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Emergency and Critical Care Nursing

Grafting and Reconstructive Surgery Practice Questions

15 free Grafting and Reconstructive Surgery practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.

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Question 1 of 15 Easy

Which nursing intervention supports successful skin grafting by immobilizing and elevating the graft site?

  1. A Encouraging the patient to move the grafted limb vigorously right away
  2. B Elevating and immobilizing the graft site to avoid shear under the dressing
  3. C Removing all dressings within 12 hours to inspect the graft site early
  4. D Keeping the patient lying completely flat in bed for three full days

Correct answer: Elevating and immobilizing the graft site to avoid shear under the dressing

Immobilizing and elevating the graft site prevents shear and fluid accumulation under the graft, enhancing vascularization and “graft take”.

Question 2 of 15 Medium

What is the primary difference between a split-thickness skin graft (STSG) and a full-thickness skin graft (FTSG)?

  1. A An STSG includes only epidermis, while an FTSG includes only dermis
  2. B An STSG takes epidermis plus part of dermis; an FTSG takes full dermis and epidermis
  3. C An FTSG can be expanded like a mesh, whereas an STSG cannot be meshed
  4. D There is no meaningful structural difference between the two graft types

Correct answer: An STSG takes epidermis plus part of dermis; an FTSG takes full dermis and epidermis

STSG removes the epidermis plus part of the dermis, whereas FTSG removes the full dermis and epidermis, leading to different outcomes and donor-site costs.

Question 3 of 15 Medium

When a patient undergoing reconstructive surgery after burns is scheduled for grafting around a joint, what issue must the nurse monitor carefully?

  1. A Excessive joint mobility developing at the grafted joint over time
  2. B Graft contraction with potential joint contracture restricting movement
  3. C Only the donor site rather than the graft site needing close monitoring
  4. D Withholding any physical therapy until full healing at about six months

Correct answer: Graft contraction with potential joint contracture restricting movement

Grafts around joints are at risk of contraction and subsequent joint contracture, necessitating early attention to positioning and range of motion.

Question 4 of 15 Medium

What donor-site complication should the nurse assess for after split-thickness skin grafting?

  1. A Hair regrowing abnormally through the surface of the healed donor site
  2. B Formation of a new deep full-thickness wound at the donor site
  3. C Delayed healing, infection, and pain as it behaves like a partial-thickness wound
  4. D Complete and normal skin regrowth at the donor site within 24 hours

Correct answer: Delayed healing, infection, and pain as it behaves like a partial-thickness wound

Donor sites from STSG behave like second-degree wounds, posing risks of delayed healing, infection, and pain requiring monitoring.

Question 5 of 15 Medium

One goal of early post-operative mobilization following grafting is to prevent which complication?

  1. A Overgrowth of the graft beyond the borders of the wound bed
  2. B Deep vein thrombosis, muscle wasting, and stiffness of the joints
  3. C An instant and unrestricted return to the patient's full activity
  4. D Graft detachment caused by immediate heavy unsupervised exercise

Correct answer: Deep vein thrombosis, muscle wasting, and stiffness of the joints

Early mobilization post-grafting helps reduce immobility-related complications and supports functional recovery without compromising graft uptake.

Question 6 of 15 Easy

Which dressing characteristic is crucial immediately after skin graft placement?

  1. A A loosely applied non-occlusive dressing that lets air freely circulate
  2. B A bolster or pressure dressing that prevents movement and fluid pooling underneath
  3. C No dressing at all, leaving the fresh graft fully exposed to open air
  4. D Frequent removal and reapplication of the dressing every four hours

Correct answer: A bolster or pressure dressing that prevents movement and fluid pooling underneath

A bolster or pressure dressing helps maintain graft-wound contact, prevents fluid accumulation, and enhances survival by eliminating dead space.

Question 7 of 15 Easy

What is the best nursing rationale for monitoring the color of a newly placed skin graft?

  1. A Colour assessment is purely cosmetic and has no bearing on graft viability
  2. B Pallor or grey hue signals poor perfusion; pink suggests successful engraftment
  3. C A blue-black colour is the expected sign of immediate graft success
  4. D Graft colour is not expected to change during the first three days

Correct answer: Pallor or grey hue signals poor perfusion; pink suggests successful engraftment

Monitoring color serves as an indicator of graft perfusion and viability where pale or grey signifies perfusion concerns.

Question 8 of 15 Easy

When is the most appropriate time for reconstructive surgery after burn scar contracture?

  1. A Immediately on the day of injury, before tissues stabilise
  2. B Once the scar has matured (around 12-18 months) and the patient is stable
  3. C Never, since burn scars should always be left untreated
  4. D Only after the contracture causes complete loss of function

Correct answer: Once the scar has matured (around 12-18 months) and the patient is stable

Reconstructive procedures for contractures are best timed when the scar and tissues are mature, ensuring optimal outcomes.

Question 9 of 15 Medium

Which type of graft is typically used for smaller, cosmetic areas like the face or around the eyes?

  1. A Mesh graft
  2. B Split-thickness graft
  3. C Full-thickness graft
  4. D Xenograft

Correct answer: Full-thickness graft

Full-thickness grafts offer better cosmetic match, less contraction, and are preferable for cosmetic areas requiring minimal shrinkage.

Question 10 of 15 Easy

Why is the donor site care as important as graft site care in reconstructive surgery?

  1. A The donor site reliably heals on its own without complications
  2. B It is essentially a second wound that can be painful, infected, or slow to heal
  3. C The donor site is identical to and managed exactly like the graft site
  4. D The donor site needs no dressing once the graft is placed

Correct answer: It is essentially a second wound that can be painful, infected, or slow to heal

Donor sites require similar attention due to risks of pain, infection, and delayed healing, emphasizing the need for monitoring and care.

Question 11 of 15 Medium

Which statement is true regarding mesh vs sheet skin grafts?

  1. A Mesh grafts are suitable only for small cosmetic areas
  2. B Sheet grafts cannot be applied over large wound surfaces
  3. C Mesh grafts cover larger wounds, leaving a pattern; sheet grafts offer better cosmesis.
  4. D There is no meaningful difference in pattern or outcome between them

Correct answer: Mesh grafts cover larger wounds, leaving a pattern; sheet grafts offer better cosmesis.

Mesh grafts permit wider coverage with less donor skin but exhibit a mesh pattern, while sheet grafts offer better aesthetics at the cost of donor skin.

Question 12 of 15 Medium

After reconstructive grafting, why is sun protection emphasized in patient teaching?

  1. A Grafted skin is more resilient to sunlight than normal skin
  2. B Sun can permanently discolour the graft and cause burns, as oil and sweat glands are absent
  3. C Sunlight promotes graft maturation, so exposure should be encouraged
  4. D Tanning beds are the only safe form of sun exposure for grafts

Correct answer: Sun can permanently discolour the graft and cause burns, as oil and sweat glands are absent

Grafted skin lacks natural protection, making it vulnerable to sun-induced damages like discoloration and fragility.

Question 13 of 15 Easy

In reconstructive surgery following burns, what does the term 'take' of the graft refer to?

  1. A The patient physically taking the graft area home with them
  2. B The adherence, revascularisation, and survival of the grafted tissue
  3. C The body actively rejecting and sloughing off the graft
  4. D The graft predictably turning a darker colour over time

Correct answer: The adherence, revascularisation, and survival of the grafted tissue

'Graft take' signifies successful adherence, revascularization, and survival of the grafted tissue on the wound bed.

Question 14 of 15 Easy

What is the most critical nursing priority immediately after graft placement?

  1. A Ensuring the patient receives frequent high-calorie meals
  2. B Preventing shear and fluid build-up while immobilising the graft site
  3. C Encouraging vigorous early exercise of the grafted limb
  4. D Leaving the dressing off to inspect the site every 30 minutes

Correct answer: Preventing shear and fluid build-up while immobilising the graft site

Maintaining graft site immobilization, preventing fluid accumulation, and minimizing shear forces are crucial to optimize graft success.

Question 15 of 15 Medium

What reconstructive technique is often used when local tissue is scarred and insufficient for grafting?

  1. A Applying a simple non-adherent dressing and nothing more
  2. B A free or pedicled flap that transfers its own vascularised tissue
  3. C Delayed direct suturing of the existing wound edges
  4. D Allowing the wound to heal entirely by secondary intention

Correct answer: A free or pedicled flap that transfers its own vascularised tissue

Free flap or pedicled flap techniques are employed when local tissue is inadequate for grafting, providing viable vascularized tissue.

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