What observations and assessment have to be completed as part of the peripheral neurovascular assessment? 1 . Skin color
2 . Toe motion
3 . Sensation in toes
4 . Proximal pulses
A) 1, 2, 3
B) 1, 2, 4
C) 1, 3, 4
D) 2, 3, 4

mtmmmmmk · **Reply #1 on:** Jul 17, 2018

Answer to Question 1

A
Feedback:
An incision is a wound with clean edges. A wound with torn, ragged edges should be documented as a laceration. Abrasion is the rubbing off of the skin's surface. A puncture is a deep stab wound.

Answer to Question 2

A
Feedback:
Observations and assessment to be completed as part of the peripheral neurovascular assessment include skin color, toe motion, sensation in the toes and distal pulses.