Which of the following adverse drug reactions would you report to the Medicines and Healthcare Products regulatory Agency (MHRA) via the yellow card system for reporting? a) A patient reports a skin rash after starting a course on amoxicillin capsules. b) A patient reports experiencing dyspepsia when they take their indomethacin capsules. c) A patient complains of a dry irritating cough since they have started taking ramipril. d) A patient complains they have experienced diarrhoea since taking azilsartan.

Which of the following adverse drug reactions would you report to the Medicines and Healthcare Products regulatory Agency (MHRA) via the yellow card system for reporting? a) A patient reports a skin rash after starting a course on amoxicillin capsules. b) A patient reports experiencing dyspepsia when they take their indomethacin capsules. c) A patient complains of a dry irritating cough since they have started taking ramipril. d) A patient complains they have experienced diarrhoea since taking azilsartan.
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Answer :

d) A patient complains they have experienced diarrhoea since taking azilsartan.
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A 75-year-old man had been receiving gentamicin (an aminoglycoside antibiotic) to treat an urinary tract infection. After three months of therapy patient's serum creatinine levels were 10 mg/dL ( normal 0.5-1.2) and serum gentamicin concentrations obtained just before the last dose were 9 mg/dL (normal < 2). Which of the following is the most likely adverse drug reaction the patient was suffering from? a) Type II allergic reaction b)Type III allergic reaction c) Pseudo allergic reaction d) Overdose toxicity

Description : A 75-year-old man had been receiving gentamicin (an aminoglycoside antibiotic) to treat an urinary tract infection. After three months of therapy patient's serum creatinine levels were 10 mg/ ... Type II allergic reaction b)Type III allergic reaction c) Pseudo allergic reaction d) Overdose toxicity

Last Answer : d) Overdose toxicity 

Which of the following patients are at the highest risk of suffering from an adverse drug reaction? a) An 8 month year old infant receiving a prescription for an antibiotic. b) A 22 year old patient with asthma receiving prescriptions for inhalers to relieve and prevent their asthma. c) A 48 year old patient who has hypertension and receives a prescription for an ACE Inhibitor. d) A 68 year old patient who has oedema receiving a prescription for a diuretic.

Description : Which of the following patients are at the highest risk of suffering from an adverse drug reaction? a) An 8 month year old infant receiving a prescription for an antibiotic. b) A 22 year old patient ... ACE Inhibitor. d) A 68 year old patient who has oedema receiving a prescription for a diuretic. 

Last Answer : d) A 68 year old patient who has oedema receiving a prescription for a diuretic. 

___________ is an example of latent adverse drug reactions. a) Antibiotic-associated diarrhea b) Tardive dyskinesia c) Serum sickness d) Severe bronchoconstriction

Description : ___________ is an example of latent adverse drug reactions. a) Antibiotic-associated diarrhea b) Tardive dyskinesia c) Serum sickness d) Severe bronchoconstriction

Last Answer : D

Which one of these is a genetically determined adverse drug reactions? a) Addication. b) Teratogenecity. c) Carcinogenicity. d) Idiosyncracy.

Description : Which one of these is a genetically determined adverse drug reactions? a) Addication. b) Teratogenecity. c) Carcinogenicity. d) Idiosyncracy.

Last Answer : b) Teratogenecity. 

Which of the following reaction is called Augmented adverse drug reactions? a) Genetically determined effects. b) Idiosyncracy. c) Rebound effect on discontinuation d) Allergic reactions & anaphylaxis.

Description : Which of the following reaction is called Augmented adverse drug reactions? a) Genetically determined effects. b) Idiosyncracy. c) Rebound effect on discontinuation d) Allergic reactions & anaphylaxis.

Last Answer : c) Rebound effect on discontinuation 

Science of collecting, monitoring, researching, assessing and evaluating information from healthcare providers and patients on the adverse effects of medications is known as a) Pharmacovigilance. b) Clinical Trails. c) Observational study. d) Qualitative study.

Description : Science of collecting, monitoring, researching, assessing and evaluating information from healthcare providers and patients on the adverse effects of medications is known as a) Pharmacovigilance. b) Clinical Trails. c) Observational study. d) Qualitative study.

Last Answer : a) Pharmacovigilance. 

Which of the following terms does not describe an Adverse Drug Reaction? a) Idiosyncrasy b) Anaphylaxis c) Teratogenic effect d) Placebo effect

Description : Which of the following terms does not describe an Adverse Drug Reaction? a) Idiosyncrasy b) Anaphylaxis c) Teratogenic effect d) Placebo effect

Last Answer : d) Placebo effect

Patient counselling helps to a) Know chemical structure of drug b) Develop business relations with pharmacist c) Motivate the patient to take medicine for improvement of his/her health status. d) Pass time at old age

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Last Answer : c) Motivate the patient to take medicine for improvement of his/her health status. 

Which is appropriate description of Average Costs? a) The value of opportunities which have been lost by utilizing resources in particular service or health technology. b) The total costs (i.e. all the costs incurred in the delivery of a service) of a health care system divided by the units of production. c) Independent of the number of units of production and include heating, lighting and fixed staffing costs. d) The cost of the consumption of medicines is a good example of variable costs.

Description : Which is appropriate description of Average Costs? a) The value of opportunities which have been lost by utilizing resources in particular service or health technology. b) The total costs (i.e. all the ... costs. d) The cost of the consumption of medicines is a good example of variable costs.

Last Answer : b) The total costs (i.e. all the costs incurred in the delivery of a service) of a health care system divided by the units of production. 

How are prescription medicines different from OTC ones? A. They contain much smaller amounts of active ingredients B. They don't contain dyes or preservatives C. They're unsafe for use without medical supervision D. They can be toxic

Description : How are prescription medicines different from OTC ones? A. They contain much smaller amounts of active ingredients B. They don't contain dyes or preservatives C. They're unsafe for use without medical supervision D. They can be toxic

Last Answer : C. They're unsafe for use without medical supervision 

___________ antidiabetic drug is preferred for elderly patient a) Gliclazide b) Glibencamide c) Metformin d) Pioglitazone

Description : ___________ antidiabetic drug is preferred for elderly patient a) Gliclazide b) Glibencamide c) Metformin d) Pioglitazone

Last Answer : a) Gliclazide  

Which of the following responsibility of the clinical pharmacist is in direct patient care area? a) Supervision of drug administration techniques. b) Providing drug information to physicians and nurses. c) Identify drugs brought into the hospital by patients. d) Reviewing of each patient’s drug administration forms periodically to ensure all doses have been administered.

Description : Which of the following responsibility of the clinical pharmacist is in direct patient care area? a) Supervision of drug administration techniques. b) Providing drug information to physicians and ... of each patient's drug administration forms periodically to ensure all doses have been administered.

Last Answer : d) Reviewing of each patient’s drug administration forms periodically to ensure all doses have been administered.

Which of the following statements best describes a lead compound? a) A compound that contains the element lead b) A compound from the research laboratory that is chosen to go forward for preclinical and clinical trials. c) A molecule that shows some activity or property of interest and serves as the starting point for the development of a drug. d) The first compound of a structural class of compounds to reach the market.

Description : Which of the following statements best describes a lead compound? a) A compound that contains the element lead b) A compound from the research laboratory that is chosen to go forward for preclinical and ... of a drug. d) The first compound of a structural class of compounds to reach the market.

Last Answer : c) A molecule that shows some activity or property of interest and serves as the starting point for the development of a drug.

You are asked to compare the cost of four different antibacterial medicines. Which of the following treatment courses is the lowest cost? a) Medicine A costs £17.00 for 28 tablets. The adult dose is one tablet twice a day and the usual treatment duration is 7 days. b) Medicine B costs £30.00 for 100 tablets. The adult dose is one tablet four times a day and the usual treatment duration is 7 days. c) Medicine C costs £20.00 for 25 tablets. The adult dose is one tablet twice a day and the usual treatment duration is 5 days. d) Medicine D costs £25.00 for 14 tablets. The adult dose is one tablet each day and the usual treatment duration is 5 days.

Description : You are asked to compare the cost of four different antibacterial medicines. Which of the following treatment courses is the lowest cost? a) Medicine A costs £17.00 for 28 tablets. The adult dose is one ... 14 tablets. The adult dose is one tablet each day and the usual treatment duration is 5 days.

Last Answer : c) Medicine C costs £20.00 for 25 tablets. The adult dose is one tablet twice a day and the usual treatment duration is 5 days.

Have you experienced an amoxicillin rash?

Description : Have you experienced an amoxicillin rash?

Last Answer : answer:Hives and antibiotics probably means you had a reaction. Talk to Dr Now Stop taking antibiotics and get some Benedryl into you. But contact Dr and have someone else monitor you for any other symptoms. It can be life threatening.

When the patient with known angina pectoris complains that he is experiencing chest pain more frequently even at rest, the period of pain is longer, and it takes less stress for the pain to occur, the nurse recognizes that the patient is describing a) unstable angina. Unstable angina is also called crescendo or pre-infarction angina and indicates the need for a change in treatment.

Description : When the patient with known angina pectoris complains that he is experiencing chest pain more frequently even at rest, the period of pain is longer, and it takes less stress for the ... or refractory angina produces severe, incapacitating chest pain that does not respond to conventional treatment.

Last Answer : a) unstable angina. Unstable angina is also called crescendo or pre-infarction angina and indicates the need for a change in treatment.

The patient taking the following non-steroidal antiinflammatory drug should be cautioned not to drive motor vehicle: A. Celecoxib B. Indomethacin C. Naproxen D. Diclofenac sodium

Description : The patient taking the following non-steroidal antiinflammatory drug should be cautioned not to drive motor vehicle: A. Celecoxib B. Indomethacin C. Naproxen D. Diclofenac sodium

Last Answer : B. Indomethacin

Which of the following is a valid therapeutic use of interaction? A. Use of Probenecid with Penicillin B. Giving Aspirin with warfarin C. Instructing patient to take levofloxacin with milk or antacid D. Treatment of depression of MAO Inhibitor and Citalopram

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Last Answer : A. Use of Probenecid with Penicillin 

Which of the following is a technique pharmacists can use to humanize themselves to their patients? a) Using the patient's preferred name in conversation b) Delegating as many tasks as possible to an assistant c) Reading the text of a medication bottle verbatim to a patient d) Providing business cards at the desk

Description : Which of the following is a technique pharmacists can use to humanize themselves to their patients? a) Using the patient's preferred name in conversation b) Delegating as many tasks as possible to an ... the text of a medication bottle verbatim to a patient d) Providing business cards at the desk

Last Answer : c) Reading the text of a medication bottle verbatim to a patient 

What is informed consent in a clinical trial? a) The subjects do not know which study treatment they receive b) Patients injected with placebo and active doses c) Fake treatment d) Signed document of the recruited patient for the clinical trial procedures

Description : What is informed consent in a clinical trial? a) The subjects do not know which study treatment they receive b) Patients injected with placebo and active doses c) Fake treatment d) Signed document of the recruited patient for the clinical trial procedures

Last Answer : d) Signed document of the recruited patient for the clinical trial procedures 

Type I ADR reactions is___________ a) Caused when T-cells bind to a specific antigen b) Caused by tissue injury c) IgE mediated d) Caused by cytotoxic antibodies

Description : Type I ADR reactions is___________ a) Caused when T-cells bind to a specific antigen b) Caused by tissue injury c) IgE mediated d) Caused by cytotoxic antibodies

Last Answer : c) IgE mediated 

Which of the following is Type B ADRS? a) Hypoglycaemia caused by Insulin b) Dryness of mouth caused by Atropine c) Anaemia in patient with G6PD deficiency caused by Primaquine d) Hyperglycaemia caused by thiazide diuretics

Description : Which of the following is Type B ADRS? a) Hypoglycaemia caused by Insulin b) Dryness of mouth caused by Atropine c) Anaemia in patient with G6PD deficiency caused by Primaquine d) Hyperglycaemia caused by thiazide diuretics

Last Answer : c) Anaemia in patient with G6PD deficiency caused by Primaquine 

The _______________ is the heart of the patient counselling session A) Preparing for the session. B) Opening the session. C) Counselling content. D) Closing the session.

Description : The _______________ is the heart of the patient counselling session  A) Preparing for the session.  B) Opening the session.  C) Counselling content.  D) Closing the session. 

Last Answer :  C) Counselling content. 

A woman has an upper respiratory infection. Six years ago, she experienced an episode of bronchospasm follwing penicillin V therapy. The cultures now reveal a strain of streptococcus pneumoniae that is sensitive to all of the following drugs. Which of these drugs would be the best choice for this patient? (a) Amoxicillin/clavulanate (b) Erythromycin (c) Ampicillin (d) cefaclor (e) Cyclacillin

Description : A woman has an upper respiratory infection. Six years ago, she experienced an episode of bronchospasm follwing penicillin V therapy. The cultures now reveal a strain of streptococcus pneumoniae that is ... ? (a) Amoxicillin/clavulanate (b) Erythromycin (c) Ampicillin (d) cefaclor (e) Cyclacillin

Last Answer : Ans: B

Pharmacovigilance is done for monitoring of a) Drug price b) Unethical practises c) Drug safety d) Pharmacy students

Description : Pharmacovigilance is done for monitoring of a) Drug price b) Unethical practises c) Drug safety d) Pharmacy students

Last Answer : c) Drug safety 

Which of the following drug is not needed to be TDM? a) Carbamazepine. b) Penicillin. c) Digoxin. d) Gentamicin.

Description : Which of the following drug is not needed to be TDM? a) Carbamazepine. b) Penicillin. c) Digoxin. d) Gentamicin.

Last Answer : b) Penicillin. 

The purpose of preclinical testing is: a. To verify that a drug is sufficiently safe and effective to be tested in humans. b. To undergo preliminary testing in healthy humans to monitor the effects of the drug. c. To create a basic outline for the larger scale future tests on a widespread population. d. To develop method of drug analysis

Description : The purpose of preclinical testing is: a. To verify that a drug is sufficiently safe and effective to be tested in humans. b. To undergo preliminary testing in healthy humans to monitor the ... for the larger scale future tests on a widespread population. d. To develop method of drug analysis

Last Answer : a. To verify that a drug is sufficiently safe and effective to be tested in humans. 

Case control studies is called as A. Drug-oriented systems. B. Dose-oriented systems. C. Disease-oriented systems. D. Complication-oriented systems.

Description : Case control studies is called as A. Drug-oriented systems. B. Dose-oriented systems. C. Disease-oriented systems. D. Complication-oriented systems.

Last Answer : B. Dose-oriented systems. 

Which of the following drug can result in result in cyanide poisoning? A. Amyl nitrite B. Hydroxycobalamine C. Sodium nitroprusside D. Sodium thiosulphate

Description : Which of the following drug can result in result in cyanide poisoning? A. Amyl nitrite B. Hydroxycobalamine C. Sodium nitroprusside D. Sodium thiosulphate

Last Answer : C. Sodium nitroprusside 

Which of the following drug is implicated in the causation of osteomalacia of the bone? A. Steroid B. Estrogen C. Heparin D. Phenytoin

Description : Which of the following drug is implicated in the causation of osteomalacia of the bone? A. Steroid B. Estrogen C. Heparin D. Phenytoin

Last Answer : D. Phenytoin

The highest serum drug concentration following a single dose or at a steady state within a dosing interval is called ………. A. Lead B. Peak C. Poison D. Mechanisms

Description : The highest serum drug concentration following a single dose or at a steady state within a dosing interval is called ………. A. Lead B. Peak C. Poison D. Mechanisms

Last Answer : B. Peak 

_________ drug is avoided in children’s under 4 years with diarrhea. a) bisacodyl b) loperamide c) Bismuth subsalicylate d) Ciprofloxacin

Description : _________ drug is avoided in children’s under 4 years with diarrhea. a) bisacodyl b) loperamide c) Bismuth subsalicylate d) Ciprofloxacin

Last Answer : d) Ciprofloxacin

___________ drug is usually avoided with breastfeeding. a) Ibuprofen b) propranalol c) Methotrexate d) Naproxe

Description : ___________ drug is usually avoided with breastfeeding. a) Ibuprofen b) propranalol c) Methotrexate d) Naproxe

Last Answer : c) Methotrexate  

Which of the following drug does not require therapeutic drug monitoring? a) Digitoxin. b) Gentamycin. c) Phenytoin. d) Paracetamol

Description : Which of the following drug does not require therapeutic drug monitoring? a) Digitoxin. b) Gentamycin. c) Phenytoin. d) Paracetamol

Last Answer : d) Paracetamol

________________ causes pharmacodynamic drug interaction. a) Gastric motility changes. b) Stimulation of metabolism. c) Alteration of pH of GIT. d)Interactions at receptor site.

Description : ________________ causes pharmacodynamic drug interaction. a) Gastric motility changes. b) Stimulation of metabolism. c) Alteration of pH of GIT. d)Interactions at receptor site.

Last Answer : d)Interactions at receptor site. 

The most specific & sensitive method for assessment of compliance can be used to detect potent therapeutic agent in body fluids is a) Drug analysis. b) Interrogation. c) Urine marker. d) Residual Tablet counting.

Description : The most specific & sensitive method for assessment of compliance can be used to detect potent therapeutic agent in body fluids is a) Drug analysis. b) Interrogation. c) Urine marker. d) Residual Tablet counting.

Last Answer : a) Drug analysis. 

Which of the following responsibility of community pharmacist is in dispensing area? a) Reviews all doses missed, reschedule the doses as necessary & signs all drugs not given notices. b) Supervision of drug administration. c) Ensures that establishes policies & procedures are followed. d) Reviewing of each patient’s drug administration forms periodically to ensure all doses have been administered.

Description : Which of the following responsibility of community pharmacist is in dispensing area? a) Reviews all doses missed, reschedule the doses as necessary & signs all drugs not given notices. b ... of each patient's drug administration forms periodically to ensure all doses have been administered.

Last Answer : b) Supervision of drug administration. 

___________ drug can cause lactic acidosis. a) Metformin b) Pioglitazone c) Repaglinide d) Glibenclamide

Description : ___________ drug can cause lactic acidosis. a) Metformin b) Pioglitazone c) Repaglinide d) Glibenclamide

Last Answer : a) Metformin  

___________ commonly reported ADR of diureticclass of drugs. a) Hypokalemia b) Alopecia c) Skin disorder d) Rhinitis

Description : ___________ commonly reported ADR of diureticclass of drugs. a) Hypokalemia b) Alopecia c) Skin disorder d) Rhinitis

Last Answer : a) Hypokalemia 

When the patient who has experienced trauma to an extremity complains of severe burning pain, vasomotor changes, and muscles spasms in the injured extremity, the nurse recognizes that the patient is likely demonstrating signs of a) reflex sympathetic dystrophy syndrome. RSD is frequently chronic and occurs most often in women.

Description : When the patient who has experienced trauma to an extremity complains of severe burning pain, vasomotor changes, and muscles spasms in the injured extremity, the nurse ... heterotrophic ossification. Heterotrophic ossification causes muscular pain and limited muscular contraction and movement.

Last Answer : a) reflex sympathetic dystrophy syndrome. RSD is frequently chronic and occurs most often in women.

The use of antibiotics can be based on either the clinical course of a patient without the benefit of well-defined microbiologic data (empiric therapy), or targeted at specific identified pathogens once sensitivity reports are available (directed therapy). The following statement(s) is/are true concerning these therapies. a. The issue of toxic side effects of antibiotics is only important in dealing with emperic therapy b. Single agent therapy is generally inferior to specific multi-drug therapy (aminoglycoside plus an antianaerobic agent) for the treatment of secondary bacterial peritonitis due to appendicitis, diverticulitis, penetrating gastrointestinal injury, or anastomotic leak c. With the empiric use of antibiotics, a diligent search for the septic source should be undertaken and co

Description : The use of antibiotics can be based on either the clinical course of a patient without the benefit of well-defined microbiologic data (empiric therapy), or targeted at ... which polymicrobial infection is identified, specifically-directed treatment for the predominant organism is satisfactory

Last Answer : Answer: c The use of empiric therapy without the benefit of well-defined microbiologic data is appropriate when there is sufficient clinical evidence to support the diagnosis such that it would ... components of the infection if the body site is such that these microorganisms may be present

The side effect of a drug which has been used as a therapeutic effect in another condition is: A. Constipation caused by codeine B. Cough caused by captopril C. Uterine stimulation caused by quinine D. Diarrhoea caused by ampicillin

Description : The side effect of a drug which has been used as a therapeutic effect in another condition is: A. Constipation caused by codeine B. Cough caused by captopril C. Uterine stimulation caused by quinine D. Diarrhoea caused by ampicillin

Last Answer : A. Constipation caused by codeine

The side effect of a drug which has been used as a therapeutic effect in another condition is: A. Constipation caused by codeine B. Cough caused by captopril C. Uterine stimulation caused by quinine D. Diarrhoea caused by ampicillin

Description : The side effect of a drug which has been used as a therapeutic effect in another condition is: A. Constipation caused by codeine B. Cough caused by captopril C. Uterine stimulation caused by quinine D. Diarrhoea caused by ampicillin

Last Answer : A. Constipation caused by codeine

Which of the following adverse drug reactions is due to a specific genetic abnormality: A. Tetracycline induced sunburn like skin lesions B. Quinidine induced thrombocytopenia C. Metoclopramide induced muscle dystonia D. Primaquine induced massive haemolysis

Description : Which of the following adverse drug reactions is due to a specific genetic abnormality: A. Tetracycline induced sunburn like skin lesions B. Quinidine induced thrombocytopenia C. Metoclopramide induced muscle dystonia D. Primaquine induced massive haemolysis

Last Answer : D. Primaquine induced massive haemolysis

Which of the following adverse drug reactions is due to a specific genetic abnormality: A. Tetracycline induced sunburn like skin lesions B. Quinidine induced thrombocytopenia C. Metoclopramide induced muscle dystonia D. Primaquine induced massive haemolysis

Description : Which of the following adverse drug reactions is due to a specific genetic abnormality: A. Tetracycline induced sunburn like skin lesions B. Quinidine induced thrombocytopenia C. Metoclopramide induced muscle dystonia D. Primaquine induced massive haemolysis

Last Answer : D. Primaquine induced massive haemolysis

What is the MOST adverse reaction to lignocaine: A. Drug interaction with patient’s medicines B. Injecting into vein C. Hypersensitivity D. Toxicity

Description : What is the MOST adverse reaction to lignocaine: A. Drug interaction with patient’s medicines B. Injecting into vein C. Hypersensitivity D. Toxicity

Last Answer : D. Toxicity

This drug has activity against many strains of Pseudomomas aeruginosa. However, when it is used alone, resistance has emerged during the course of treatment. The drug should not be used in penicillinallergic patients. Its activity against gramnegative rods is enhanced if it is given in combination with tazobactam (a) Amoxicillin (b) Aztreonam (c) Imipenem (d) Piperacillin (e) Vancomycin

Description : This drug has activity against many strains of Pseudomomas aeruginosa. However, when it is used alone, resistance has emerged during the course of treatment. The drug should not be used in ... with tazobactam (a) Amoxicillin (b) Aztreonam (c) Imipenem (d) Piperacillin (e) Vancomycin

Last Answer : Ans: D

A patient presents complaining of a stomach upset 48 hours after starting a course of antibiotic for oral infection, this is an example of, A. Type I allergic reaction B. Nervous disorder C. Side effect of the drug D. Type IV hypersensitivity reaction E. Pyloric stenosis

Description : A patient presents complaining of a stomach upset 48 hours after starting a course of antibiotic for oral infection, this is an example of, A. Type I allergic reaction B. Nervous disorder C. Side effect of the drug D. Type IV hypersensitivity reaction E. Pyloric stenosis

Last Answer : C. Side effect of the drug

A higher incidence of adverse effects to cotrimoxazole occurs when this drug is used for: A. Typhoid fever B. Whooping cough C. Pneumocystis carinii pneumonia in AIDS patients D. Chancroid

Description : A higher incidence of adverse effects to cotrimoxazole occurs when this drug is used for: A. Typhoid fever B. Whooping cough C. Pneumocystis carinii pneumonia in AIDS patients D. Chancroid

Last Answer : C. Pneumocystis carinii pneumonia in AIDS patients

During which stage of pressure ulcer development does the ulcer extend into the underlying structures, including the muscle and possibly the bone? a) Stage IV A stage IV pressure ulcer extends into the underlying structure, including the muscle and possibly the bone. b) Stage III A stage III ulcer extends into the subcutaneous tissue. c) Stage II A stage II ulcer exhibits a break in the skin through the epidermis or dermis. d) Stage I A stage I pressure ulcer is an area of nonblanchable erythema, tissue swelling, and congestion, and the patient complains of discomfort.

Description : During which stage of pressure ulcer development does the ulcer extend into the underlying structures, including the muscle and possibly the bone? a) Stage IV A stage IV pressure ulcer ... area of nonblanchable erythema, tissue swelling, and congestion, and the patient complains of discomfort.

Last Answer : a) Stage IV A stage IV pressure ulcer extends into the underlying structure, including the muscle and possibly the bone.