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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.

Steps 1 - 4 of Basic Wound Care Algorithm

2. 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

3. 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

4. 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

5. 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

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

A. True B. False

7. _____ 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

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

A. True B. False

9. 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

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

A. True B. False

11. Unless cellulitis is confirmed, _____ is recommended.

A. Antiseptic treatment B. Antibiotic therapy C. Both (A) and (B) D. None of the above

Common Wound Types

12. 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.

13. 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.

14. 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

15. 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

16. 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.

17. 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

General Concepts of Wound Healing Science

18. 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.

19. 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.

20. 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

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

A. True B. False

22. 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

Appendix 1: Phases of Healing

23. During which phase of healing should the use of anti-inflammatory medications be limited?

A. Hemostasis phase B. Inflammatory phase C. Proliferative phase D. Remodeling phase

24. Epithelialization is the resurfacing of the wound and the primary cell is the _____, derived predominantly from epidermal stem cells located in the bulge area of the hair follicle and the epidermis at the edges of the wound.

A. Keratinocyte B. Macrophage C. Neutrophil D. Fibroblast

Appendix 2: Basic Dressing Types

25. Which of the following should not be used for wounds that have moderate to copious amount of drainage?

A. Saline-moistened gauze B. Hydrogels C. Hydrocolloids D. Alginates and hydrofibers

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