Physiological AdaptationQuestion 2295 of 2368
A sacral wound has full-thickness tissue loss, and yellow slough covers the wound bed so that the depth cannot be seen. How should the nurse classify this wound?
- Stage 1 pressure injury
- Stage 2 pressure injury
- Deep tissue pressure injury
- Unstageable pressure injury
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Correct answer: Unstageable pressure injury
When slough or eschar hides the extent of tissue damage, the pressure injury is unstageable.
Source: Nursing Fundamentals, 2nd edition (Open RN, Chippewa Valley Technical College, 2024), Integumentary: Unstageable Pressure Injuries. Licensed under CC BY 4.0.
Practice the topic "Physiological Adaptation"Questions last reviewed: 18 October 2026