Difficulty: Medium
Average Score: 70%
Simulated
A surgical incision that is healing by secondary intention develops a thick tan exudate. Which action should the nurse take first?
Correct answer
D
Rationale
Thick, tan exudate is a sign of possible infection, such as purulent drainage. The priority is to obtain a wound culture to identify the causative organism before initiating any treatment, including debridement or applying dressings. This ensures appropriate antibiotic therapy. Steri-strips are for primary intention healing. Removing sutures is not indicated and could dehisce the wound.