NSG 3280 EXAM 2 with questions and well
verified answers real 2026!!!
Integumentary System & Infectious Diseases
1. Which of the following is the primary reason older adults are more prone to pressure ulcers?
A. Decreased sweat gland activity
B. Loss of subcutaneous tissue
C. Reduced melanocyte function
D. Thinning of the epidermis
ANSWER>✔-: B. Loss of subcutaneous tissue
Rationale: Subcutaneous tissue provides cushioning and insulation, protecting underlying structures
from pressure. Loss of this tissue with aging reduces the padding over bony prominences, increasing
pressure ulcer risk. Decreased sweat gland activity affects temperature regulation, reduced melanocytes
affect pigmentation, and epidermal thinning affects barrier function, but none are the primary reason
for pressure ulcer susceptibility.
2. An 82-year-old patient is admitted to a long-term care facility. Which assessment finding indicates the
highest risk for pressure ulcer development?
A. Skin turgor of 3 seconds
B. Body mass index of 32
C. Braden Scale score of 14
D. History of diabetes mellitus
,ANSWER>✔-: C. Braden Scale score of 14
Rationale: A Braden Scale score of 14 indicates moderate risk (scores ≤18 indicate risk; lower scores =
higher risk). Advanced age alone is not a direct risk factor without other contributors. Obesity (BMI 32)
may actually provide additional padding, though immobility can still pose risk. Diabetes contributes to
risk but is factored into the Braden Scale assessment.
3. Which intervention is most effective in preventing pressure ulcers in an immobile patient?
A. Massaging bony prominences daily
B. Using ring cushions on heels
C. Repositioning every 2 hours
D. Applying barrier cream only
ANSWER>✔-: C. Repositioning every 2 hours
Rationale: Regular repositioning relieves pressure on vulnerable areas, allowing tissue reperfusion.
Massaging bony prominences can damage fragile capillaries. Ring cushions are no longer recommended
as they can cause venous pooling and tissue ischemia. Barrier cream protects from moisture but does
not address pressure.
4. A patient has a Stage 2 pressure ulcer on the sacrum. Which finding is characteristic of this stage?
A. Non-blanchable erythema of intact skin
B. Full-thickness skin loss with visible fat
C. Partial-thickness skin loss with exposed dermis
D. Full-thickness tissue loss with bone exposure
ANSWER>✔-: C. Partial-thickness skin loss with exposed dermis
,Rationale: Stage 2 pressure ulcers present as partial-thickness skin loss involving epidermis and dermis.
Non-blanchable erythema describes Stage 1. Full-thickness skin loss with visible fat describes Stage 3.
Full-thickness tissue loss with bone exposure describes Stage 4.
5. Which laboratory finding is associated with Lyme disease transmission?
A. Elevated C-reactive protein
B. Positive Western blot test
C. Decreased platelet count
D. Elevated liver enzymes
ANSWER>✔-: B. Positive Western blot test
Rationale: Western blot is a confirmatory test for Lyme disease. C-reactive protein is non-specific for
inflammation. Platelet counts are not specifically affected. Liver enzymes may be elevated but are not
diagnostic for Lyme disease.
6. A patient reports exposure to white-tailed deer in a wooded area and presents with erythema
migrans. Which organism is responsible for this condition?
A. Rickettsia rickettsii
B. Borrelia burgdorferi
C. Ehrlichia chaffeensis
D. Anaplasma phagocytophilum
ANSWER>✔-: B. Borrelia burgdorferi
Rationale: Borrelia burgdorferi is the spirochete responsible for Lyme disease, transmitted by Ixodes
ticks that feed on white-tailed deer. Rickettsia rickettsii causes Rocky Mountain spotted fever. Ehrlichia
and Anaplasma are other tick-borne pathogens but are not associated with erythema migrans.
, 7. Which statement by a patient indicates understanding of Lyme disease prevention?
A. "I will apply insect repellent only after entering wooded areas."
B. "I should wear dark clothing to repel ticks."
C. "I will check for ticks after spending time outdoors and remove them promptly."
D. "Ticks must be attached for at least 48 hours to transmit disease."
ANSWER>✔-: C. "I will check for ticks after spending time outdoors and remove them promptly."
Rationale: Prompt tick removal within 24-36 hours prevents transmission. Repellent should be applied
before entering wooded areas. Light-colored clothing makes ticks easier to see. Transmission can occur
within 24-36 hours of attachment.
8. A patient presents with target-like skin lesions, fever, and fatigue after a camping trip. Which
diagnostic test confirms Lyme disease?
A. Complete blood count
B. Erythrocyte sedimentation rate
C. Enzyme-linked immunosorbent assay (ELISA)
D. Chest X-ray
ANSWER>✔-: C. Enzyme-linked immunosorbent assay (ELISA)
Rationale: ELISA is the initial screening test for Lyme disease, followed by Western blot confirmation.
CBC and ESR are non-specific. Chest X-ray is not diagnostic for Lyme disease.
9. Which education should the nurse provide about Lyme disease treatment?
A. "Antibiotics are effective only in the early stages."
B. "Treatment typically requires intravenous antibiotics for all cases."
verified answers real 2026!!!
Integumentary System & Infectious Diseases
1. Which of the following is the primary reason older adults are more prone to pressure ulcers?
A. Decreased sweat gland activity
B. Loss of subcutaneous tissue
C. Reduced melanocyte function
D. Thinning of the epidermis
ANSWER>✔-: B. Loss of subcutaneous tissue
Rationale: Subcutaneous tissue provides cushioning and insulation, protecting underlying structures
from pressure. Loss of this tissue with aging reduces the padding over bony prominences, increasing
pressure ulcer risk. Decreased sweat gland activity affects temperature regulation, reduced melanocytes
affect pigmentation, and epidermal thinning affects barrier function, but none are the primary reason
for pressure ulcer susceptibility.
2. An 82-year-old patient is admitted to a long-term care facility. Which assessment finding indicates the
highest risk for pressure ulcer development?
A. Skin turgor of 3 seconds
B. Body mass index of 32
C. Braden Scale score of 14
D. History of diabetes mellitus
,ANSWER>✔-: C. Braden Scale score of 14
Rationale: A Braden Scale score of 14 indicates moderate risk (scores ≤18 indicate risk; lower scores =
higher risk). Advanced age alone is not a direct risk factor without other contributors. Obesity (BMI 32)
may actually provide additional padding, though immobility can still pose risk. Diabetes contributes to
risk but is factored into the Braden Scale assessment.
3. Which intervention is most effective in preventing pressure ulcers in an immobile patient?
A. Massaging bony prominences daily
B. Using ring cushions on heels
C. Repositioning every 2 hours
D. Applying barrier cream only
ANSWER>✔-: C. Repositioning every 2 hours
Rationale: Regular repositioning relieves pressure on vulnerable areas, allowing tissue reperfusion.
Massaging bony prominences can damage fragile capillaries. Ring cushions are no longer recommended
as they can cause venous pooling and tissue ischemia. Barrier cream protects from moisture but does
not address pressure.
4. A patient has a Stage 2 pressure ulcer on the sacrum. Which finding is characteristic of this stage?
A. Non-blanchable erythema of intact skin
B. Full-thickness skin loss with visible fat
C. Partial-thickness skin loss with exposed dermis
D. Full-thickness tissue loss with bone exposure
ANSWER>✔-: C. Partial-thickness skin loss with exposed dermis
,Rationale: Stage 2 pressure ulcers present as partial-thickness skin loss involving epidermis and dermis.
Non-blanchable erythema describes Stage 1. Full-thickness skin loss with visible fat describes Stage 3.
Full-thickness tissue loss with bone exposure describes Stage 4.
5. Which laboratory finding is associated with Lyme disease transmission?
A. Elevated C-reactive protein
B. Positive Western blot test
C. Decreased platelet count
D. Elevated liver enzymes
ANSWER>✔-: B. Positive Western blot test
Rationale: Western blot is a confirmatory test for Lyme disease. C-reactive protein is non-specific for
inflammation. Platelet counts are not specifically affected. Liver enzymes may be elevated but are not
diagnostic for Lyme disease.
6. A patient reports exposure to white-tailed deer in a wooded area and presents with erythema
migrans. Which organism is responsible for this condition?
A. Rickettsia rickettsii
B. Borrelia burgdorferi
C. Ehrlichia chaffeensis
D. Anaplasma phagocytophilum
ANSWER>✔-: B. Borrelia burgdorferi
Rationale: Borrelia burgdorferi is the spirochete responsible for Lyme disease, transmitted by Ixodes
ticks that feed on white-tailed deer. Rickettsia rickettsii causes Rocky Mountain spotted fever. Ehrlichia
and Anaplasma are other tick-borne pathogens but are not associated with erythema migrans.
, 7. Which statement by a patient indicates understanding of Lyme disease prevention?
A. "I will apply insect repellent only after entering wooded areas."
B. "I should wear dark clothing to repel ticks."
C. "I will check for ticks after spending time outdoors and remove them promptly."
D. "Ticks must be attached for at least 48 hours to transmit disease."
ANSWER>✔-: C. "I will check for ticks after spending time outdoors and remove them promptly."
Rationale: Prompt tick removal within 24-36 hours prevents transmission. Repellent should be applied
before entering wooded areas. Light-colored clothing makes ticks easier to see. Transmission can occur
within 24-36 hours of attachment.
8. A patient presents with target-like skin lesions, fever, and fatigue after a camping trip. Which
diagnostic test confirms Lyme disease?
A. Complete blood count
B. Erythrocyte sedimentation rate
C. Enzyme-linked immunosorbent assay (ELISA)
D. Chest X-ray
ANSWER>✔-: C. Enzyme-linked immunosorbent assay (ELISA)
Rationale: ELISA is the initial screening test for Lyme disease, followed by Western blot confirmation.
CBC and ESR are non-specific. Chest X-ray is not diagnostic for Lyme disease.
9. Which education should the nurse provide about Lyme disease treatment?
A. "Antibiotics are effective only in the early stages."
B. "Treatment typically requires intravenous antibiotics for all cases."
