NUR 155 EXAM QUESTIONS AND
THEIR ANSWERS
What is a Circular Turn Bandage?
used to anchor bandages and to terminate them. usually are
not applies directly over a wound because of the discomfort the
bandage would cause
what is a spiral turn bandage?
used to bandage parts of the body that are fairly uniform in
circumference.
What is a binder used for?
used to support large areas of the body, such as the abdomen
or chest. helps to prevent dehiscent
Pressure Ulcer stage I
nonbankable erythema signaling potential ulceration.
Pressure Ulcer Stage 2
partial thickness skin loss (abrasion, blister, or shallow crater)
involving the epidermis and possibly the dermis
Pressure Ulcer Stage 3
Full thickness skin loss involving damage or necrosis of
subcutaneous tissue that may extend down to, but not through,
,underlying fascia. the ulcer presents clinically as a deep crater
with or without undermining of adjacent tissue.
Pressure ulcer stage 4
full thickness skin loss with tissue necrosis or damage to
muscle, bone, or supporting structures, such as tendons or joint
capsule. undermining and sinus tracts may be present
Pressure ulcer stage unstagable
full thickness skin or tissue loss. depth is unknown. actual depth
of the ulcer is completely obscured by slough (yellow, tan, gray,
green, or brown) and or eschar (brown, tan, black) in the
wound bed
Suspected deep tissue injury
Purple or maroon localized area of discolored intact skin or
blood-filled blister due to damage of underlying soft tissue from
pressure and/or shear.
What is stage 1 ulcer treatment?
relieve pressure by frequent turning
keep the client dry, clean, and well nourished and hydrated
what is stage 2 ulcer treatment?
maintain a moist healing environment (saline or occlusive
dressing) apply hyocolloid dressing
promote natural healing while preventing the formation of scar
tissues
, administer analgesics
provide nutritional supplements
what is stage 3 ulcer treatment?
clean and debride the following:
prescribed dressing, surgical intervention, and proteolytic
enzymes
administer antimicrobials (topical or systemic)
what is stage 4 ulcer treatment?
perform non adherent dressing changes every 12 hr
treatment can be skin grafts or specialized therapy such as
hyperbaric oxygen
same as rest of stages
what is wound exudate?
material such as fluid and cells, that has escaped from blood
vessels during the inflammatory process and is deposited in
tissue or on tissue surfaces
what is serous exudate?
clear watery fluid from plasma
ex. fluid in blister from a burn
what is purulent exudate?
thicker than serous exudate because of the presence of pus,
which consists of leukocytes, liquified dead tissue debris, and
dead and living bacteria.
THEIR ANSWERS
What is a Circular Turn Bandage?
used to anchor bandages and to terminate them. usually are
not applies directly over a wound because of the discomfort the
bandage would cause
what is a spiral turn bandage?
used to bandage parts of the body that are fairly uniform in
circumference.
What is a binder used for?
used to support large areas of the body, such as the abdomen
or chest. helps to prevent dehiscent
Pressure Ulcer stage I
nonbankable erythema signaling potential ulceration.
Pressure Ulcer Stage 2
partial thickness skin loss (abrasion, blister, or shallow crater)
involving the epidermis and possibly the dermis
Pressure Ulcer Stage 3
Full thickness skin loss involving damage or necrosis of
subcutaneous tissue that may extend down to, but not through,
,underlying fascia. the ulcer presents clinically as a deep crater
with or without undermining of adjacent tissue.
Pressure ulcer stage 4
full thickness skin loss with tissue necrosis or damage to
muscle, bone, or supporting structures, such as tendons or joint
capsule. undermining and sinus tracts may be present
Pressure ulcer stage unstagable
full thickness skin or tissue loss. depth is unknown. actual depth
of the ulcer is completely obscured by slough (yellow, tan, gray,
green, or brown) and or eschar (brown, tan, black) in the
wound bed
Suspected deep tissue injury
Purple or maroon localized area of discolored intact skin or
blood-filled blister due to damage of underlying soft tissue from
pressure and/or shear.
What is stage 1 ulcer treatment?
relieve pressure by frequent turning
keep the client dry, clean, and well nourished and hydrated
what is stage 2 ulcer treatment?
maintain a moist healing environment (saline or occlusive
dressing) apply hyocolloid dressing
promote natural healing while preventing the formation of scar
tissues
, administer analgesics
provide nutritional supplements
what is stage 3 ulcer treatment?
clean and debride the following:
prescribed dressing, surgical intervention, and proteolytic
enzymes
administer antimicrobials (topical or systemic)
what is stage 4 ulcer treatment?
perform non adherent dressing changes every 12 hr
treatment can be skin grafts or specialized therapy such as
hyperbaric oxygen
same as rest of stages
what is wound exudate?
material such as fluid and cells, that has escaped from blood
vessels during the inflammatory process and is deposited in
tissue or on tissue surfaces
what is serous exudate?
clear watery fluid from plasma
ex. fluid in blister from a burn
what is purulent exudate?
thicker than serous exudate because of the presence of pus,
which consists of leukocytes, liquified dead tissue debris, and
dead and living bacteria.
