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NURS 1503: FINAL EXAM Questions with Correct Answers
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NURS 1503: FINAL EXAM Questions with Correct Answers
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NURS 1503: FINAL EXAM Questions with CorrectAnswers
two layers of the skin Correct Answer-- epidermis (thin outer layer;
mainly connective tissue and few skin cells
- dermis (inner layer; provides protection of underlying muscles, bones
and organs)
examples of skin-associated issues Correct Answer-- age related changes
(decreased collagen/elasticity)
- attachment of dermis and epidermis become flat in older persons
- aging causes diminishes inflammatory response
- reduced nutritional intake
pressure injury Correct Answer-localized damage to the skin and/or
underlying soft tissue usually over a bony prominence or related to a
medical or other device
Three pressure related factors that contribute to pressure ulcer
development Correct Answer-pressure intensity
pressure duration
tissue tolerance
pressure intensity Correct Answer--pressure exceeds normal capillary
pressure (15-32mm)
-vessels occlude and tissue ischemia develops
, -tissue may be damaged or tissue death may result
characteristics of dark skin at risk of skin breakdown Correct Answer--
colour remains unchanged
- localized area may turn a purplish colour rather than red
- look in a natural light
- compare to surrounding skin
- warm to touch
- edema may occur
- area may be sensitive and tender to touch
pressure duration Correct Answer-- Low pressure over prolonged period
of time &/or High pressure over a short period of time
-pressures occur quickly (1-2hrs)
- occludes blood flow and nutrients and contributes to cell death
tissue tolerance Correct Answer-- the ability of tissue to endure pressure
depends on the integrity of the tissue and the supporting structures
- extrinsic factors: shear friction and moisture
- poor nutrition, age and low blood pressure affect tissue tolerance
risk factors for pressure injury development Correct Answer-- factors
directly related to disease like decreased consciousness, aftereffects of
trauma and presence of cast
- braden scale helps to determine appropriate interventions
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