GENERAL PURPOSE To provide information about nurses' knowledge and practices in the prevention and care of wounds, based on responses to a Nursing survey.
LEARNING OBJECTIVES After reading the preceding article and taking this test, you should be able to:–1. Discuss the Nursing2005 wound care survey results. 2. Relate the survey responses to best practice standards for preventing and treating wounds. 3. Identify implications for improvements in wound care education and practice based on survey results.
1. Survey responses indicated that
a. younger nurses need more education about wound care.
b. younger nurses are more knowledgeable about wound care than older nurses.
c. nurses in hospital settings are especially knowledgeable about wound care.
d. years of experience has little effect on wound care expertise.
2. Most respondents knew that the gold standard for chronic wound management is
a. dry wound therapy.
b. moist wound therapy.
c. dry-to-wet dressings.
d. wet-to-dry dressings.
3. Which of the following helped revolutionize chronic wound care practices?
a. dressings that maintain a moist healing environment
b. wound care certification
c. the Braden risk assessment tool
d. the AHRQ guidelines
4. Which of the following is consistent with Joint Commission on Accreditation of Healthcare Organizations and American Pain Society standards?
a. Wound pain is best rated by the clinician.
b. Wound assessment should be based on risk assessment tools.
c. Objective assessment data is more reliable than a patient's self-report of wound pain.
d. A patient's self-report of wound pain is more reliable than anyone else's assessment.
5. The subscales in the Braden scale are based on
a. the stages of wound healing.
b. the location of the wound.
c. age-specific criteria.
d. pressure ulcer risk factors.
6. Responses to the survey item about the Braden scale suggest that hospital nurses
a. are familiar with wound risk assessment tools.
b. need more education about risk assessment tools.
c. routinely use wound risk assessment tools.
d. know more about wound risk assessment tools than home/community health nurses.
7. What percentage of survey respondents knew that classic signs of infection may not be present in patients with chronic wounds or in those who are immunosuppressed?
8. For patients with chronic wounds and those who are immunosuppressed, which of the following may best help in assessing wound infection?
a. the signs and symptoms checklist developed by Gardner, Frantz, and colleagues
b. the AHRQ pressure ulcer assessment guidelines
c. the WOCN checklist
d. the Braden risk assessment tool
9. Which of the following suggests a chronic wound infection?
a. decreasing pain in the wound and surrounding area
c. pocketing at the base of the wound
d. tough granulation tissue
10. According to best practice standards, which of the following is most appropriate for clean granulating wounds?
a. wet-to-moist gauze dressings
b. wet-to-dry gauze dressings
c. dry gauze dressings
d. enzyme preparations
11. Which of the following can be used to mechanically debride a wound?
a. wet-to-dry gauze dressings
b. wet gauze dressings
c. wet-to-moist gauze dressings
d. moist gauze dressings
12. Which of the following statements is true?
a. In a chronic wound, the only good bacteria are dead bacteria.
b. Some bacteria in the wound bed can be beneficial.
c. Bacteria colonizing a wound allow overgrowth of more virulent strains in the wound bed.
d. Infection doesn't hinder wound healing.
13. According to AHRQ clinical guidelines, bacterial colonization
a. hinders wound healing.
b. causes more virulent organisms to adhere to the wound bed.
c. means bacteria are present within the wound without indication of infection.
d. inhibits blood flow.
14. Most survey respondents believed that the selection of a wound dressing should be based on
a. reimbursement issues.
b. wound bed characteristics.
c. the patient's preference.
d. the clinician's preference.
15. When the level of bacteria in a wound exceeds 105 microorganisms/ml, the wound is considered
d. critically colonized.
16. In patients with darkly pigmented skin, Stage II pressure ulcers may be more common than Stage I ulcers because
a. current pressure ulcer assessment tools are inadequate.
b. diagnostic tests for pressure ulcers are lacking.
c. patients fail to seek medical attention soon enough.
d. clinicians fail to recognize pressure ulcers at an early stage.
17. Which of the following statements about debridement is true?
a. Enzymes aren't effective for removing necrotic tissue in chronic wounds.
b. Many students are unfamiliar with the use of enzymes for wound debridement.
c. Maggots are no longer used for wound debridement.
d. Enzymes are used only for removing necrotic tissue in acute wounds.
18. What percentage of respondents said they can identify the four stages of pressure ulcers?
19. Which of the following has been identified by the NPUAP as a basic competency for nurses?
a. using aseptic technique
b. electing the appropriate specialty bed for patients
c. performing a needle aspiration for culture
d. staging a pressure ulcer
20. Which of the following is true about specialty beds and mattresses?
a. They're inappropriate for elderly patients.
b. Patient repositioning isn't necessary when using a specialty mattress.
c. Specialty beds are rarely available in acute and subacute inpatient settings.
d. They're indicated to prevent pressure ulcers in high-risk patients.
21. When obtaining swab wound culture specimens, you should
a. clean the wound before obtaining the specimen.
b. take the specimen from necrotic tissue.
c. avoid expressing wound fluid from viable tissue.
d. take the specimen from the wound–surface.
22. Under current standards, which statement is correct about changing a dressing on a chronic wound?
a. You needn't wear gloves.
b. You may wear nonsterile gloves.
c. You should always wear sterile gloves.
d. You must use sterile technique when removing the dressing.
23. The gold standard for wound culture is
a. needle aspiration.
b. swab culture.
c. culture of necrotic wound tissue.
d. tissue biopsy.
24. To clean chronic wounds, the AHRQ currently recommends using
c. noncytotoxic wound cleansers.
d. soap and water.
25. What percentage of respondents said they perform daily skin assessments on their patients?
26. Which statement is correct about skin assessment?
a. This task should be performed daily by nurses in acute care settings.
b. Nurses should delegate it to unlicensed assistive personnel.
c. A home health care patient's skin should be assessed daily by a nurse.
d. Only nurses certified in wound care are qualified to perform skin assessments.
27. What percentage of wound-care–certified nurses responding to this survey said that skin assessment is part of their daily routine?
28. What do the best wound assessment tools have in common?
a. They're computerized.
b. They include flowcharts and diagrams.
c. They help clinicians document routine care.
d. They have a uniform structure and use consistent terminology.
29. What percentage of respondents who work in a hospital said they have access to a computerized wound assessment tool?
30. What percentage of respondents said they received sufficient education about chronic wounds in their basic nursing education program?
31. Which of these groups of survey respondents felt best about their level of wound care education?
a. younger, less experienced nurses
b. community health nurses
c. long-term-care nurses
d. subacute care nurses
32. Which group of respondents said that they're comfortable making recommendations to practitioners on appropriate wound dressings all or most of the time?
a. nurses who specialize in geriatrics
b. hospital nurses
c. home health care nurses
d. wound-care-certified nurses
33. Which of the following organizations provides detailed information on wound care certification to nurses?
a. American Academy of Wound Management
d. American Pain Society