NURS 5354 Final Exam UPDATED ACTUAL
Questions and CORRECT Answers
What is a single suture strand called? - CORRECT ANSWER -Monofilament; more resistant to harboring
microorganisms.
What are several filaments twisted or braided together called? - CORRECT ANSWER -Multifilament; They
are less stiff, have greater tensile strength but fluid may be absorbed along the filament to introduce pathogens.
Infection risk!
What are absorbable sutures? - CORRECT ANSWER -Two types: Natural-surgical gut; plain or surgical
gut chromic (treated with chromium salt)
Synthetic polymers-Vicryl (braided suture) or monocryl (monofilament)
What are non-absorbable sutures? - CORRECT ANSWER -Two types: Natural-Surgical silk
Synthetic-Nylon (Ethilon) or Polyprolene (Prolene)
How do you determine the diameter of a suture? - CORRECT ANSWER -The smaller the number, the
larger the strand.
Ex: a 2-0 is larger than 5-0 suture.
What size suture would you use for the face? - CORRECT ANSWER -5-0 or 6-0
What size suture would you use for the scalp? - CORRECT ANSWER -4-0
What size suture would you use for the upper body? - CORRECT ANSWER -4-0
What size suture would you use for the hand? - CORRECT ANSWER -4-0 or 5-0
What size suture would you use for the lower body? - CORRECT ANSWER -4-0
What size suture would you use over a joint? - CORRECT ANSWER -4-0
What suture pattern would be used for a laceration with irregular edges? - CORRECT ANSWER -
Interrupted
What suture pattern is best for high tension wounds, palms/feet or over joint areas? - CORRECT
ANSWER -Horizontal mattress
What suture pattern is best for loose/thin skin? - CORRECT ANSWER -Vertical mattress
What suture pattern would be used on lacerations with low risk for infection and low wound tension? -
CORRECT ANSWER -Continuous
How far apart should two sutures be from one another? - CORRECT ANSWER -No closer than 2 mm in a
fine plastic closure. The distance between sutures should equal half the total distance across the incision.
When should sutures be removed from the face? - CORRECT ANSWER -4-5 days
When should sutures be removed from the scalp? - CORRECT ANSWER -10-14 days
When should sutures be removed from the upper body? - CORRECT ANSWER -7-10 days
When should sutures be removed from the hand? - CORRECT ANSWER -7-10 days
When should sutures be removed from the lower body? - CORRECT ANSWER -10-14 days
, When should sutures be removed over joints? - CORRECT ANSWER -14-21 days
Consult/referral should be done for...? - CORRECT ANSWER -Deep wounds of the hand or foot,
lacerations of the eyelid/lip/ear, lacerations involving tendon, nerves, arteries, bones or joints, penetrating wounds
of unknown depth, severe crush injuries, severely contaminated wounds requiring drainage, wounds for which the
patient or clinical is strongly concerned about cosmetic outcome. and galea
What are other methods of wound repair/closure? - CORRECT ANSWER -Tape, adhesives or staples
What needs to be documented/coded when suturing? - CORRECT ANSWER -Lesion location, lesion size,
benign/malignant (discuss path report), and closure.
What needs to be documented for wound repair? - CORRECT ANSWER -laceration length and location,
any neurovascular damage distal to the injury, laceration clean or contaminated, anesthetic medication used, how
the wound was cleansed, suture size, number and layer sutured (skin, dermis, fascia) and discussion of potential
for infection or impaired function.
What should be considered for post procedural care? - CORRECT ANSWER -Cleansing, antibiotics (if
needed), use of steri-strips after suture removal to decrease wound tension and applying sunscreen to the area for
at least 6 months to reduce scarring.
What history should be obtained with laceration injuries? - CORRECT ANSWER -When did it occur
(greater than 12-24 hours)?
Where did it occur (dirty vs. clean)?
Any foreign body?
What was the mechanism of injury (sharp, blunt, animal bite, human bite, puncture?)
What are present symptoms and care prior to arrival?
Any history of impaired healing (HIV, DM, PVD, allergies, tetanus exposure, malnutrition, chemo, alcoholism,
chronic steroid use, obesity)?
What should ALWAYS be checked distal to the injury? - CORRECT ANSWER -Movement, circulation and
sensation.
With hand injuries, what should always be documented? - CORRECT ANSWER -Hand dominance and
occupation.
What are the goals of laceration/incision repair? - CORRECT ANSWER -Achieve hemostasis, prevent
infection, preserve function, preserve cosmetic appearance, minimize discomfort.
What is primary closure/intention? - CORRECT ANSWER -Direct approximation of the wound edges by
suture, tape, adhesives, etc.
What is secondary closure/intention? - CORRECT ANSWER -Wound is left open to heal by the formation
of granulation tissue and contraction.
What is delayed primary closure or tertiary intention? - CORRECT ANSWER -Wound is left open and
would benefit from closure in a few days. Irrigation, packings and/or may be done while wound is left open and
then by the 3rd day, definitive closure occurs.
What is the main reason not to use primary closure? - CORRECT ANSWER -Infection.
What is the equipment needed for wound closure? - CORRECT ANSWER -Forceps, anesthetic, needle
holder, suture.
What are the two types of forceps? - CORRECT ANSWER -Locking-Ex: needle holder, hemostat and Kelly
clamps. These are typically used for suturing, hemostasis and extraction.
Non-locking-Ex: DeBakey or Cooley. These are typically used for grasping/handling delicate tissue.
What type of forcep is used for the skin? - CORRECT ANSWER -The Adson forceps (non-locking forcep)
Questions and CORRECT Answers
What is a single suture strand called? - CORRECT ANSWER -Monofilament; more resistant to harboring
microorganisms.
What are several filaments twisted or braided together called? - CORRECT ANSWER -Multifilament; They
are less stiff, have greater tensile strength but fluid may be absorbed along the filament to introduce pathogens.
Infection risk!
What are absorbable sutures? - CORRECT ANSWER -Two types: Natural-surgical gut; plain or surgical
gut chromic (treated with chromium salt)
Synthetic polymers-Vicryl (braided suture) or monocryl (monofilament)
What are non-absorbable sutures? - CORRECT ANSWER -Two types: Natural-Surgical silk
Synthetic-Nylon (Ethilon) or Polyprolene (Prolene)
How do you determine the diameter of a suture? - CORRECT ANSWER -The smaller the number, the
larger the strand.
Ex: a 2-0 is larger than 5-0 suture.
What size suture would you use for the face? - CORRECT ANSWER -5-0 or 6-0
What size suture would you use for the scalp? - CORRECT ANSWER -4-0
What size suture would you use for the upper body? - CORRECT ANSWER -4-0
What size suture would you use for the hand? - CORRECT ANSWER -4-0 or 5-0
What size suture would you use for the lower body? - CORRECT ANSWER -4-0
What size suture would you use over a joint? - CORRECT ANSWER -4-0
What suture pattern would be used for a laceration with irregular edges? - CORRECT ANSWER -
Interrupted
What suture pattern is best for high tension wounds, palms/feet or over joint areas? - CORRECT
ANSWER -Horizontal mattress
What suture pattern is best for loose/thin skin? - CORRECT ANSWER -Vertical mattress
What suture pattern would be used on lacerations with low risk for infection and low wound tension? -
CORRECT ANSWER -Continuous
How far apart should two sutures be from one another? - CORRECT ANSWER -No closer than 2 mm in a
fine plastic closure. The distance between sutures should equal half the total distance across the incision.
When should sutures be removed from the face? - CORRECT ANSWER -4-5 days
When should sutures be removed from the scalp? - CORRECT ANSWER -10-14 days
When should sutures be removed from the upper body? - CORRECT ANSWER -7-10 days
When should sutures be removed from the hand? - CORRECT ANSWER -7-10 days
When should sutures be removed from the lower body? - CORRECT ANSWER -10-14 days
, When should sutures be removed over joints? - CORRECT ANSWER -14-21 days
Consult/referral should be done for...? - CORRECT ANSWER -Deep wounds of the hand or foot,
lacerations of the eyelid/lip/ear, lacerations involving tendon, nerves, arteries, bones or joints, penetrating wounds
of unknown depth, severe crush injuries, severely contaminated wounds requiring drainage, wounds for which the
patient or clinical is strongly concerned about cosmetic outcome. and galea
What are other methods of wound repair/closure? - CORRECT ANSWER -Tape, adhesives or staples
What needs to be documented/coded when suturing? - CORRECT ANSWER -Lesion location, lesion size,
benign/malignant (discuss path report), and closure.
What needs to be documented for wound repair? - CORRECT ANSWER -laceration length and location,
any neurovascular damage distal to the injury, laceration clean or contaminated, anesthetic medication used, how
the wound was cleansed, suture size, number and layer sutured (skin, dermis, fascia) and discussion of potential
for infection or impaired function.
What should be considered for post procedural care? - CORRECT ANSWER -Cleansing, antibiotics (if
needed), use of steri-strips after suture removal to decrease wound tension and applying sunscreen to the area for
at least 6 months to reduce scarring.
What history should be obtained with laceration injuries? - CORRECT ANSWER -When did it occur
(greater than 12-24 hours)?
Where did it occur (dirty vs. clean)?
Any foreign body?
What was the mechanism of injury (sharp, blunt, animal bite, human bite, puncture?)
What are present symptoms and care prior to arrival?
Any history of impaired healing (HIV, DM, PVD, allergies, tetanus exposure, malnutrition, chemo, alcoholism,
chronic steroid use, obesity)?
What should ALWAYS be checked distal to the injury? - CORRECT ANSWER -Movement, circulation and
sensation.
With hand injuries, what should always be documented? - CORRECT ANSWER -Hand dominance and
occupation.
What are the goals of laceration/incision repair? - CORRECT ANSWER -Achieve hemostasis, prevent
infection, preserve function, preserve cosmetic appearance, minimize discomfort.
What is primary closure/intention? - CORRECT ANSWER -Direct approximation of the wound edges by
suture, tape, adhesives, etc.
What is secondary closure/intention? - CORRECT ANSWER -Wound is left open to heal by the formation
of granulation tissue and contraction.
What is delayed primary closure or tertiary intention? - CORRECT ANSWER -Wound is left open and
would benefit from closure in a few days. Irrigation, packings and/or may be done while wound is left open and
then by the 3rd day, definitive closure occurs.
What is the main reason not to use primary closure? - CORRECT ANSWER -Infection.
What is the equipment needed for wound closure? - CORRECT ANSWER -Forceps, anesthetic, needle
holder, suture.
What are the two types of forceps? - CORRECT ANSWER -Locking-Ex: needle holder, hemostat and Kelly
clamps. These are typically used for suturing, hemostasis and extraction.
Non-locking-Ex: DeBakey or Cooley. These are typically used for grasping/handling delicate tissue.
What type of forcep is used for the skin? - CORRECT ANSWER -The Adson forceps (non-locking forcep)
