OSCE OSCE Wound Care and Dressings 3 — Questions and Answers
Question 1: A patient's surgical wound shows dehiscence with no signs of infection. The wound edges are approximated but have separated at the surface. What is the FIRST action?
- Apply Steri-Strips to re-approximate the edges
- Irrigate with hydrogen peroxide
- Notify the surgeon immediately (Correct answer)
- Pack the wound with dry gauze
Correct answer: Notify the surgeon immediately
Wound dehiscence requires prompt surgical assessment; the nurse should notify the physician immediately while keeping the wound moist and covered.
Question 2: Which characteristic of wound exudate is MOST concerning for infection?
- Clear serous exudate in small amounts
- Serosanguineous exudate in moderate amounts
- Thick, malodorous, purulent exudate (Correct answer)
- Sanguineous exudate immediately post-operatively
Correct answer: Thick, malodorous, purulent exudate
Thick, purulent, foul-smelling exudate is a classic indicator of wound infection and requires further assessment and culture.
Question 3: When applying a compression bandage to a venous leg ulcer, which technique is used to ensure graduated compression?
- Apply equal tension throughout the entire limb
- Apply highest pressure at the knee, decreasing toward the ankle
- Apply highest pressure at the ankle, decreasing toward the knee (Correct answer)
- Apply bandage from the knee downward to the foot
Correct answer: Apply highest pressure at the ankle, decreasing toward the knee
Graduated compression applies the highest pressure at the ankle (approximately 40 mmHg) decreasing toward the knee to promote venous return.
Question 4: A patient develops maceration of the periwound skin. Which intervention is MOST appropriate to protect this area?
- Apply a petroleum-based skin protectant or barrier cream (Correct answer)
- Increase dressing change frequency to twice daily
- Leave the periwound skin exposed to air
- Apply talcum powder to absorb moisture
Correct answer: Apply a petroleum-based skin protectant or barrier cream
Skin barrier products such as zinc oxide or petrolatum protect periwound skin from excess moisture and maceration.
Question 5: In the OSCE station, you are asked to identify the type of tissue visible in a wound bed. The tissue appears bright red and granular with a bumpy surface. This describes:
- Slough
- Eschar
- Granulation tissue (Correct answer)
- Epithelial tissue
Correct answer: Granulation tissue
Granulation tissue is bright red, moist, and has a granular or cobblestone appearance, indicating healthy wound healing.
Question 6: A patient with a chronic wound is receiving negative pressure wound therapy (NPWT). What is the primary mechanism of action of this treatment?
- Delivers topical antibiotics directly to the wound bed
- Applies continuous or intermittent suction to remove exudate and stimulate healing (Correct answer)
- Maintains a dry wound environment to prevent infection
- Provides UV light exposure to kill surface bacteria
Correct answer: Applies continuous or intermittent suction to remove exudate and stimulate healing
NPWT works by applying negative pressure to remove excess exudate, reduce edema, and stimulate granulation tissue formation.
Question 7: When removing an adherent dressing from a wound, which technique minimizes pain and tissue trauma?
- Pull the dressing off quickly in one motion parallel to the skin
- Soak the dressing with saline before removal and lift gently (Correct answer)
- Use dry forceps to peel the dressing perpendicular to the wound
- Apply additional tape to secure the dressing before removal
Correct answer: Soak the dressing with saline before removal and lift gently
Soaking adherent dressings with saline loosens the adhesive bond, reducing pain and preventing disruption of healing tissue.
OSCE OSCE Wound Care and Dressings 3
A patient's surgical wound shows dehiscence with no signs of infection.
The wound edges are approximated but have separated at the surface.
What is the FIRST action?