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Prevention and Management of Wounds in Prison Populations

Tables for Basic Wound Care Algorithm

1. All of the following are basic interventions for arterial insufficiency, except for:

A. Limit constriction and elevation of affected area.

B. Keep warm and protect from injury.

C. Use external heating devices for warmth.

D. Provide padding over the ulcer.


2. Which of the following is the 2-week healing goal for a wound bed color of mostly red or pink?

A. Discuss therapy goal with provider: healing vs. stabilization.

B. 25% reduction in size.

C. 25 % reduction in slough.

D. Remains healed x 2 weeks.


3. Which of the following topical antiseptics should be limited to 50 g per application or 150 g per week?

A. Iodasorb gel 0.9% ointment.

B. Silvadene 1% cream.

C. 0.25% acetic acid solution.

D. All of the above.


Steps 1 - 4 of Basic Wound Care Algorithm

4. A basic vascular exam for wounds on the upper extremities should be performed, in addition to a wound history and a wound assessment, when performing the initial evaluation of a wound if the wound is located on the upper extremity.

A. True

B. False


5. There are a variety of methods to measure the size or volume of a wound, but the key is to use the same pattern of measurement to evaluate wound size so that comparisons over time are valid.

A. True

B. False


6. If a wound bed contains _____, then depth cannot be determined and should be labeled as “indeterminate.”

A. Yellow

B. Brown

C. Black

D. Any of the above


7. The drainage amount, color, and odor of a wound can indicate increased numbers of microorganisms living on the wound bed and should be the primary reason to select topical antiseptic treatment for critical colonization.

A. True

B. False


8. The condition of the surrounding skin up to _____ cm from the edge of the wound is important to evaluate.

A. 1

B. 3

C. 5

D. 7


9. Inadequate treatment of pain can lead to poor wound healing and increased infection rates.

A. True

B. False


10. _____ is the most crucial step in determining appropriate wound management.

A. Identifying the underlying cause of the wound

B. Vascular assessment

C. Identifying barriers to healing

D. All of the above


11. Frequent wound cleansing and dressing changes interrupt the body’s natural healing processes and can delay healing.

A. True

B. False


12. Which of the following agents, believed to be toxic to many cells involved in healing, should be reserved for patients with wounds where stabilization, not healing, is the goal of therapy?

A. Hydrogen peroxide

B. Providone-iodine

C. Dakin’s solution

D. All of the above


13. In the case of black wounds, the therapy goal may be:

A. Healing

B. Stabilization

C. Palliation

D. Any of the above


14. Solutions or dressings that contain _____ adversely affect the enzymatic activity of collagenase and eliminates the debridement action.

A. Acid

B. Metal ions

C. Either (A) and/or (B)

D. None of the above


15. Mechanical debridement is encouraged in the clinical setting as it is selective in terms of the tissue removed.

A. True

B. False


16. Drainage getting onto the surrounding skin and soaking through dressings indicates the appropriate time to change the dressing.

A. True

B. False


17. Which of the following should be used for the depth measurement when calculating the size reduction of a wound that previously had measurable depth and now does not?

A. 0 cm

B. 0.1 cm

C. 1 cm

D. None of the above


18. Unless cellulitis is confirmed, _____ is recommended.

A. Antiseptic treatment

B. Antibiotic therapy

C. Both (A) and (B)

D. None of the above


19. Once treatment is started, not meeting healing goals for the first 2 weeks is indicative of a wound which is unlikely to heal without additional assistance.

A. True

B. False


Common Wound Types

20. Which of the following is a risk factor for pressure ulcerations?

A. Recent weight loss related to an illness.

B. Incontinence of either bowel or bladder.

C. A medical reason to have the head of their bed elected at or above 30 degrees for extended periods of time.

D. All of the above.


21. Erythema over bony prominences that blanches is:

A. Considered a pressure ulcer.

B. A warning that pressure ulcer development is likely.

C. Both (A) and (B).

D. None of the above.


22. When should osteomyelitis be ruled out?

A. If the ulceration extends close to the bone.

B. If the bone is palpable.

C. If the patient develops cellulitis.

D. All of the above.


23. If a culture is needed, which of the following is recommended?

A. Routine swab cultures.

B. A biopsy.

C. Both (A) and (B).

D. None of the above.


24. For a pressure-redistributing cushion for patients with a sitting ulcer who uses a wheelchair, at a minimum, a CMS-defined “skin protection wheelchair seat cushion” that offers at least _____ of immersion should be issued.

A. 1 inch

B. 2 inches

C. 4 centimeters

D. 8 centimeters


25. In the correctional environment, any patient with a spinal cord injury should be considered at high risk for pressure ulcerations, and prevention strategies should be taken, even in the absence of a current pressure ulcer.

A. True

B. False


26. Which of the following sites of ischemic pain indicates occlusion in the superficial femoral artery?

A. Thigh and buttock pain

B. Calf pain

C. Foot pain

D. All of the above


27. Having the patient lie in a supine position and elevate their leg approximately 60 degrees to see if discoloration fades is the method used to differentiate dependent rubor from cellulitis or other mechanisms.

A. True

B. False


28. Which of the following is indicated as the gold standard for osteomyelitis diagnosis?

A. MRI

B. X-ray

C. Ultrasound

D. CT


29. Because of the poor condition of the skin around wounds with black dry tissue, great caution must be used in applying any type of tape to the skin, therefore, rolled gauze is preferred to assist with securing any dressing in place.

A. True

B. False


30. The presence of _____ discoloration of the skin, most commonly on the anterior portion of the lower leg and the ankle is a cardinal sign of venous insufficiency.

A. Black or brown

B. Yellow or pink

C. Reddish-gray or brown

D. Pink or brown


31. The presence of distended veins in the legs is normal and does not imply venous insufficiency.

A. True

B. False


32. Caution should be used for applying even introductory compression to patients with non-palpable dorsalis pedis and post-tibial pulses - especially if they have additional signs and symptoms of arterial insufficiency such as dependent rubor or a pallor elevation test of less than 25 seconds.

A. True

B. False


33. Compression therapy should be used with caution for patients with:

A. Uncompensated congestive heart failure.

B. Concurrent arterial disease.

C. Bed-bound and non-ambulatory conditions.

D. All of the above.


34. Moisturizers used for the treatment of dermatitis, dry skin, and skin sensitivities should be limited to emollients for lotions that do not contain _____, as this ingredient will often exacerbate the cutaneous inflammation, which manifests as increased dry skin.

A. Lanolin

B. Sterol alcohol

C. Both (A) and (B)

D. None of the above


35. Due to chronic cutaneous inflammation, the skin is prone to developing sensitivities to _____, therefore, caution should be used when applying this agent, and the site should be monitored for allergic contact dermatitis.

A. Tape

B. Sealants

C. Topical antibiotics and antiseptics

D. All of the above


General Concepts of Wound Healing Science

36. The primary role of the health care professional, with regard to healing, is to:

A. Evaluate and support the body’s natural healing processes.

B. Evaluate the intrinsic and extrinsic barriers to healing.

C. Alleviate the mechanism(s) of injury causing the wound.

D. Choose what type of dressing to use.


37. Which of the following is a factor that can alter the normal histo-chemical complex cascade - potentially converting a healing wound to a non-healing one?

A. Wound care performed too frequently.

B. Use of agents with a high cytotoxic profile.

C. Lack of good moisture balance.

D. All of the above.


38. Which of the following describe the presence of non-replicating microorganisms on the surface of the wound?

A. Colonization

B. Contamination

C. Infection

D. Biofilm


39. Culturing wounds is not generally recommended in the initial steps of therapy unless clinical signs of colonization are present.

A. True

B. False


40. Adequate _____ is required by the body to maintain tissue integrity, to prevent breakdown, and to support the body’s natural healing processes.

A. Calories

B. Protein

C. Fluids

D. All of the above


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