LVN Wound Care 3 — Questions and Answers
Question 1: Which solution is considered the safest and most recommended for routine wound irrigation?
- Povidone-iodine (Betadine)
- Hydrogen peroxide
- Normal saline (0.9% sodium chloride) (Correct answer)
- Acetic acid
Correct answer: Normal saline (0.9% sodium chloride)
Normal saline is isotonic and non-cytotoxic, making it the preferred solution for wound irrigation without damaging granulation tissue.
Question 2: Autolytic debridement is best achieved by which wound care intervention?
- Applying enzymatic ointment such as collagenase
- Using a scalpel to remove necrotic tissue at the bedside
- Covering the wound with a moisture-retentive dressing to allow the body's enzymes to dissolve dead tissue (Correct answer)
- Irrigating the wound with high-pressure saline
Correct answer: Covering the wound with a moisture-retentive dressing to allow the body's enzymes to dissolve dead tissue
Autolytic debridement uses the body's own enzymes under a moisture-retentive dressing (such as a hydrocolloid or hydrogel) to liquefy necrotic tissue.
Question 3: A patient with a diabetic foot ulcer has a wound with a dry, black eschar firmly adhered to the heel. What is the priority LVN action?
- Immediately debride the eschar with scissors
- Apply a hydrogel dressing to soften the eschar
- Leave the eschar intact and do not debride without physician orders (Correct answer)
- Soak the foot in warm water to loosen the eschar
Correct answer: Leave the eschar intact and do not debride without physician orders
Stable dry eschar on a heel ulcer should not be debrided without a physician's order, as it can serve as a protective barrier; clinical guidelines require provider evaluation first.
Question 4: A foam dressing is MOST appropriate for which type of wound?
- A dry wound with minimal exudate needing moisture donation
- A heavily exudating wound requiring absorption (Correct answer)
- A wound with exposed tendon needing a non-adherent surface only
- A superficial abrasion in a dry environment
Correct answer: A heavily exudating wound requiring absorption
Foam dressings are highly absorbent and best suited for moderate-to-heavily draining wounds.
Question 5: Which clinical finding indicates that a wound is in the proliferative phase of healing?
- The wound has a pale, fibrinous slough covering the base
- Bright red, moist granulation tissue is filling the wound from the base (Correct answer)
- The wound edges show no signs of tissue approximation
- Copious purulent drainage is present
Correct answer: Bright red, moist granulation tissue is filling the wound from the base
Bright red granulation tissue filling the wound bed is the hallmark of the proliferative (repair) phase of wound healing.
Question 6: When applying a wet-to-dry dressing for mechanical debridement, the LVN should:
- Moisten the gauze and remove it while still wet to minimize patient discomfort
- Pack dry gauze into the wound and moisten it just before removal
- Place moist gauze into the wound and allow it to dry before removal to debride non-viable tissue (Correct answer)
- Saturate the dressing heavily and seal with an occlusive film to retain moisture
Correct answer: Place moist gauze into the wound and allow it to dry before removal to debride non-viable tissue
Wet-to-dry dressings work by placing moist gauze that dries and adheres to necrotic tissue; when removed dry, it mechanically debrides the wound.
Question 7: A patient receiving negative pressure wound therapy (NPWT/wound VAC) should be monitored for which priority complication?
- Hyperthermia from the vacuum seal
- Bleeding or hemorrhage at the wound site (Correct answer)
- Hypertension from the negative pressure
- Skin breakdown from excessive moisture
Correct answer: Bleeding or hemorrhage at the wound site
NPWT can dislodge clots or damage fragile tissue, making bleeding and hemorrhage a priority safety concern requiring ongoing monitoring.
LVN Wound Care 3
Which solution is considered the safest and most recommended for routine wound irrigation?