NFDN 1002 FINAL REVIEW EXAM AND
ALL ACTUAL ANSWERS.
11 medication rights - Answer Person
Drug/Medication
Dose
Route
Time
Assessment
Reason
Education
Documentation
Evaluation
Refuse
different routes of medication administration - Answer SC
IM
IV
Subdermal
PO - by mouth
Topical - inhaler, cream, spray, rectal, drops, sublingual (under tongue), buccal (cheek),
transdermal
different stages of pressure ulcers - Answer Deep Tissue Injury
Stage 1
Stage 2
Stage 3
Stage 4
Unstageable
Deep Tissue Injury - Answer Persistent non-blanchable deep red, purple discoloration
Epidermis separated, blister
Results from prolonged pressure
Stage 1 Pressure Ulcer - Answer Non-blanchable erythema of area
,Over bony prominence
Skin discolouration
Warmth; edema; hardness; pain
Darker skin
No visible blanching
Area painful; firmer/softer
Warm/cooler
Managing Stage 1 Pressure Ulcer - Answer Relieve pressure
Barrier cream
Stage 2 Pressure Ulcer - Answer Partial thickness skin loss or blister
Shallow open ulcer ; pink wound bed
No slough/bruising
Management of Stage 2 Pressure Ulcer - Answer transparent film
Stage 3 Pressure Ulcer - Answer Full thickness skin loss
Necrosis & drainage
Infection develops
Managing Stage 3 Pressure Ulcer - Answer Treated with wound vacuum assisted closure
surgical - skin closure, flaps, grafting
synthetic gauze
Stage 4 Pressure Ulcer - Answer Extends to underlying muscle & bone
Deep pockets of infection
Necrosis & drainage
Management of Stage 4 Pressure Ulcer - Answer Foam dressings
Wound vacuum
Unstagable Pressure Ulcer - Answer Full thickness skin & tissue loss
Tissue damage undetermined - presence of slough/discharge & eschar
, Negative Pressure Wound Therapy [NPWT] - Answer promotes wound healing and closure
application of negative pressure on wound bed = decreased bacteria, removal of excess
drainage
provides moist environment
pressure stimulates blood flow & cell growth
growth of new blood vessels
Pressure Ulcer Contributing Factors - Answer Nutritional deficiencies
Anemia - Decrease blood O2 carrying capacity
Vitamin D
Metabolic disorders - low protein levels
4 places that you would assess for pressure ulcer development - Answer heels, shoulders,
coccyx, sacrum, spine, elbows, scapula, back of head, toes, greater trochanter, iliac crest, ear,
knees, breasts, cheek, mens genitalia
3 strategies for pressure ulcer prevention - Answer braden scale
manage incontience
apply barrier cream
nutrition - protein [wound healing], carb [energy], fats [energy], vitamins/minerals [support vital
functions]
frequent changing of position
keep skin clean and dry
hydration
don't elevate hob more than 45 degrees
positions you can place a patient in - Answer supine - on back
prone - face down
sims - on side, knees bent
side lying
high fowlers - 90 degrees
semi fowlers - 45 degrees
transdelenberg -
moments of hand hygiene - Answer When coming on duty
Before and after breaks
ALL ACTUAL ANSWERS.
11 medication rights - Answer Person
Drug/Medication
Dose
Route
Time
Assessment
Reason
Education
Documentation
Evaluation
Refuse
different routes of medication administration - Answer SC
IM
IV
Subdermal
PO - by mouth
Topical - inhaler, cream, spray, rectal, drops, sublingual (under tongue), buccal (cheek),
transdermal
different stages of pressure ulcers - Answer Deep Tissue Injury
Stage 1
Stage 2
Stage 3
Stage 4
Unstageable
Deep Tissue Injury - Answer Persistent non-blanchable deep red, purple discoloration
Epidermis separated, blister
Results from prolonged pressure
Stage 1 Pressure Ulcer - Answer Non-blanchable erythema of area
,Over bony prominence
Skin discolouration
Warmth; edema; hardness; pain
Darker skin
No visible blanching
Area painful; firmer/softer
Warm/cooler
Managing Stage 1 Pressure Ulcer - Answer Relieve pressure
Barrier cream
Stage 2 Pressure Ulcer - Answer Partial thickness skin loss or blister
Shallow open ulcer ; pink wound bed
No slough/bruising
Management of Stage 2 Pressure Ulcer - Answer transparent film
Stage 3 Pressure Ulcer - Answer Full thickness skin loss
Necrosis & drainage
Infection develops
Managing Stage 3 Pressure Ulcer - Answer Treated with wound vacuum assisted closure
surgical - skin closure, flaps, grafting
synthetic gauze
Stage 4 Pressure Ulcer - Answer Extends to underlying muscle & bone
Deep pockets of infection
Necrosis & drainage
Management of Stage 4 Pressure Ulcer - Answer Foam dressings
Wound vacuum
Unstagable Pressure Ulcer - Answer Full thickness skin & tissue loss
Tissue damage undetermined - presence of slough/discharge & eschar
, Negative Pressure Wound Therapy [NPWT] - Answer promotes wound healing and closure
application of negative pressure on wound bed = decreased bacteria, removal of excess
drainage
provides moist environment
pressure stimulates blood flow & cell growth
growth of new blood vessels
Pressure Ulcer Contributing Factors - Answer Nutritional deficiencies
Anemia - Decrease blood O2 carrying capacity
Vitamin D
Metabolic disorders - low protein levels
4 places that you would assess for pressure ulcer development - Answer heels, shoulders,
coccyx, sacrum, spine, elbows, scapula, back of head, toes, greater trochanter, iliac crest, ear,
knees, breasts, cheek, mens genitalia
3 strategies for pressure ulcer prevention - Answer braden scale
manage incontience
apply barrier cream
nutrition - protein [wound healing], carb [energy], fats [energy], vitamins/minerals [support vital
functions]
frequent changing of position
keep skin clean and dry
hydration
don't elevate hob more than 45 degrees
positions you can place a patient in - Answer supine - on back
prone - face down
sims - on side, knees bent
side lying
high fowlers - 90 degrees
semi fowlers - 45 degrees
transdelenberg -
moments of hand hygiene - Answer When coming on duty
Before and after breaks
