Which description indicates an unstageable pressure injury?
Correct answer: C. Full-thickness loss hidden by slough or eschar
- A. Intact skin with localized non-blanchable redness
- B. Partial-thickness loss with exposed dermis
- C. Full-thickness loss hidden by slough or eschar
- D. Full-thickness loss with visible muscle and tendon
Explanation
An unstageable injury has full-thickness skin and tissue loss, but slough or eschar prevents assessment of the wound depth. The true stage cannot be confirmed until the covering is removed or the depth becomes visible.
Report an error
The more specific you are, the faster it gets fixed. A source beats an opinion.
Prefer email? support@testustad.com
About Wound Care and Dressings
Wound care covers wound classification, healing stages, assessment of tissue and drainage, pain, infection signs, dressing selection and clean or sterile dressing technique. It also includes pressure injuries by stage and the factors affecting healing, such as nutrition, circulation, diabetes, infection and prolonged pressure.
Practise Wound Care and Dressings
50 free Wound Care and Dressings MCQs from Fundamentals of Nursing, each with the correct answer and an explanation. Unlimited attempts, no account needed.
Discussion
Stuck on an option, or know a faster way to get there? Ask or explain it here.
No comments yet. Be the first to explain this one.
Exams that ask Fundamentals of Nursing questions like this
Fundamentals of Nursing is on 9 papers prepared for on TestUstad, and all of them draw the same bank, so this question is worth knowing for every one of them.
More Wound Care and Dressings questions
A pressure injury has intact skin with persistent, non-blanchable redness over a bony prominence. How should it be classified?
Which event is characteristic of the proliferative phase of wound healing?
A nurse is caring for a patient at risk of a pressure injury. Which intervention best prevents prolonged pressure over the sacrum?
A patient suddenly develops wound separation and abdominal organs are visible through the incision. Which action should the nurse take first?
A postoperative patient becomes pale and restless, and the dressing is rapidly saturated with bright-red blood. Which finding requires the most immediate action?
Which dressing is most suitable for a clean wound with heavy drainage?