Midterm Exam: NR 571/ NR571 (Latest 2026/ 2027 Update) Complex Diagnosis & Management in Acute Care Practicum Review| Q/A | Grade A| 100% Correct (Verified Answers) -Chamberlain

Midterm Exam: NR 571/ NR571 (Latest 2026/ 2027 Update) Complex Diagnosis & Management in Acute Care Practicum Review| Q/A | Grade A| 100% Correct (Verified Answers) -Chamberlain QUESTION Pressure Ulcer Staging is used for: Answer: method of classifying pressure ulcer based on depth of tissue destroyed QUESTION deep tissue injury Answer: Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. QUESTION Stage 1 pressure ulcer Answer: intact skin with non-blanchable redness of a localized area, usually over a bony prominence QUESTION stage II pressure ulcer Answer: Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open wound/ruptured serum-filled blister QUESTION Stage III pressure ulcer Answer: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. slough may be present but dose not obscure the depth of tissue loss. MAY include undermining and tunneling QUESTION Stage IV pressure ulcer Answer: Full-thickness tissue loss with exposed bone, muscle, or tendon. Slough or eschar may be present on some parts of the wound bed. OFTEN includes undermining and tunneling. QUESTION unstageable/unclassified pressure ulcer Answer: depth unknown full thickness (full skin loss) base of ulcer is completely covered by slough (yellow, tan, gray, or brown) and/or eschar (tan, brown or black) in wound bed. QUESTION Differentials for Osteomyelitis Answer: potential dx r/t bone pain including: Cellulitis Diabetic ulcer Tuberculosis bone infection Metastatic cancer QUESTION Appropriate diagnostic testing in osteomyelitis Answer: Blood cultures (x2) CBC Baseline erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) MRI Bone scan, CT/PET scan Bone biopsy Additional diagnostic testing: fungal blood cultures, testing for Brucella species, and mycobacterium. QUESTION what are ESR & CRP used for? Answer: general markers of inflammation and are used to monitor disease progression and resolution. ESR changes slowly, while CRP changes occur more rapidly. CRP may drop within 1-2 weeks of starting therapy. QUESTION What will WBC markers will include what in osteomyelitis? Answer: bands or a left shift. WBC markers of bacterial infection include an increase in immature band neutrophils "bands" and/or a "left shift". A left shift indicates an increase in neutrophil consumption equal to an increase in production. These markers allow a more accurate evaluation of the patient's condition. QUESTION What is the most accurate dx imaging for osteomyelitis? Answer: MRI -X-ray to rule out a fracture. CT scan is often performed to detect soft tissue infection or a foreign body. -MRI is the most accurate imaging test to detect osteomyelitis. -In cases where MRI is not available or contraindicated, a bone scan or PET scan may be performed. QUESTION What is a bone biopsy used for with osteomyelitis? Answer: GOLD STANDARD Bone biopsy is the gold standard for detecting the causative pathogen or for differentiating an infectious cause from a malignant or degenerative process. QUESTION empiric management of osteomyelitis includes (inpatient) Answer: begin after collecting cultures. vancomycin- for gram-positive coverage AND second drug such as cipro, ceftazidime or cefepime -activity against Pseudomonas & other gram-negative bacili. treatment usually last 6 weeks QUESTION Which of the following patients is at highest risk of osteomyelitis? •32-year-old IV drug user who is homeless. •45-year-old schoolteacher with history renal transplant. •72-year-old with laboratory confirmed influenza. •22-year-old with Crohn's disease. Answer: •32-year-old IV drug user who is homeless. •45-year-old schoolteacher with history renal transplant. Rationale: IV drug use is a strong risk factor for osteomyelitis. Renal transplant patients are often on immunosuppressant therapy, increasing risk. Influenza and Chron's disease are not strong risk factors for osteomyelitis. QUESTION what are the 4 classifications of osteomyelitis? Answer: Hematogenous = Bloodborne Contiguous = Adjacent to the site Acute Chronic QUESTION Hematogenous osteomyelitis Answer: arises from blood-borne infections For example, hematogenous osteomyelitis may be precipitated from distant sites such as vascular line infections; -Infected Dialysis Catheter -Vertebral Osteomyelitis