CPEN UPDATED ACTUAL EXAM QUESTIONS CORRECT ANSWERS GRADED A PLUS
Question:
What can the nurse implement to relieve pain prior to a dressing change?
Answer:
Administer an analgesic 30-45 minutes prior to the dressing change. Rationale: Dressing changes
can be very painful and it is important to manage the pts pain. So, giving pain meds can help reduce
stress and pain level during dressing changes.
Question:
The NAP asks you the difference between a wound that heals by primary or secondary intention.
You will reply that a wound heals by primary intention when?
Answer:
The skin edges are approximated. Rationale: Primary intention the wound edges are approximated
and closed. The risk of infection is low. Healing occurs quickly and minimal scar tissue forms. An
example is a clean surgical incision.
Question:
Which nursing interventions should be included for the patient who has full thickness and deep
partial thickness burns to 50% of the body? Select all that apply.
Answer:
Perform meticulous hand hygiene, use sterile gloves for dressing changes, use a mask and gown
when in contact with wound and Administer antibiotics for infection. Rationale: Burns this severe
are very painful for the patient and very high risk of getting infected. It is important that we perform
hand hygiene thoroughly and keep any microbes away from the pts open wounds.
Question:
, The nurse writes a nursing diagnosis "Impaired skin integrity related to open burn wounds." Which
nursing intervention would be appropriate for this nursing diagnosis?
Answer:
Clean the clients wounds, body and hair daily Rationale: Open burn wounds have a high risk of
infection due to not having that protective skin barriers. It is important to keep the areas clean and
areas around it free of microbes.
Question:
The ICU burn nurse is developing a nursing care plan for a client with severe full-thickness and
deep partial thickness burns over half the body. Which client problem has priority?
Answer:
High risk for infection Rationale: Infection can kill our pt so it is important to be high priority to
prevent.
Question:
The nurse is assessing a 78 year old African American patient with dark pigmented skin. When
assessing the skin, the nurse should use which lighting?
Answer:
Florescent lighting Rationale: This lighting won't give a false cyanotic shadow like a regular
lighting would.
Question:
The initial nursing intervention for the assessment of external hemorrhaging includes?
Answer:
Close monitoring of the would dressing for bloody drainage. Rationale: We do not want to see
bleeding because this indicates hemorrhaging.
Question:
To reduce pressure points that may lead to pressure ulcers, the nurse should?
Question:
What can the nurse implement to relieve pain prior to a dressing change?
Answer:
Administer an analgesic 30-45 minutes prior to the dressing change. Rationale: Dressing changes
can be very painful and it is important to manage the pts pain. So, giving pain meds can help reduce
stress and pain level during dressing changes.
Question:
The NAP asks you the difference between a wound that heals by primary or secondary intention.
You will reply that a wound heals by primary intention when?
Answer:
The skin edges are approximated. Rationale: Primary intention the wound edges are approximated
and closed. The risk of infection is low. Healing occurs quickly and minimal scar tissue forms. An
example is a clean surgical incision.
Question:
Which nursing interventions should be included for the patient who has full thickness and deep
partial thickness burns to 50% of the body? Select all that apply.
Answer:
Perform meticulous hand hygiene, use sterile gloves for dressing changes, use a mask and gown
when in contact with wound and Administer antibiotics for infection. Rationale: Burns this severe
are very painful for the patient and very high risk of getting infected. It is important that we perform
hand hygiene thoroughly and keep any microbes away from the pts open wounds.
Question:
, The nurse writes a nursing diagnosis "Impaired skin integrity related to open burn wounds." Which
nursing intervention would be appropriate for this nursing diagnosis?
Answer:
Clean the clients wounds, body and hair daily Rationale: Open burn wounds have a high risk of
infection due to not having that protective skin barriers. It is important to keep the areas clean and
areas around it free of microbes.
Question:
The ICU burn nurse is developing a nursing care plan for a client with severe full-thickness and
deep partial thickness burns over half the body. Which client problem has priority?
Answer:
High risk for infection Rationale: Infection can kill our pt so it is important to be high priority to
prevent.
Question:
The nurse is assessing a 78 year old African American patient with dark pigmented skin. When
assessing the skin, the nurse should use which lighting?
Answer:
Florescent lighting Rationale: This lighting won't give a false cyanotic shadow like a regular
lighting would.
Question:
The initial nursing intervention for the assessment of external hemorrhaging includes?
Answer:
Close monitoring of the would dressing for bloody drainage. Rationale: We do not want to see
bleeding because this indicates hemorrhaging.
Question:
To reduce pressure points that may lead to pressure ulcers, the nurse should?
