The nurse is performing a focused wound assessment on a patient. The following should be included in the documentation: (Select all that apply.)
a. Location and size
b. Characteristics of the wound bed
c. Patient's response to wound treatment
d. Patient's pain level
e. Presence of drainage
ANS: A, B, C, E
A focused wound assessment includes an evaluation of the wound's location, size, and color; presence of drainage; condition of the wound edges; characteristics of the wound bed; and patient's response to the wound or wound treatment. The patient's pain level would be documented with his/her pain assessment.
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Which of the following statements reflects just culture within an organization (select all that apply)?
a. Just culture is a punitive reaction to patient errors. b. Just culture occurs when the organization is transparent about its mistakes. c. Interpersonal learning is balanced with personal accountability and discipline. d. Expectations for system and individual learning are apparent. e. Serious safety events are reported to se-nior leadership and kept confidential.
During a routine dressing change, the nurse accidentally pulls the drain tubing 2 inches out of the insertion site. Place the nursing interventions in the order the nurse should use for subsequent nursing actions
1. Provide wound care and apply dressing. 2. Ask client to describe wound sensations. 3. Swab tubing with chlorhexidine solution. 4. Collaborate with the surgeon immediately.
Which of the following is true of cold treatments?
A. They constrict the blood vessels to numb pain. B. They can help reduce bleeding and swelling. C. They are provided as localized or generalized treatments. D. All of these are true.
The Affordable Care Act Patient's Bill of Rights supports which of the following?
A) Coverage for persons with pre-existing conditions B) Coverage for children under age 26 on their parents' health plan C) The right of subscribers to appeal payment denials by insurers D) All of the above