CRNFA Wound Closure and Healing 2

Question 1

Which patient factor is the single greatest systemic risk factor for surgical site infection?

Accepted Answer

Uncontrolled diabetes mellitus (HbA1c > 8%)

Answer

Uncontrolled diabetes mellitus impairs leukocyte function, reduces tissue perfusion, and provides a glucose-rich environment for bacterial growth, making it the strongest systemic SSI risk factor.

Question 2

Which absorbable suture retains the most tensile strength at 6 weeks postoperatively?

Accepted Answer

Polydioxanone (PDS II)

Answer

PDS II (polydioxanone) retains approximately 50% tensile strength at 6 weeks and 25% at 6 months, outlasting all other common absorbable sutures.

Question 3

Dead space in a wound is most dangerous because it:

Accepted Answer

Collects serum and blood that serve as a bacterial culture medium, promoting infection and seroma

Answer

Dead space allows fluid accumulation, creating a seroma or hematoma that is an ideal medium for bacterial growth and dramatically increases infection and dehiscence risk.

Question 4

When closing a laparotomy fascial layer, which suture placement technique is recommended to reduce the risk of wound dehiscence?

Accepted Answer

Small bites technique — sutures placed 5 mm from edge and 5 mm apart in a continuous fashion

Answer

The small bites technique (STITCH trial) using 5 mm bite size and 5 mm spacing in a running fashion significantly reduces incisional hernia and dehiscence compared to large bites.

Question 5

A patient develops a seroma 10 days after a mastectomy. The CRNFA understands that the most common contributing factor is:

Accepted Answer

Lymphatic and small blood vessel disruption during flap creation leading to fluid accumulation

Answer

Mastectomy seromas form when lymphatic and small vessels in the dissection planes continue to weep serous fluid into the dead space beneath skin flaps.

CRNFA - Certified Registered Nurse First Assistant Practice Test

CRNFA - Certified Registered Nurse First Assistant Practice Test

CRNFA Wound Closure and Healing 2