Hondros Nursing Nur 150:
Exam 2 Questions And Answers
Stage 1 pressure ulcer - ANS ✔✔ - Intact skin with nonblanchable redness
Stage 2 pressure ulcer - ANS ✔✔ - Partial loss of dermis. Shallow open ulcer,
usually shiny, or dry. Red-pink wound bed without sloughing or bruising.
Stage 3 pressure ulcer - ANS ✔✔ - Full thickness tissue loss, subcutaneous
fat may be visible. Possible undermining and tunneling.
Stage 4 pressure ulcer - ANS ✔✔ - Full thickness tissue loss with exposed
bone, tendon,or muscle. Slough or eschar may be present as well as
undermining and tunneling.
Unstageable pressure ulcer - ANS ✔✔ - Full thickness tissue loss, wound base
covered by slough and eschar therefor dull depth cannot be determined.
Slough - ANS ✔✔ - Fibrous tissue in wound bed that can be yellow, tan, gray,
green, or brown.
Nursing interventions to prevent pressure unlcers - ANS ✔✔ - Reposition bed
bound pt every two hours, instruct pt in wheelchair to shift their weight every
hour. Use of cushions and barrier cream. Manage moisture, optimize
nutrition and hydration.
Cognition - ANS ✔✔ - All the processes involved in human thought
External nutrition - ANS ✔✔ - Nutrition support via tube feedings
Parenteral nutrition - ANS ✔✔ - Nutrition supplied intravenously
DRI - ANS ✔✔ - Refers to a set of nutritional based values that serve for both
assessing and planning diets
Three ways to confirm proper NG placement - ANS ✔✔ - Chest x-ray, PH test
gastric contents, air bolus.
With tube feeding what must be monitored daily - ANS ✔✔ - I/O, daily weight,
daily labs
Fatal risk of dysphagia - ANS ✔✔ - Aspiration pneumonia
Exam 2 Questions And Answers
Stage 1 pressure ulcer - ANS ✔✔ - Intact skin with nonblanchable redness
Stage 2 pressure ulcer - ANS ✔✔ - Partial loss of dermis. Shallow open ulcer,
usually shiny, or dry. Red-pink wound bed without sloughing or bruising.
Stage 3 pressure ulcer - ANS ✔✔ - Full thickness tissue loss, subcutaneous
fat may be visible. Possible undermining and tunneling.
Stage 4 pressure ulcer - ANS ✔✔ - Full thickness tissue loss with exposed
bone, tendon,or muscle. Slough or eschar may be present as well as
undermining and tunneling.
Unstageable pressure ulcer - ANS ✔✔ - Full thickness tissue loss, wound base
covered by slough and eschar therefor dull depth cannot be determined.
Slough - ANS ✔✔ - Fibrous tissue in wound bed that can be yellow, tan, gray,
green, or brown.
Nursing interventions to prevent pressure unlcers - ANS ✔✔ - Reposition bed
bound pt every two hours, instruct pt in wheelchair to shift their weight every
hour. Use of cushions and barrier cream. Manage moisture, optimize
nutrition and hydration.
Cognition - ANS ✔✔ - All the processes involved in human thought
External nutrition - ANS ✔✔ - Nutrition support via tube feedings
Parenteral nutrition - ANS ✔✔ - Nutrition supplied intravenously
DRI - ANS ✔✔ - Refers to a set of nutritional based values that serve for both
assessing and planning diets
Three ways to confirm proper NG placement - ANS ✔✔ - Chest x-ray, PH test
gastric contents, air bolus.
With tube feeding what must be monitored daily - ANS ✔✔ - I/O, daily weight,
daily labs
Fatal risk of dysphagia - ANS ✔✔ - Aspiration pneumonia
