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    RN Comprehensive Predictor 2023 Proctored Exam

    A nurse is performing wound care for a client who has an abdominal incision. Which of the following techniques should the nurse implement?

    Explanation & Rationale

    A. Irrigate the wound with a low-pressure flow of solution: Low-pressure irrigation (typically using a 30–60 mL syringe with an 18-gauge catheter) effectively removes debris and reduces tissue trauma, promoting wound healing while preventing the spread of bacteria deeper into the tissue. B. Cleanse the insertion site of the drain using a circular motion toward the center: Wound cleansing should proceed from the center outward, not toward the center, to avoid introducing contaminants into the wound or insertion site. C. Cleanse the wound starting at the bottom and moving upward: Wound cleansing should always be done from the cleanest to dirtiest area starting at the top (incision site) and moving downward, not the reverse, to prevent contamination. D. Irrigate the wound using a 10 mL syringe: A 10 mL syringe does not generate sufficient volume or pressure for effective wound irrigation. Larger syringes (30–60 mL) are preferred to provide adequate flow for proper cleansing.

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