Chapter 39 Dressings, Bandages, and Binders

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Chapter 39  Dressings, Bandages, and Binders

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. The nurse is caring for a patient who is bleeding. To control bleeding, she would apply a _____ dressing.
a.
pressure
b.
alginate
c.
foam
d.
hydrocolloid

ANS: A
Apply a pressure dressing to control bleeding, but when wound drainage is present, use a highly absorbent dressing. Use an alginate, foam, or hydrocolloid dressing in a noninfected wound that is draining a moderate to large amount of exudate.

DIF: Cognitive Level: Application REF: Text reference: p. 943
OBJ: Choose the correct dressing for a wound. TOP: Pressure Dressings
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

2. The nurse is changing a dry, woven gauze dressing when she notices that the gauze has inadvertently stuck to the wound. What should the nurse do?
a.
Pull the dressing off to aid in debridement.
b.
Recover the dressing and leave in place.
c.
Moisten the gauze to minimize trauma.
d.
Ensure that the shiny side of the dry gauze dressing does not stick.

ANS: C
When a dry dressing inadvertently adheres to the wound, moisten the dressing with sterile normal saline or sterile water before removing the gauze to minimize wound trauma. Moistening the gauze applies only to dry dressings and is not applicable for moist-to-dry dressings. A dry dressing is not used for debriding wounds. Telfa gauze dressings (not dry woven gauze dressings) contain a shiny, nonadherent surface on one side that does not stick to the wound.

DIF: Cognitive Level: Application REF: Text reference: p. 946
OBJ: Understand the technique of a dressing, bandage, or binder application.
TOP: Dry Woven Gauze Dressings KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

3. The nurse is caring for a patient who has a wound healing by primary intention that has little to no drainage. Which dressing is most appropriate for this type of wound?
a.
Moist-to-dry dressing
b.
Hydrocolloid dressing
c.
Dry dressing
d.
Hydrogel dressing

ANS: C
Dry dressings are used for wound healing by primary intention with little drainage. These dressings protect the wound from injury, prevent the introduction of bacteria, reduce discomfort, and speed healing. The primary purpose of moist-to-dry dressings is to mechanically debride a wound. Hydrocolloid dressings provide a moist environment for wound healing while facilitating softening and subsequent removal of wound debris. Hydrogel dressings (e.g., Curasol, IntraSite Gel, Vigilon) have a high moisture content (95%), causing them to swell and retain fluid. They are useful over clean, moist, or macerated tissues.

DIF: Cognitive Level: Analysis REF: Text reference: p. 946
OBJ: Choose the correct dressing for a wound. TOP: Dry Dressings
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

4. The nurse would consider a dry dressing appropriate for a wound that requires which of the following?
a.
Protection
b.
Debridement
c.
Absorption of heavy exudate
d.
Healing by second intention

ANS: A
A dry dressing may be chosen for management of a wound healing by primary intention with little drainage. The dressing protects the wound from injury, reduces discomfort, and speeds healing. The dry dressing does not interact with wound tissues and causes little wound irritation. A dry dressing is not appropriate for an open wound that is healing by secondary intention.

DIF: Cognitive Level: Application REF: Text reference: p. 946
OBJ: Choose the correct dressing for a wound. TOP: Dry Dressings
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

5. What should the nurse do for a patient who is having a wet-to-dry dressing applied?
a.
Moisten the old inner dressing to remove it.
b.
Pack the gauze in flat pieces into the wound.
c.
Wet the new inner dressing with a cytotoxic solution.
d.
Apply a secondary dressing over the inner wet packing.

ANS: D
The primary purpose of wet-to-dry dressings is to mechanically debride a wound. The moistened contact layer of the dressing (primary dressing) increases the absorptive ability of the dressing to collect exudate and wound debris. As the dressing dries, it adheres to the wound and debrides the wound of tissue when the dressing is removed. The moistened gauze must be covered with a secondary dressing layer that is dry. It is incorrect technique and a common error by some clinicians to moisten the dried gauze before removing it. This defeats the purpose of using this type of dressing and reduces the amount of debris that the dressing will remove. Open or “fluff” the woven gauze that will be placed directly against the wound bed. Moisten the packing material with a noncytotoxic solution such as normal saline. Never use cytotoxic solutions.

DIF: Cognitive Level: Application REF: Text reference: p. 946
OBJ: Choose the correct dressing for a wound. TOP: Wet-to-Dry Dressings
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

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