Arrange the steps of hernioplasty in the correct order:

a) Skin incision

b) Identify the sac and reduce content

c) Place the mesh

d) Wound closure

1. A

   a-b-c-d

2. B

   b-c-a-d

3. C

   a-d-c-b

4. D

   b-a-d-c

Appeared in: INI-CET EXAM -2025

Explanation

• The correct sequence for a hernioplasty is a-b-c-d.
• Surgery logically begins with a skin incision (a) to access the surgical field.
• Following the incision, the surgeon must identify the hernia sac and reduce its contents back into the abdominal cavity (b).
• After reduction, the weakened abdominal wall is repaired by placing a synthetic mesh (c) for reinforcement.
• The final step is the closure of the surgical wound (d) in layers.

Why Other Options Were Wrong

• Option B: This sequence (b-c-a-d) is incorrect because it is impossible to identify the hernia sac (b) before making a skin incision (a) to access it.
• Option C: This sequence (a-d-c-b) is incorrect. It suggests closing the wound (d) before placing the mesh (c) and reducing the hernia contents (b). This would trap the hernia and fail to repair the defect.
• Option D: This sequence (b-a-d-c) is incorrect as it starts with identifying the sac (b) before the incision (a). The internal order is also illogical.

Related Visual

• Visual 1: Diagram - An illustration showing the four key stages of a hernioplasty: the initial incision, the reduction of the hernia sac, the placement of the mesh over the defect, and the final wound closure. This helps visualize the entire process sequentially.

Clinical Relevance

• Nursing practice connection: Safe nursing care depends on performing Surgical procedure steps for hernioplasty in the correct sequence, documenting the action clearly, and monitoring for the expected response.
• A nurse's role in post-hernioplasty care is crucial. This includes monitoring the surgical site for signs of infection (redness, swelling, pus), hematoma (excessive bruising or a hard lump), and ensuring the patient's pain is well-managed.
• Patient education is vital. The nurse should instruct the patient on activity restrictions, such as avoiding heavy lifting for several weeks, to prevent stress on the new repair and allow the mesh to integrate with the tissue.
• What if? If a patient develops a persistent fever, localized pain, and a draining sinus tract weeks or months after surgery, the nurse should recognize these as potential signs of a chronic mesh infection, which requires immediate medical evaluation and may necessitate surgical removal of the mesh.

How to Approach the Question

• First, identify the question type. This is a process-based question that requires you to order steps logically.
• Think about the fundamental principles of any surgical procedure. It must start with gaining access to the body and end with closing the entry point.
• Identify the first logical step. A 'skin incision' is the only possible starting point to begin an open surgery.
• Identify the last logical step. 'Wound closure' is always the final part of the surgical procedure itself.
• With the start and end points fixed (a...d), evaluate the intermediate steps. The problem (hernia) must be corrected (b - reduce content) before the repair (c - place mesh) is made.
• Assemble the full sequence (a-b-c-d) and match it to the given options.

Concept Tested & Keywords

• Concept Tested: Surgical procedure steps for hernioplasty.
• Stem keywords: hernioplasty, steps, correct order, skin incision, identify the sac, place the mesh, wound closure
• Lead-in keywords: Arrange

Question ID

QbLRv1Q3DQ0jiJd_dSjxn5

Copy ID