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EXAM 3

During the treatment of a post-surgical patient, the treating PTA notes a raised red scar that appears to extend beyond the wound boundaries of the incision. Which of the following would be the most appropriate documentation of how the wound is healing?

A. Observed abnormal wound healing as indicated by the presence of keloid scarring at the incision site.

B. Observed abnormal wound healing as indicated by the presence of hypertrophic scarring at the incision site.

C. Observed abnormal wound healing as indicated by the presence of eschar at the incision site.

D. Observed normal wound healing at the incision site.

The correct answer is A.

Rationale: A. Both keloid and hypertrophic scarring are considered abnormal wound healing. Both of these abnormal scar tissue presentations are due to a dysfunction forming excessive scar tissue. However, hypertrophic scar tissue forms within the wound borders while the keloid expands beyond the borders. Eschar describes necrotic tissue that is usually black/brown in coloration.

A PTA is treating a patient with thoracic outlet syndrome of the left upper extremity. The evaluating PT has advised the PTA to check the capillary refill at the hand if the patient reports worsening symptoms. Which of the following correctly outlines how to check capillary refill?

A. Press down on the soft tissue of the palm for 30 seconds and count the time the skin indentation takes to resolve.

B. Hold pressure over the ulnar and radial arteries at the wrist level while the patient repeatedly opens and closes the fist.

C. Press down on the fingernail until it pales, release the pressure, and then note the time elapsed for normal color to return.

D. Tap repeatedly over the anterior wrist and monitor the patient for increased numbness or tingling.

The correct answer is C.

Rationale: C. Capillary refill is tested at the fingernail when pressure is applied, and upon release, the clinician observes how long it takes for the normal pink color to return. The normal time is less than 3 seconds for the capillary refill to occur.

A patient who is three days post–right total knee arthroplasty presents to a therapy session with a report of increased right knee edema and pain. Upon visual inspection of the incision, the PTA notes a foul odor and moderate purulent drainage upon removal of the non-adherent gauze dressing. Which of the following actions would be most appropriate ...

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