Certified Medical-Surgical Registered Nurse Practice Test

A patient, age 54, is admitted with a diagnosis of venous ulceration unresponsive to treatment. What is the nurse most likely to find during an assessment of this patient?

1. Deep wound bed

2. Gangrene

3. Heavy exudate

4. Pale wound bed

The correct answer is: Gangrene

In a patient with venous ulceration unresponsive to treatment, the nurse is most likely to find gangrene during the assessment. Gangrene is the localized death and decomposition of body tissue resulting from a lack of blood supply. In the context of venous ulcers that are not healing properly, the lack of proper blood circulation can lead to tissue necrosis, which can manifest as gangrene. This complication is a serious concern that requires immediate attention to prevent further deterioration and potential complications.