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Exam (elaborations)

Tissue Integrity ATI Questions & Correct Answers/ Graded A+

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  • Course
  • Tissue Integrity ATI
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  • Tissue Integrity ATI

A nurse is providing teaching to a client who is in a wheelchair about measures to avoid skin breakdown. Which of the following instructions by the nurse is related to preventing skin breakdown? : You should shift your weight off your buttocks at intervals throughout the day A wound, ostomy a...

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  • June 9, 2024
  • 6
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
  • tissue
  • Tissue Integrity ATI
  • Tissue Integrity ATI
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Tissue Integrity ATI Questions & Correct
Answers/ Graded A+


A nurse is providing teaching to a client who is in a wheelchair about measures to avoid skin

breakdown. Which of the following instructions by the nurse is related to preventing skin

breakdown?


🗸🗸: You should shift your weight off your buttocks at intervals throughout the day




A wound, ostomy and continence nurse (WOCN) is providing an in service to a group of nurses about

documentation of pressure injuries. Which of the following statements by one of the group

members indicates an understanding of the teaching?


🗸🗸: Pressure injury documentation includes location, stage, measurements and condition of the

wound bed and any drainage present




A nurse is caring for a client who has sustained a gunshot wound to the abdomen and is 6 hr

postoperative. The nurse notices protrusion of the client's organs from the incision site and call for

help. Which of the following actions should the nurse take?


🗸🗸: Cover the client's wound with a sterile saline dressing




A nurse is teaching assistive personnel (AP) about the skin of older adults. Which of the following

statements by the AP indicates an understanding of the teaching?



1

, 🗸🗸: The skin of older adults is thinner and has less subcutaneous padding over bony prominences




A nurse is preparing to obtain a wound culture from a client who has a suspected wound infection.

Which of the following actions should the nurse take?


🗸🗸: Clean the wound with 0.9% sodium chloride




A nurse is assisting with the care of a client following abdominal surgery. The nurse removes the

client's surgical dressing and notes a separation of the wound edges. The nurse should identify that

the client is experiencing which of the following complications?


🗸🗸: Dehiscence




A nurse is providing teaching to a client about staple removal. Which of the following statements

should the nurse include in the teaching?


🗸🗸: Your staples will be removed in about 2 weeks




A nurse is caring for a group of clients. Which of the following clients should the nurse identify as

having the highest risk for developing alterations in tissue integrity?


🗸🗸: A client who is incontinent and taking a prescribed diuretic




A nurse is caring for a client who has dime-sized stage 1 pressures injury located on the sacrum.

Which of the following dressing types should the nurse use?



2

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