WTA COURSE FINAL COMPREHENSIVE
QUESTIONS AND CORRECT ANSWERS
◉ TRUE OR FALSE
___ Dermis is normally acid and dry
Answer: F
Dermis is the inner most layer of skin that is naturally moist and
slightly acid.
◉ TRUE OR FALSE
___ Epidermis can regenerate
Answer: T
Epidermis is the outer layer of skin, composed of stratified
squamous epithelial cells, which can reproduce/regenerate to
replace lost cells.
◉ TRUE OR FALSE
___ Subcutaneous tissue is the 3rd layer of the skin.
Answer: F
Subcutaneous tissue is not a layer of skin. Only the epidermis and
dermis comprise the skin. Subcutaneous tissue is fatty
tissue/adipose tissue underneath the skin that provides padding
and protection.
,◉ Muscle tissue is more susceptible to pressure injury than skin.
Answer: T
Muscle tissue is highly vascular with a higher metabolic rate and
therefore is more susceptible than skin to effects of prolonged
pressure. Muscle is also not capable of reproduction/regeneration.
◉ Identify anatomical differences that increase the risk of skin tears
among newborns and the elderly. __________
Answer: Rete pegs and rete ridges are epidermal protrusions that
project down into the dermis to interlock with the dermal papillae to
provide strength and stability of the skin layers and prevent skin
tears. Without the interlocking of the epidermis to the dermis, or if
there is flattening of this junction, the epidermis can easily be torn
away from the dermis. This interlocking feature has not yet formed
in the newborn, and is lost in the elderly; this results in reduced
cohesion between the epidermis and dermis, and increased risk for
skin tears. There is decreased cohesion between the epidermis and
dermis in the very young and in the elderly.
◉ TRUE OR FALSE
___ Pressure applied to the skin causes the greatest amount of
pressure at the epidermis.
Answer: F
,Pressure extends from the surface in a pressure gradient with the
highest pressure at the bone/tissue interface rather than at the skin
surface. Pressure usually results in full thickness damage.
◉ TRUE OR FALSE
___ Partial thickness (superficial) breakdown can be caused by
friction or maceration
Answer: T
Superficial partial thickness skin ulcers are loss of epidermis and
possible partial loss of the dermis. The damage occurs from top
down in superficial injuries. Overhydrated skin is more susceptible
to injury and friction where the top layers of skin can be damaged or
abraded from excess rubbing of skin (such as elbows/heels) on /or
against external surfaces.
◉ TRUE OR FALSE
___ Pressure ulcers/injuries are caused by ischemia.
Answer: T
Tissues need intermittent blood flow. Compression of tissue
between a bone and external surface/cast/splint or device,
compresses blood vessels and can cut off the blood flow to tissue
resulting in ischemia that causes tissue damage and, if prolonged,
ulceration
◉ TRUE OR FALSE
, ___ Maceration toughens the skin.
Answer: F
Maceration causes cellular edema, which makes the cell more
vulnerable to breakdown. Healthy skin is "cool and dry"; macerated
skin is "at risk".
◉ Name 2 preventive interventions for skin tears:
Answer: For patients with/ or at risk for skin tears, caution should
be used with their skin at all times to avoid injury and damage.
Aggressive, adhesive products/tapes/dressings should be avoided
when at all possible. Dressings can be secured with roller gauze or
wraps instead of tapes. If taping cannot be avoided, skin sealants or
protective dressings can be placed on the skin prior to application of
the tape to prevent stripping of the skin on removal. Patients' skin
should be treated/handled gently at all times to prevent injury.
Emollients should be routinely applied to help keep skin supple to
resist injury. Protective sleeves, garments or clothes can provide a
protective layer over the skin to prevent injury. Staff should use lift
sheets or lift products for transfers and avoid grasping patients by
their limbs.
◉ Which of the following represents appropriate goals for topical
management of a skin tear with total flap loss?
A. Debridement necrotic tissue; treatment infection; management
exudate
QUESTIONS AND CORRECT ANSWERS
◉ TRUE OR FALSE
___ Dermis is normally acid and dry
Answer: F
Dermis is the inner most layer of skin that is naturally moist and
slightly acid.
◉ TRUE OR FALSE
___ Epidermis can regenerate
Answer: T
Epidermis is the outer layer of skin, composed of stratified
squamous epithelial cells, which can reproduce/regenerate to
replace lost cells.
◉ TRUE OR FALSE
___ Subcutaneous tissue is the 3rd layer of the skin.
Answer: F
Subcutaneous tissue is not a layer of skin. Only the epidermis and
dermis comprise the skin. Subcutaneous tissue is fatty
tissue/adipose tissue underneath the skin that provides padding
and protection.
,◉ Muscle tissue is more susceptible to pressure injury than skin.
Answer: T
Muscle tissue is highly vascular with a higher metabolic rate and
therefore is more susceptible than skin to effects of prolonged
pressure. Muscle is also not capable of reproduction/regeneration.
◉ Identify anatomical differences that increase the risk of skin tears
among newborns and the elderly. __________
Answer: Rete pegs and rete ridges are epidermal protrusions that
project down into the dermis to interlock with the dermal papillae to
provide strength and stability of the skin layers and prevent skin
tears. Without the interlocking of the epidermis to the dermis, or if
there is flattening of this junction, the epidermis can easily be torn
away from the dermis. This interlocking feature has not yet formed
in the newborn, and is lost in the elderly; this results in reduced
cohesion between the epidermis and dermis, and increased risk for
skin tears. There is decreased cohesion between the epidermis and
dermis in the very young and in the elderly.
◉ TRUE OR FALSE
___ Pressure applied to the skin causes the greatest amount of
pressure at the epidermis.
Answer: F
,Pressure extends from the surface in a pressure gradient with the
highest pressure at the bone/tissue interface rather than at the skin
surface. Pressure usually results in full thickness damage.
◉ TRUE OR FALSE
___ Partial thickness (superficial) breakdown can be caused by
friction or maceration
Answer: T
Superficial partial thickness skin ulcers are loss of epidermis and
possible partial loss of the dermis. The damage occurs from top
down in superficial injuries. Overhydrated skin is more susceptible
to injury and friction where the top layers of skin can be damaged or
abraded from excess rubbing of skin (such as elbows/heels) on /or
against external surfaces.
◉ TRUE OR FALSE
___ Pressure ulcers/injuries are caused by ischemia.
Answer: T
Tissues need intermittent blood flow. Compression of tissue
between a bone and external surface/cast/splint or device,
compresses blood vessels and can cut off the blood flow to tissue
resulting in ischemia that causes tissue damage and, if prolonged,
ulceration
◉ TRUE OR FALSE
, ___ Maceration toughens the skin.
Answer: F
Maceration causes cellular edema, which makes the cell more
vulnerable to breakdown. Healthy skin is "cool and dry"; macerated
skin is "at risk".
◉ Name 2 preventive interventions for skin tears:
Answer: For patients with/ or at risk for skin tears, caution should
be used with their skin at all times to avoid injury and damage.
Aggressive, adhesive products/tapes/dressings should be avoided
when at all possible. Dressings can be secured with roller gauze or
wraps instead of tapes. If taping cannot be avoided, skin sealants or
protective dressings can be placed on the skin prior to application of
the tape to prevent stripping of the skin on removal. Patients' skin
should be treated/handled gently at all times to prevent injury.
Emollients should be routinely applied to help keep skin supple to
resist injury. Protective sleeves, garments or clothes can provide a
protective layer over the skin to prevent injury. Staff should use lift
sheets or lift products for transfers and avoid grasping patients by
their limbs.
◉ Which of the following represents appropriate goals for topical
management of a skin tear with total flap loss?
A. Debridement necrotic tissue; treatment infection; management
exudate
