Stage 3 of pressure ulcer is characterized by ________.

full thickness tissue loss with visible fat

non-blanchable erythema of intact skin

partial thickness loss of dermis presenting as a shallow open ulcer

Stage 4 of pressure ulcer is characterized by ________.

full thickness tissue loss with exposed bone, muscle, or tendon

full thickness non-blanchable erythema of intact skin

partial thickness loss of dermis presenting as a shallow open ulcer

full-thickness tissue loss with localized area of non-blanchable deep red, maroon, or purple discoloration

An unstageable pressure ulcer is characterized by ________.

full thickness tissue loss in which the base of the ulcer is covered by eschar/necrosis in the wound bed

full thickness loss of dermis presenting as a shallow open ulcer

full thickness tissue loss in which the base of the ulcer is covered by erythema/petechiae in the wound bed

full thickness tissue loss with exposed bone, tendon, or muscle in the wound bed

The normal process of wound healing involves which of the following differences between partial thickness and full thickness healing?

Partial thickness wounds heal mainly by epithelialization, while full thickness wounds heal by granulation, contraction, and epithelialization.

Partial thickness wounds heal by granulation tissue formation only, while full thickness wounds heal by epithelialization only.

Both partial and full thickness wounds heal exclusively by contraction, granulation, and contraction.

Partial thickness wounds do not require any cellular activity, while full thickness wounds require only inflammation.

Wound healing by primary and secondary intention differ in which of the following aspects?

Primary intention involves minimal tissue loss and faster healing, while secondary intention involves significant tissue loss and slower healing.

Primary intention results in more scarring than secondary intention.

Secondary intention is used for clean, surgical wounds with edges that can be approximated.

Secondary intention involves minimal tissue loss and faster healing, while primary intention involves significant tissue loss and slower healing.

Factors that impede or promote wound healing include which of the following: moisture accumulation and nutrition?

Moisture accumulation and nutrition both affect wound healing.

Only moisture accumulation affects wound healing, not nutrition.

Only nutrition affects wound healing, not moisture accumulation.

Neither moisture accumulation nor nutrition affect wound healing.

State differences between nursing care of acute and chronic wounds.

Acute wounds are usually from surgical incisions or acute trauma, with the goal to have a complete heal if possible. Chronic wounds include pressure ulcers, cancers, major trauma, etc., with the goal to stave off infection and not allow the wound to get worse, keep wounds clean, dressings changed, and debride. Chronic wounds will likely never fully heal and require constant monitoring and attention.

Acute wounds are usually from surgical incisions or acute trauma, with the goal to have a incomplete heal if possible. Chronic wounds include pressure ulcers, cancers, major trauma, etc., with the goal to promote infection and not allow the wound to get worse, keep wounds clean, dressings changed, and debride. Chronic wounds will likely never fully heal and require constant monitoring and attention.

Nursing care for both acute and chronic wounds is identical, with no difference in approach or goals.

Acute wounds are usually from surgical incisions or acute trauma, with the goal to have a complete heal if possible. Chronic wounds include pressure ulcers, cancers, major trauma, etc., with the goal to stave off infection and not allow the wound to get better, keep wounds clean, dressings changed, and debride. Chronic wounds will likely fully heal and require constant monitoring and attention.

List appropriate nursing assessments for a patient with impaired skin integrity.

When inspecting a wound, the type of wound will guide assessment. For abrasions: superficial, little bleeding, plasma leakage, damaged capillaries. For lacerations: slice, may be heavy bleeding. For punctures: poke, deeper punctures have the potential to damage more structures than just the skin. For surgical wounds: wound made from procedure, should be tightly controlled and as small as possible. Describe the amount, color, consistency, and odor of wound drainage. Use REEDA for assessment.

When inspecting a wound, the type of wound will guide assessment. For abrasions: deep, heavy bleeding, plasma leakage, damaged capillaries. For lacerations: slice, may be heavy bleeding. For punctures: poke, deeper punctures have less potential to damage more structures than just the skin. For surgical wounds: wound made from procedure, should be tightly controlled and as small as possible. Describe the amount, color, consistency, and odor of wound drainage. Use REEDA for assessment.

When inspecting a wound, the type of wound will guide assessment. For abrasions: superficial, little bleeding, plasma leakage, damaged capillaries. For lacerations: chunk missing, may be heavy bleeding. For punctures: poke, deeper punctures have the potential to damage more structures than just the skin. For surgical wounds: wound made from procedure, should be tightly controlled and as large as possible. Describe the amount, color, consistency, and odor of wound drainage. Use REEDA for assessment.

When inspecting a wound, the type of wound will guide assessment. For abrasions: superficial, little bleeding, plasma leakage, damaged capillaries. For lacerations: slice, may be heavy bleeding. For punctures: poke, deeper punctures have the potential to damage more structures than just the skin. For surgical wounds: wound made from procedure, should be tightly controlled and as small as possible. Describe the amount, color, consistency, and taste of wound drainage. Use DIVA for assessment.

Identify different 'drainage' & significance of each type. What is serous drainage?

Serous drainage is clear (weeping, possible infection).

Serous drainage is thick and greenish-yellow in color.

Serous drainage contains large amounts of blood and clots.

Serous drainage is always foul-smelling and quite pussy.

Identify different 'drainage' & significance of each type. What is sanguineous drainage?

Sanguineous drainage is bright red bloody (active bleeding).

Sanguineous drainage is clear and watery.

Sanguineous drainage is thick and yellow-green.

Sanguineous drainage is pink and serous.

Identify different 'drainage' & significance of each type. What is serosanguineous drainage?

Serosanguineous drainage is clear and red combined (some active bleeding).

Serosanguineous drainage is thick, yellow, and foul-smelling.

Serosanguineous drainage is pure, bright red blood only (active bleeding) .

Serosanguineous drainage is watery and completely clear (active juicing).

Identify different 'drainage' & significance of each type. What is purulent drainage?

Purulent drainage is yellow/green (infection).

Purulent drainage is clear and watery (normal healing).

Purulent drainage is thin and pink (serosanguineous).

Purulent drainage is thick and brown (old blood).

Describe physiological processes of ventilation, perfusion, & exchange of respiratory gases. What is ventilation?

Ventilation is the process of moving gases into and out of the lungs.

Ventilation is the process of oxygen binding to hemoglobin in the blood.

Ventilation is the exchange of nutrients between blood and tissues.

Ventilation is the process of filtering blood in the kidneys.

Describe physiological processes of ventilation, perfusion, & exchange of respiratory gases. What is perfusion?

Perfusion is the ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs.

Perfusion is the process of air moving in and out of the lungs.

Perfusion is the exchange of gases between alveoli and ciliated pulmonary epithelium.

Perfusion is the breakdown of nutrients in the cardiopulmonary complex.

Describe physiological processes of ventilation, perfusion, & exchange of respiratory gases. What is diffusion?

Diffusion is the exchange of respiratory gases in the alveoli and capillaries.

Diffusion is the process of blood flow through the heart chambers.

Diffusion is the movement of air into and out of the lungs only.

Diffusion is the contraction of respiratory muscles during inhalation.

Discuss the effect of a patient’s level of health, age, lifestyle, and environment on oxygenation. (List at least three factors and their effects.)

Poor nutrition, lack of exercise, smoking, CVD disease, old age, and working around toxic chemicals, fumes, and pollution can all have a negative effect on oxygenation.

High levels of physical activity, young age, and living in clean environments always decrease oxygenation.

Only genetic factors affect oxygenation, not lifestyle or environment.

Oxygenation is only affected by age and not by lifestyle or environment.

Assess for risk factors affecting a patient’s oxygenation.

Substance abuse and constant state of stress can have a negative effect. Physiological factors include decreased oxygen-carrying capacity and decreased inspired oxygen concentration.

High carbohydrate intake and constant chest pain can have a negative effect. Physiological factors include decreased oxygen-carrying capacity and decreased inspired oxygen concentration.

Substance abuse and constant state of stress can have a negative effect. Physiological factors include decreased oxygen-carrying capacity and decreased expired oxygen concentration.

Not doing enough hard drugs and constant state of relaxation can have a negative effect. Physiological factors include decreased oxygen-carrying capacity and decreased inspired oxygen concentration.

Which of the following is NOT a nursing care intervention used to promote oxygenation?

Review of drug, food, and other allergies

Which of the following is an invasive pulmonary diagnostic procedure?

PFT (pulmonary fibrosis therapy)

Which of the following is NOT a method of health promotion listed in the worksheet?

Avoidance of environmental pollutants

Which technique helps to mobilize pulmonary secretions?

Coughing/deep-breathing techniques

Fundamentals Exam #2: Part 1

Authored by Ben Alter

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MULTIPLE CHOICE QUESTION

30 sec • 1 pt

State risk factors that contribute to pressure ulcer formation.

Immobility, poor nutrition, and decreased sensation

Frequent repositioning and good hydration

Regular exercise and balanced diet

High levels of physical activity

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Impaired sensory perception (i.e. neuropathy) is a risk factor for what condition related to skin integrity?

Pressure ulcer formation

Psoriasis

Eczema

Acne

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Alterations in LOC is a risk factor for what condition related to skin integrity?

Pressure ulcer formation

Eczema

Psoriasis

Acne

Shearing is a risk factor for what condition related to skin integrity?

Pressure ulcer formation

Eczema

Psoriasis

Cellulitis

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

The pressure ulcer staging system is used to:

Classify the severity of tissue damage in pressure ulcers

Measure blood pressure in patients with ulcers

Diagnose the cause of pressure ulcers

Determine the type of bacteria in ulcers

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Stage 1 of pressure ulcer is characterized by ________.

intact skin with non-blanchable redness

open wound with exposed bone

blister with serous fluid

necrotic tissue with eschar

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Stage 2 of pressure ulcer is characterized by ________.

partial thickness skin loss involving epidermis, dermis, or both

full thickness skin loss with damage to or necrosis of subcutaneous tissue

intact skin with non-blanchable redness

exposed bone, tendon, or muscle

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