Finall Exam:l NSGl 320/l NSG320l (Latestl
2025/l 2026l Update)l Adultl Healthl Nursingl
Il Completel Guide|l Questionsl &l Answers|l
Gradel A|l 100%l Correctl (Verifiedl
Solutions)-l GCU
Q:l pressurel injuries
Answer:
*mustl assessl alll patientsl onl admission
RISKl FACTORS
-anemia
-obesity
-diabetes
-aging
-incontinence
-mentall deterioration
-neurologicall disorders
-decreasedl circulation
-increasedl bodyl temp
-immobility
-lowl diastolic
-pain
-friction
REDUCINGl RISK
-skinl inspection,l cleaning,l carel forl dryl skin,l moisturel barriers
-increasingl mobility
-nutrition
-positioning,l repositioning,l transferringl techniques,l andl turning
-devicesl tol decreasel pressure:l wheelchairl pad,l foaml mattress,l transferl sheets
-decreasedl exposurel tol moisturel
COMPLICATIONS
ifl leftl untreated->
-cellulitis:l bacteriall skinl infection
-chronicl infection
-osteomyelitis
-death
-mcl isl recurrencel
,BRADENl SCALE
-19l tol 23:l nol risk
-15l tol 18:l mildl risk
-13l tol 14:l modl risk
-lessl 9:l severe
Q:l pressurel injuriesl inl thosel wl darkl skin
Answer:
-lookl forl areasl ofl darkerl colorl thanl surroundingl tissue:l blue,l brown,l purple
-naturall orl halogenl lightl whenl assessing
-feell skinl temp:l mayl bel warml initially,l thanl cool
-feell consistencyl ofl skin:l boggyl orl edematous
-askl abtl painl orl itchy
Q:l stagesl ofl pressurel injuries
Answer:
STAGEl 1
-epidermis
-skinl intact,l nonl blanchablel redness
STAGEl 2
-epidermisl andl dermis
-partiall skinl loss,l dermisl isl exposed
-bedl isl moistl andl red
STAGEl 3
-epidermis,l dermis,l SQ
-fulll thicknessl loss,l SQl mayl bel visible
-canl havel underminingl orl tunneling
STAGEl 4
-epidermis,l dermis,l SQ,l involvesl deeperl structuresl (bone,l tendon,l muscle)
Q:l pressurel injuryl interventions
Answer:
DOCUMENT
-usel pish:l pressurel injuryl scalel ofl healing
-location,l stage,l size/depth,l exudate,l infection,l type,l pain
-uploadl digitall picl perl hospital
,EDUCATE
-risksl andl causesl ofl pressurel injury
-incontinence:l cleanl rightl away,l absorbentl padsl orl briefsl
-importancel ofl positioning-neverl onl thel injury,l repositionl everyl 2l hoursl andl ifl chairl
boundl everyl 1l hourl
-placel cleanl dressingsl overl sterilel onesl withl nol touchl method
-inspectl skinl daily
-goodl nutrition
ACUTE
-debridement
-properl dressings:l alginates,l hydrocolloid,l foam
-stagel 2l tol 4l isl consideredl contaminated:l rememberl thatl ifl personl isl
immunocompromisedl orl hasl chronicl woundsl theyl mayl notl showl signsl ofl infection
-keepl thel woundl bedl moist->irrigatel wl 30l mLl syringel andl 19l g
-nutrition:l 30-35l cal/kg/dayl andl 1.25-1.5l gl protein/kg/day
>mayl needl ENl orl PN
**pressurel injuriesl typicallyl heall byl secondaryl intention
Q:l immune
Answer:
IMMUNOCOMPETENCE
bodiesl abilityl tol IDl foreignl substancel andl destroyl them
-ourl immunel systeml hasl 3l functions:
1.l defense:l bodyl protectsl froml invasionl andl destroysl foreignl substances
2.l homeostasis:l bodyl removesl damagedl cellularl material
3.l surveillance:l mutationsl arel continuouslyl occurring->destroy
TYPES
1.l innate:
-wel havel thisl atl birth,l firstl linel defense,l respondsl quick
-nonl specific
-neutrophilsl andl monocytesl respond
2.l acquired:
-activel acquired:l wel developl antibodiesl afterl exposurel tol anl antigen.l everyl newl
exposurel wel respondl fasterl andl stronger,l occursl froml al diseasel orl vaccinel wl antigenl
(likel flul vacc)
-passivel acquired:l wel arel givenl thel antibodiesl ratherl thanl makingl them.l eitherl froml
motherl throughl thel placental orl froml injectionl froml personl whol alreadyl hasl thel
antibodiesl
IMMUNOINCOMPETENT
-resultsl inl severel infection,l cancer,l orl immunodeficiencyl disorders
, OVERREACTIVEl IMMUNE
-hypersensitivityl disordersl likel allergiesl andl autoimmunel disordersl
IMMUNOSENESCENCE
decreasedl immunel responsel thatl occursl withl aging
-evidence:l mccl deathl isl bacteriall pneumonia,l higherl incidencel ofl cancer
-producel lessl antibodiesl whenl givenl al vaccine
-thymicl shrinkage->lessl Tl cellsl tol bel produced,l accuml ofl memoryl cellsl butl nonel forl
exposurel tol newl pathogens
-slowerl hypersensitivityl response
>anergy:l lackl ofl responsel tol antigen
-increasel autoantibodies:l attackl normall tissuel andl organs
-decreasel inl IL
Q:l humorall vsl celll mediatedl immunity
Answer:
HUMORALl IMMUNITY
-antibodyl mediated
-mainl celll isl Bl lymphocytes
-whenl al pathogenl meetsl al Bl celll orl isl presentedl tol Bl celll byl macrophage/monocytel itl
proliferatesl producingl antibodiesl andl memoryl cells
CELLl MEDIATED
-pathogensl comel acrossl Tl cells
-alsol hasl memoryl cellsl
**cytokinesl arel madel byl WBCl andl actl asl messengersl bwl cellsl tol producel al responsel
(ILl andl INF)
Q:l hypersensitivityl reactions
Answer:
occurl withl anl overl responsel tol anl antigenl orl anl attackl onl ownl bodyl
-4l types
>1-3:l immediate
>4:l delayedl
TYPEl 1
-IgGl mediated,l r/tl humorall immunity
-geneticl predisposition
-allergen->productionl ofl IgGl antibody
1.l atopicl reaction:l (allergicl reaction)
2025/l 2026l Update)l Adultl Healthl Nursingl
Il Completel Guide|l Questionsl &l Answers|l
Gradel A|l 100%l Correctl (Verifiedl
Solutions)-l GCU
Q:l pressurel injuries
Answer:
*mustl assessl alll patientsl onl admission
RISKl FACTORS
-anemia
-obesity
-diabetes
-aging
-incontinence
-mentall deterioration
-neurologicall disorders
-decreasedl circulation
-increasedl bodyl temp
-immobility
-lowl diastolic
-pain
-friction
REDUCINGl RISK
-skinl inspection,l cleaning,l carel forl dryl skin,l moisturel barriers
-increasingl mobility
-nutrition
-positioning,l repositioning,l transferringl techniques,l andl turning
-devicesl tol decreasel pressure:l wheelchairl pad,l foaml mattress,l transferl sheets
-decreasedl exposurel tol moisturel
COMPLICATIONS
ifl leftl untreated->
-cellulitis:l bacteriall skinl infection
-chronicl infection
-osteomyelitis
-death
-mcl isl recurrencel
,BRADENl SCALE
-19l tol 23:l nol risk
-15l tol 18:l mildl risk
-13l tol 14:l modl risk
-lessl 9:l severe
Q:l pressurel injuriesl inl thosel wl darkl skin
Answer:
-lookl forl areasl ofl darkerl colorl thanl surroundingl tissue:l blue,l brown,l purple
-naturall orl halogenl lightl whenl assessing
-feell skinl temp:l mayl bel warml initially,l thanl cool
-feell consistencyl ofl skin:l boggyl orl edematous
-askl abtl painl orl itchy
Q:l stagesl ofl pressurel injuries
Answer:
STAGEl 1
-epidermis
-skinl intact,l nonl blanchablel redness
STAGEl 2
-epidermisl andl dermis
-partiall skinl loss,l dermisl isl exposed
-bedl isl moistl andl red
STAGEl 3
-epidermis,l dermis,l SQ
-fulll thicknessl loss,l SQl mayl bel visible
-canl havel underminingl orl tunneling
STAGEl 4
-epidermis,l dermis,l SQ,l involvesl deeperl structuresl (bone,l tendon,l muscle)
Q:l pressurel injuryl interventions
Answer:
DOCUMENT
-usel pish:l pressurel injuryl scalel ofl healing
-location,l stage,l size/depth,l exudate,l infection,l type,l pain
-uploadl digitall picl perl hospital
,EDUCATE
-risksl andl causesl ofl pressurel injury
-incontinence:l cleanl rightl away,l absorbentl padsl orl briefsl
-importancel ofl positioning-neverl onl thel injury,l repositionl everyl 2l hoursl andl ifl chairl
boundl everyl 1l hourl
-placel cleanl dressingsl overl sterilel onesl withl nol touchl method
-inspectl skinl daily
-goodl nutrition
ACUTE
-debridement
-properl dressings:l alginates,l hydrocolloid,l foam
-stagel 2l tol 4l isl consideredl contaminated:l rememberl thatl ifl personl isl
immunocompromisedl orl hasl chronicl woundsl theyl mayl notl showl signsl ofl infection
-keepl thel woundl bedl moist->irrigatel wl 30l mLl syringel andl 19l g
-nutrition:l 30-35l cal/kg/dayl andl 1.25-1.5l gl protein/kg/day
>mayl needl ENl orl PN
**pressurel injuriesl typicallyl heall byl secondaryl intention
Q:l immune
Answer:
IMMUNOCOMPETENCE
bodiesl abilityl tol IDl foreignl substancel andl destroyl them
-ourl immunel systeml hasl 3l functions:
1.l defense:l bodyl protectsl froml invasionl andl destroysl foreignl substances
2.l homeostasis:l bodyl removesl damagedl cellularl material
3.l surveillance:l mutationsl arel continuouslyl occurring->destroy
TYPES
1.l innate:
-wel havel thisl atl birth,l firstl linel defense,l respondsl quick
-nonl specific
-neutrophilsl andl monocytesl respond
2.l acquired:
-activel acquired:l wel developl antibodiesl afterl exposurel tol anl antigen.l everyl newl
exposurel wel respondl fasterl andl stronger,l occursl froml al diseasel orl vaccinel wl antigenl
(likel flul vacc)
-passivel acquired:l wel arel givenl thel antibodiesl ratherl thanl makingl them.l eitherl froml
motherl throughl thel placental orl froml injectionl froml personl whol alreadyl hasl thel
antibodiesl
IMMUNOINCOMPETENT
-resultsl inl severel infection,l cancer,l orl immunodeficiencyl disorders
, OVERREACTIVEl IMMUNE
-hypersensitivityl disordersl likel allergiesl andl autoimmunel disordersl
IMMUNOSENESCENCE
decreasedl immunel responsel thatl occursl withl aging
-evidence:l mccl deathl isl bacteriall pneumonia,l higherl incidencel ofl cancer
-producel lessl antibodiesl whenl givenl al vaccine
-thymicl shrinkage->lessl Tl cellsl tol bel produced,l accuml ofl memoryl cellsl butl nonel forl
exposurel tol newl pathogens
-slowerl hypersensitivityl response
>anergy:l lackl ofl responsel tol antigen
-increasel autoantibodies:l attackl normall tissuel andl organs
-decreasel inl IL
Q:l humorall vsl celll mediatedl immunity
Answer:
HUMORALl IMMUNITY
-antibodyl mediated
-mainl celll isl Bl lymphocytes
-whenl al pathogenl meetsl al Bl celll orl isl presentedl tol Bl celll byl macrophage/monocytel itl
proliferatesl producingl antibodiesl andl memoryl cells
CELLl MEDIATED
-pathogensl comel acrossl Tl cells
-alsol hasl memoryl cellsl
**cytokinesl arel madel byl WBCl andl actl asl messengersl bwl cellsl tol producel al responsel
(ILl andl INF)
Q:l hypersensitivityl reactions
Answer:
occurl withl anl overl responsel tol anl antigenl orl anl attackl onl ownl bodyl
-4l types
>1-3:l immediate
>4:l delayedl
TYPEl 1
-IgGl mediated,l r/tl humorall immunity
-geneticl predisposition
-allergen->productionl ofl IgGl antibody
1.l atopicl reaction:l (allergicl reaction)
