Pressure Ulcer Stage

Question 1

intact skin with nonblanchable redness (erythema) of a localized area.

Answer 1

stage I

Question 2

partial thickness loss of dermis presenting a shallow open ulcer with a red pink wound bed, without slough.

Answer 2

stage II

Question 3

full-thickness tissue loss. subcutaneous may be visible but bone, tendon or muscle is not exposed.

Answer 3

Stage III

Question 4

full thickness tissue loss with exposed bone, tendon or muscle.

Answer 4

stage IV

Question 5

full thickness tissue loss in which the base of the ulcer is covered by slough or eschar in the wound bed.

Answer 5

unstageable