Which of the following is NOT a type of open wound?

Appeared in: NIA - 29 January 2023

Explanation

A contusion, or bruise, is a type of closed wound where the skin remains intact.
It is caused by blunt force trauma that ruptures capillaries and small blood vessels beneath the skin, leading to bleeding into the surrounding tissues.
The key differentiator is the unbroken skin surface, which distinguishes it from open wounds like lacerations, abrasions, and penetrating injuries.
Management for a contusion typically involves RICE (Rest, Ice, Compression, Elevation) to reduce swelling and pain.

Option A: A lacerated wound is a classic example of an open wound. It involves a tear or cut in the skin with irregular edges.
Option B: An abrasion is a superficial open wound, like a scrape. The skin is broken, even if only the outermost layers are affected.
Option C: A penetrating wound is an open wound where an object pierces the skin, creating an entry point and potentially causing deep tissue damage.

Clinical Relevance

Nursing practice connection: Knowing Classification of Wounds helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Differentiating between open and closed wounds is critical for nurses to determine immediate care priorities.
Open wounds carry a significant risk of infection (including tetanus) and require meticulous cleaning, dressing, and monitoring for signs of infection.
Closed wounds like contusions are primarily managed by controlling swelling and pain (RICE protocol), but require monitoring for complications like compartment syndrome if swelling is severe.

How to Approach the Question

First, identify the negative keyword 'NOT' in the question stem. This means you are looking for the exception among the options.
The question asks which option is NOT an 'open wound'. This means three options will be types of open wounds, and one will be a closed wound.
Define each term in your mind: Lacerated (cut), Abrasion (scrape), Penetrating (pierced), Contusion (bruise).
Analyze the definitions based on the core concept of an 'open wound' (broken skin).
A laceration, abrasion, and penetrating wound all involve a break in the skin.
A contusion is damage under the skin without an external break. Therefore, it is the correct answer as it is not an open wound.

Concept Tested & Keywords

Concept Tested: Classification of Wounds
Stem keywords: wound, open wound
Lead-in keywords: NOT
Negative lead-in flag: The question uses the negative keyword 'NOT', requiring you to identify the option that does not fit the specified category (open wound).

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 746-748

E6 Nursing Fundamentals Potter Perry 12e Part 6 pp. 81-83, 89-91

Practise the full NIA - 29 January 2023

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