BSN 206- Hallmark Final
Exam
2026–2027 || Real Exam Questions
With Verified Correct Solutions ||100%
Guaranteed Pass!! || Latest Version ||
Grade A+
, Tertiary healing Wounds intentially left open for 3-5 days to allow edema or/and infection to
resolve or drain & are then closed w/ sutures or staples (aka delayed primary
healing)
Primary intention wound assessment: 1. Asses location of wound on body
2. Note wound margins. Approximated or closed together?
3. Observe drainage
4. Look for evidence of infection
5. Palpate along edges to feel healing ridge.
Secondary intention wound assessment: 1. Assess anatomical location
2. Assess wound deminsions (length, width and depth)
3. Assess for undermining
4. Assess extent of tissue loss (determine deepest viable
tissue layer in wound bed and determine stage)
5. observe tissue type
6. presence of exudate
7. Note is wound edges are rounded toward wound bed
Dehiscence - partial or total separation of wound layers
- Occurs before collagen formation beings (3-11 days after surgery)
- wound is now to heal by secondary intention
Evisceration wound separation with protrusion of organs
- emergency that requires surgical repair
- sterile gauze soaked in sterile saline must be placed over to prevent infection
or skin dryness
Fistula abnormal passageway between two organs or between an internal organ and
the body surface
Common sites for pressure injuries: - Sacrum -Coccyx -Ischial tuberosities -Greater trochanters -Heels -Scapula -
Iliac crest -Lateral and medial malleoli
Sheer stress Force per unit area exerted parallel to the plane of interest
- Skin tears
- Shearing of epidermal layer from dermal layer (inappropriate tape removal)
Shear strain Distortion or defamation of tissue as a result of sheer stress
- Subcutaneous tissue shears against dermal layer distorting the blood vessel
(Pt. slides down in bed)
Braden scale sensory perception, moisture, activity, mobility, nutrition, friction and shear
4-23, <17 high risk for pressure injury
Exam
2026–2027 || Real Exam Questions
With Verified Correct Solutions ||100%
Guaranteed Pass!! || Latest Version ||
Grade A+
, Tertiary healing Wounds intentially left open for 3-5 days to allow edema or/and infection to
resolve or drain & are then closed w/ sutures or staples (aka delayed primary
healing)
Primary intention wound assessment: 1. Asses location of wound on body
2. Note wound margins. Approximated or closed together?
3. Observe drainage
4. Look for evidence of infection
5. Palpate along edges to feel healing ridge.
Secondary intention wound assessment: 1. Assess anatomical location
2. Assess wound deminsions (length, width and depth)
3. Assess for undermining
4. Assess extent of tissue loss (determine deepest viable
tissue layer in wound bed and determine stage)
5. observe tissue type
6. presence of exudate
7. Note is wound edges are rounded toward wound bed
Dehiscence - partial or total separation of wound layers
- Occurs before collagen formation beings (3-11 days after surgery)
- wound is now to heal by secondary intention
Evisceration wound separation with protrusion of organs
- emergency that requires surgical repair
- sterile gauze soaked in sterile saline must be placed over to prevent infection
or skin dryness
Fistula abnormal passageway between two organs or between an internal organ and
the body surface
Common sites for pressure injuries: - Sacrum -Coccyx -Ischial tuberosities -Greater trochanters -Heels -Scapula -
Iliac crest -Lateral and medial malleoli
Sheer stress Force per unit area exerted parallel to the plane of interest
- Skin tears
- Shearing of epidermal layer from dermal layer (inappropriate tape removal)
Shear strain Distortion or defamation of tissue as a result of sheer stress
- Subcutaneous tissue shears against dermal layer distorting the blood vessel
(Pt. slides down in bed)
Braden scale sensory perception, moisture, activity, mobility, nutrition, friction and shear
4-23, <17 high risk for pressure injury
