NCLEX Practice Test

What is a characteristic of a stage 5 pressure ulcer?

1. Full thickness, ulcer base covered by slough

2. Partial thickness, with redness

3. Non-blanchable erythema

4. Stable, intact skin with non-blanchable redness

The correct answer is: Full thickness, ulcer base covered by slough

A characteristic of a stage 5 pressure ulcer is full thickness of skin with the ulcer base being covered by slough, which is yellow or white tissue that forms in the wound as it heals. This stage 5 ulcer is the most serious and severe stage, and it involves the loss of tissue through all layers of the skin, exposing muscle, bone, or tendons. Option B is incorrect because partial thickness means that the wound only affects the surface layers of skin, and there would be no exposure of muscle, bone, or tendons. Option C is incorrect because non-blanchable erythema, or redness, is a characteristic of a stage 1 pressure ulcer, which is the mildest form. Option D is incorrect because non-blanchable redness is a characteristic of stage 2 pressure ulcers, which still only affect the surface layers of skin.