For treatment for Class III dog bite, all of these are correct EXCEPT?

Appeared in: WCL Staff Nurse - 2019

Explanation

The question asks to identify the incorrect action for managing a Class III dog bite.
Immediate suturing (stitching) of a Class III bite wound is contraindicated.
Closing the wound can trap the rabies virus, preventing its removal through washing and increasing the risk of the virus entering the nervous system.
If suturing is unavoidable (e.g., for severe bleeding or on the face), it should be delayed and performed with minimal stitches only after the wound has been thoroughly cleaned and infiltrated with Rabies Immunoglobulin (RIG).

Option A: This is a correct and essential action. Giving Rabies Immunoglobulin (RIG) provides immediate, passive immunity, which is critical for neutralizing the virus in severe (Class III) exposures before the body can produce its own antibodies.
Option B: This is a correct and essential action. Administering an Anti-Rabies Vaccine (ARV) is necessary to stimulate the body's long-term active immunity against the rabies virus.
Option D: This is a correct and essential action. Immediate and thorough washing of the wound with soap and water for at least 15 minutes is the most important initial step to mechanically remove the virus and reduce the risk of infection.

Clinical Relevance

Nursing practice connection: Knowing Management of Class III animal bites and rabies post-exposure prophylaxis (PEP) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a critical role in the immediate management of animal bites, including performing correct wound care, administering vaccines and immunoglobulins, and educating the patient and family.
Understanding that bite wounds are not immediately sutured is a key patient safety principle to prevent rabies.
Patient education is vital. The nurse must explain the importance of completing the entire rabies vaccine schedule for it to be effective.

How to Approach the Question

First, identify the keywords in the question: 'Class III dog bite' and 'EXCEPT'.
The word 'EXCEPT' is critical; it means you are looking for the action that is INCORRECT or contraindicated.
Recall the standard protocol for rabies Post-Exposure Prophylaxis (PEP) for a severe, or Class III, exposure.
Evaluate each option against this protocol:
Is giving immunoglobulin correct? Yes, for passive immunity.
Is giving ARV correct? Yes, for active immunity.

Concept Tested & Keywords

Concept Tested: Management of Class III animal bites and rabies post-exposure prophylaxis (PEP).
Stem keywords: Class III dog bite, treatment
Lead-in keywords: EXCEPT
Negative lead-in flag: Question asks for the exception, meaning three options are correct actions and one is incorrect.

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Practise the full WCL Staff Nurse - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.