Wound Care Certification Exam Wound Care Certification Pressure Injury Prevention 3 — Questions and Answers
Question 1: A patient has a pressure injury over the ischial tuberosity. Which sitting position places LEAST pressure on this anatomical site?
- Leaning forward with weight distributed to thighs (Correct answer)
- Sitting upright at 90 degrees with feet flat on floor
- Reclining back 45 degrees in the wheelchair
- Crossing legs to shift weight laterally
Correct answer: Leaning forward with weight distributed to thighs
Leaning forward redistributes weight from the ischial tuberosities to the thighs, significantly reducing focal pressure on this site.
Question 2: Which laboratory finding is MOST strongly associated with impaired pressure injury healing?
- Serum sodium of 138 mEq/L
- Hemoglobin A1c of 9.8% (Correct answer)
- Total cholesterol of 210 mg/dL
- Serum potassium of 3.8 mEq/L
Correct answer: Hemoglobin A1c of 9.8%
Poorly controlled diabetes (HbA1c ≥9%) impairs immune function, collagen synthesis, and microvascular circulation, significantly hindering wound healing.
Question 3: A patient develops a new pressure injury despite being on a pressure-redistribution mattress. What is the FIRST action the wound care nurse should take?
- Upgrade to the next level of support surface immediately
- Reassess the patient's risk factors and current prevention protocol (Correct answer)
- Notify the physician for antibiotic orders
- Document the wound and continue the current plan
Correct answer: Reassess the patient's risk factors and current prevention protocol
Reassessing the patient's risk factors and current prevention protocol identifies gaps and guides revision of the care plan.
Question 4: Which heel offloading device is considered the GOLD STANDARD for preventing heel pressure injuries in immobile patients?
- Foam heel elevator boot (Correct answer)
- Sheepskin heel pad
- Donut-shaped foam ring
- Pneumatic compression device
Correct answer: Foam heel elevator boot
Foam heel elevator boots that offload the entire heel by suspending it are the gold standard for heel pressure injury prevention in immobile patients.
Question 5: Incontinence-associated dermatitis (IAD) differs from a Stage 2 pressure injury primarily because IAD:
- Only occurs over bony prominences
- Results from chemical irritation rather than pressure or shear (Correct answer)
- Always presents with a full-thickness skin loss
- Is classified using the same NPUAP staging system
Correct answer: Results from chemical irritation rather than pressure or shear
IAD is caused by prolonged skin exposure to urine or feces, not mechanical pressure or shear forces that cause pressure injuries.
Question 6: A bariatric patient (350 kg) requires repositioning every 2 hours. Which resource is MOST essential to ensure safe repositioning AND pressure injury prevention?
- Additional nursing documentation forms
- Bariatric-rated friction-reducing repositioning aids and adequate staff (Correct answer)
- A standard hospital mattress with extra foam topper
- More frequent vital sign monitoring
Correct answer: Bariatric-rated friction-reducing repositioning aids and adequate staff
Bariatric patients require weight-rated repositioning equipment and sufficient staff to safely redistribute pressure without injury to patient or staff.
Question 7: What is the PRIMARY purpose of a structured skin inspection protocol performed every shift in a hospital setting?
- To fulfill regulatory documentation requirements only
- To detect early signs of pressure injury before they progress (Correct answer)
- To assess the effectiveness of topical wound treatments
- To measure wound dimensions for billing purposes
Correct answer: To detect early signs of pressure injury before they progress
Regular structured skin inspection enables early identification of pressure injury signs, allowing timely intervention before wounds progress to deeper stages.
Wound Care Certification Exam Wound Care Certification Pressure Injury Prevention 3
A patient has a pressure injury over the ischial tuberosity.
Which sitting position places LEAST pressure on this anatomical site?