NR-511 Differential Diagnosis & Primary Care Practicum
Final Exam Study Guide
What is the first thing to do if a patient comes with an animal bite?
Correct Answer:
Wash bite to remove saliva from wound
Bites and scratches should be cleansed with what?
Correct Answer:
Mild soap and water or 1% provide iodine (betadine) to remove saliva.
What to do for an animal bite/scratch after cleansing?
Correct Answer:
Irrigate wound with 500-2000 mL of normal saline with 30 cc syringe with 18-20-gauge plastic catheter to do a pressure of 5-8 psi.
Which bite wounds should not be sutured?
Correct Answer:
Bite wounds of the hands. 1 / 4
When should a tetanus shot booster be given?
Correct Answer:
If patient received primary vaccine but no booster within the last 5 years.
What treatment should be given to a patient with a fresh bite wound ?
Correct Answer:
Antibiotic prophylaxis for 3-5 days.
No rabies treatment of the exposed person is necessary if?
Correct Answer:
If animal is healthy and available for 10 days for observation and shows no signs of sickness.
What is important to ask a Patient who comes in with a wound or lac?
Correct Answer:
History of tetanus vaccines. If more than 5 years since last one, tetanus shot should be administered to patient.
When should sutures be removed from face?
Correct Answer:
4-6 days.
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When should sutures be removed from scalp?
Correct Answer:
6-10 days.
When should sutures be removed from trunk?
Correct Answer:
7-10 days.
When should sutures be removed from arms and legs?
Correct Answer:
10-14 days.
When should sutures be removed from joints?
Correct Answer:
14 days.
What should the NP educate patients on who have a wound?
Correct Answer:
Watch for red streaks, increased warmth, increased pain, foul odor, or increased drainage. If these things are happening seek urgent assessment in clinic or ED.
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What should be given to patient for pain for animal bites?
Correct Answer:
NSAIDs and acetaminophen. If that does not work, then toradol/ ketorolac 30-60mg can work.
What should be used to clean a lac? What should be avoided?
Correct Answer:
Saline or soapy water is preferred to betadine bc betadine can be irritating and cytotoxic to lacerated tissue. Hydrogen peroxide should also be avoided bc it's irritating.
What is the key thing for puncture wounds?
Correct Answer:
Assess for skin integrity, vascular and neurological function and normal range of motion.
What to do with a patient who comes in with a flexor tendon injury?
Correct Answer:
Patient is required to see an orthopedic specialist for wound closure, bc there is a high morbidity associated with flexor tendon injuries.
What are the goals for general abscess care?
Correct Answer:
To relieve symptoms, promote healing and prevent complications.
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