NSG 100- TEST 3 EXAM QUESTIONS AND ANSWERS
WITH COMPLETE SOLUTIONS
Stage 1 Pressure Injury
Stage 1 pressure injuries are not open wounds. The skin may be painful, but it has no
breaks or tears. The skin appears reddened and does not blanch (lose colour briefly
when you press your finger on it and then remove your finger).
Stage 2 Pressure Injury
*partial thickness skin loss with exposed dermis.
*the wound bed is pink or red and moist, may appear as an intact or ruptured blister.
Stage 3 Pressure Injury
full thickness loss, looks like deep crater extend to fascia, subtaneous tissue
damged/necrpticfat visable
undermining/tunneling may be present damage to surrounding tissue
Stage 4 Pressure Injury
Full thickness skin and tissue loss, exposed fascia, muscle, tendon, ligament, cartilage,
or bone
Eshcar wound
Dead tissue that forms over healthy skin and then, over time, falls off (sheds)
Granulation Tissue
new tissue that is pink/red in color and composed of fibroblasts and small blood vessels
that fill an open wound when it starts to heal
Closed Wound
, an internal injury with no open pathway from the outside
Wound healing phases
1. Inflammation
2. Proliferation
3. Remodeling
Primary wound healing (first intention)
Occurs in clean lacerations and surgical incisions; closed with skin adhesives or sutures
Secondary wound healing
(Second Intention Healing) type of healing that occurs when wounds have increased
tissue loss, a more intense inflammatory reaction, increased formation of granulation
tissue, and the formation of a substantial scar
Tertiary wound healing
the healing of wounds through the use of tissue grafts to cover large wounds and
bridge the gap between wound edges.
Evisceration
The displacement of organs outside of the body.
Irrigating a wound
Gloves, gown, mask/goggles or a face shield
Irrigating a wound
Irrigation are useful for cleaning open deep wounds or sensitive or inaccessible body
parts
Braden Scale
A tool for predicting pressure ulcer risk
WITH COMPLETE SOLUTIONS
Stage 1 Pressure Injury
Stage 1 pressure injuries are not open wounds. The skin may be painful, but it has no
breaks or tears. The skin appears reddened and does not blanch (lose colour briefly
when you press your finger on it and then remove your finger).
Stage 2 Pressure Injury
*partial thickness skin loss with exposed dermis.
*the wound bed is pink or red and moist, may appear as an intact or ruptured blister.
Stage 3 Pressure Injury
full thickness loss, looks like deep crater extend to fascia, subtaneous tissue
damged/necrpticfat visable
undermining/tunneling may be present damage to surrounding tissue
Stage 4 Pressure Injury
Full thickness skin and tissue loss, exposed fascia, muscle, tendon, ligament, cartilage,
or bone
Eshcar wound
Dead tissue that forms over healthy skin and then, over time, falls off (sheds)
Granulation Tissue
new tissue that is pink/red in color and composed of fibroblasts and small blood vessels
that fill an open wound when it starts to heal
Closed Wound
, an internal injury with no open pathway from the outside
Wound healing phases
1. Inflammation
2. Proliferation
3. Remodeling
Primary wound healing (first intention)
Occurs in clean lacerations and surgical incisions; closed with skin adhesives or sutures
Secondary wound healing
(Second Intention Healing) type of healing that occurs when wounds have increased
tissue loss, a more intense inflammatory reaction, increased formation of granulation
tissue, and the formation of a substantial scar
Tertiary wound healing
the healing of wounds through the use of tissue grafts to cover large wounds and
bridge the gap between wound edges.
Evisceration
The displacement of organs outside of the body.
Irrigating a wound
Gloves, gown, mask/goggles or a face shield
Irrigating a wound
Irrigation are useful for cleaning open deep wounds or sensitive or inaccessible body
parts
Braden Scale
A tool for predicting pressure ulcer risk
