NSG300 EXAM 2 REAL EXAM PTRACTICE
QUESTIONS WITH VERIFIED SOLUTIONS
CURRENTLY TESTING AND APPROVED EXAM
How does a full thickness wound heal? ---- ANSWER----by forming new
tissue/scar formation, which takes longer (pressure ulcers)
-hemostasis: injured vessels constrict and platelets gather to stop bleeding
-inflammation: damaged tissue and mast cells secrete histamine (vasodilation of
surrounding capillaries and movement of serum and WBCs into damaged
tissue)
-proliferation: the vascular bed is reestablished (granulation tissue), the area is
filled with replacement tissue (collagen, contraction, and granulation tissue),
and the surface is repaired (epithelialization)
-maturation: The collagen scar continues to reorganize and gain strength for
several months. Collagen fibers undergo remodeling or reorganization before
assuming their normal appearance
primary intention ---- ANSWER----wound that is closed/approximated; little
tissue loss; low risk of infection; quick healing with no scar usually (surgical
incision)
secondary intention ---- ANSWER----a wound with loss of tissue; wound is not
approximated; have to heal from the inside-out; if scarring is severe, loss of
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,tissue function may be permanent (pressure ulcers, surgical wound that has
tissue loss)
tertiary intention ---- ANSWER----Wound that is left open for several days, then
wound edges are approximated; doctor can monitor status of wound
complications of wound healing ---- ANSWER----hemorrhage, infection,
dehiscence, evisceration
CMS ---- ANSWER----created policy for hospitals to no longer receive additional
reimbursement for care related to eight conditions to improve quality of health
care
Braden Scale ---- ANSWER----assesses risk for developing pressure ulcers;
includes patient's sensory perception, moisture, activity, mobility, nutrition,
friction and shear; the lower the number the higher the risk
>9= very high risk
10-12= high risk
13-14= moderate risk
15-18= mild risk
19-23= generally not at risk
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,type 1 ulcers ---- ANSWER----skin is intact but may be red or pink and warm to
the touch; no blanching
-for POC, there may be no noticeable blanching but skin color may vary
type 2 ulcers ---- ANSWER----partial-thickness loss of dermis; shallow broken
skin; red-pink wound bed
type 3 ulcers ---- ANSWER----full-thickness tissue loss with visible fat
(subcutaneous layer); pale-yellow color; may include slough but does not
obstruct view of depth of injury
type 4 ulcers ---- ANSWER----full-thickness tissue loss with exposed bone,
muscle, or tendon. possible tunneling and undermining
unstageable pressure ulcer ---- ANSWER----base of ulcer covered by slough
and/or eschar in the wound bed so the depth is unknown; exudate;
deep tissue injury ---- ANSWER----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.
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, how should you clean a wound ---- ANSWER----from least to most
contaminated
eschar ---- ANSWER----black, brown or necrotic tissue in wound bed; needs to
be removed before healing
slough ---- ANSWER----stringy pale-yellowish tissue that lays in the wound
bed; needs to be removed before healing
if a patient has slough, eschar, and infectious exudate which one would you be
most concerned about ---- ANSWER----infectious exudate
factors influencing heat and cold tolerance ---- ANSWER----Exposure time
Exposed skin
Temperature
Age
Perception of sensory stimuli
assessment for pressure ulcers includes ---- ANSWER----location, staging
(depth), type and % of tissue in wound bed, wound dimensions (including
tunneling), exudate description (if odor is present), and condition of
surrounding skin
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QUESTIONS WITH VERIFIED SOLUTIONS
CURRENTLY TESTING AND APPROVED EXAM
How does a full thickness wound heal? ---- ANSWER----by forming new
tissue/scar formation, which takes longer (pressure ulcers)
-hemostasis: injured vessels constrict and platelets gather to stop bleeding
-inflammation: damaged tissue and mast cells secrete histamine (vasodilation of
surrounding capillaries and movement of serum and WBCs into damaged
tissue)
-proliferation: the vascular bed is reestablished (granulation tissue), the area is
filled with replacement tissue (collagen, contraction, and granulation tissue),
and the surface is repaired (epithelialization)
-maturation: The collagen scar continues to reorganize and gain strength for
several months. Collagen fibers undergo remodeling or reorganization before
assuming their normal appearance
primary intention ---- ANSWER----wound that is closed/approximated; little
tissue loss; low risk of infection; quick healing with no scar usually (surgical
incision)
secondary intention ---- ANSWER----a wound with loss of tissue; wound is not
approximated; have to heal from the inside-out; if scarring is severe, loss of
Page | 1
,tissue function may be permanent (pressure ulcers, surgical wound that has
tissue loss)
tertiary intention ---- ANSWER----Wound that is left open for several days, then
wound edges are approximated; doctor can monitor status of wound
complications of wound healing ---- ANSWER----hemorrhage, infection,
dehiscence, evisceration
CMS ---- ANSWER----created policy for hospitals to no longer receive additional
reimbursement for care related to eight conditions to improve quality of health
care
Braden Scale ---- ANSWER----assesses risk for developing pressure ulcers;
includes patient's sensory perception, moisture, activity, mobility, nutrition,
friction and shear; the lower the number the higher the risk
>9= very high risk
10-12= high risk
13-14= moderate risk
15-18= mild risk
19-23= generally not at risk
Page | 2
,type 1 ulcers ---- ANSWER----skin is intact but may be red or pink and warm to
the touch; no blanching
-for POC, there may be no noticeable blanching but skin color may vary
type 2 ulcers ---- ANSWER----partial-thickness loss of dermis; shallow broken
skin; red-pink wound bed
type 3 ulcers ---- ANSWER----full-thickness tissue loss with visible fat
(subcutaneous layer); pale-yellow color; may include slough but does not
obstruct view of depth of injury
type 4 ulcers ---- ANSWER----full-thickness tissue loss with exposed bone,
muscle, or tendon. possible tunneling and undermining
unstageable pressure ulcer ---- ANSWER----base of ulcer covered by slough
and/or eschar in the wound bed so the depth is unknown; exudate;
deep tissue injury ---- ANSWER----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.
Page | 3
, how should you clean a wound ---- ANSWER----from least to most
contaminated
eschar ---- ANSWER----black, brown or necrotic tissue in wound bed; needs to
be removed before healing
slough ---- ANSWER----stringy pale-yellowish tissue that lays in the wound
bed; needs to be removed before healing
if a patient has slough, eschar, and infectious exudate which one would you be
most concerned about ---- ANSWER----infectious exudate
factors influencing heat and cold tolerance ---- ANSWER----Exposure time
Exposed skin
Temperature
Age
Perception of sensory stimuli
assessment for pressure ulcers includes ---- ANSWER----location, staging
(depth), type and % of tissue in wound bed, wound dimensions (including
tunneling), exudate description (if odor is present), and condition of
surrounding skin
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