NPTE Pressure Injury Practice Exam
2026–2027 | 100 Advanced Scenario-
Based Questions with Answers &
Detailed Rationales | Pressure Injury
Staging, Prevention & Management,
Wound Assessment, Skin Integrity,
Tissue Healing & Integumentary
Physical Therapy Exam Prep | NPTE
Study Guide & Practice Test
1. A patient with a T6 spinal cord injury develops a nonblanchable erythematous
area over the sacrum. The skin is intact, and the patient reports no pain because
of sensory impairment. Which pressure injury stage is most appropriate?
A. Stage 1
B. Stage 2
,C. Stage 3
D. Deep tissue pressure injury
Answer: A. Stage 1
Rationale: Stage 1 pressure injury is characterized by intact skin with localized
nonblanchable erythema. Lack of pain does not exclude the diagnosis,
particularly in patients with impaired sensation.
2. A patient has a shallow open ulcer with a pink-red wound bed and no visible
adipose tissue, slough, or granulation tissue. Which stage best describes the
injury?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Answer: B. Stage 2
Rationale: Stage 2 involves partial-thickness skin loss with exposed dermis. The
wound bed is typically viable and pink or red without slough or adipose tissue.
3. A patient with prolonged immobility has full-thickness skin loss over the ischial
tuberosity. Adipose tissue and granulation tissue are visible, but fascia, muscle,
tendon, cartilage, and bone are not exposed. Which stage is most appropriate?
A. Stage 2
B. Stage 3
C. Stage 4
D. Unstageable
Answer: B. Stage 3
,Rationale: Stage 3 involves full-thickness skin loss in which adipose and
granulation tissue may be visible, but exposed fascia, muscle, tendon, cartilage,
or bone are absent.
4. A wound over the sacrum contains extensive slough and eschar that completely
obscure the depth of tissue damage. Which classification is most appropriate?
A. Stage 2
B. Stage 3
C. Stage 4
D. Unstageable pressure injury
Answer: D. Unstageable pressure injury
Rationale: A pressure injury is unstageable when full-thickness skin and tissue
loss is obscured by slough or eschar such that the extent of tissue damage
cannot be confirmed.
5. A patient develops a localized area of persistent dark maroon discoloration
over the heel. The skin is intact, but the tissue is painful and warmer than
surrounding tissue. Which diagnosis is most likely?
A. Stage 1 pressure injury
B. Stage 2 pressure injury
C. Deep tissue pressure injury
D. Moisture-associated skin damage
Answer: C. Deep tissue pressure injury
Rationale: Deep tissue pressure injury may present as persistent nonblanchable
deep red, maroon, or purple discoloration with intact or disrupted skin and may
be associated with pain or temperature changes.
, 6. Which mechanical factor most directly contributes to pressure injury
development when a patient slides downward in bed?
A. Friction
B. Shear
C. Moisture
D. Vibration
Answer: B. Shear
Rationale: Shear occurs when tissues remain relatively fixed against a surface
while deeper tissues move in another direction, commonly occurring when a
patient slides down in bed with the head elevated.
7. A patient with poor mobility spends prolonged periods sitting in a wheelchair.
Which tissue characteristics most increase susceptibility to pressure injury?
A. Thick adipose tissue and high muscle mass
B. High tissue oxygenation and low metabolic demand
C. Reduced soft-tissue thickness and impaired perfusion
D. Increased skin elasticity and hydration
Answer: C. Reduced soft-tissue thickness and impaired perfusion
Rationale: Reduced soft-tissue padding increases mechanical stress over bony
prominences, while impaired perfusion reduces tissue tolerance to sustained
loading.
8. During a skin inspection, a physical therapist notes erythema over the sacrum
that does not blanch when pressure is applied. Which additional finding most
strongly supports Stage 1 pressure injury?
A. Exposed adipose tissue
B. Full-thickness tissue loss
2026–2027 | 100 Advanced Scenario-
Based Questions with Answers &
Detailed Rationales | Pressure Injury
Staging, Prevention & Management,
Wound Assessment, Skin Integrity,
Tissue Healing & Integumentary
Physical Therapy Exam Prep | NPTE
Study Guide & Practice Test
1. A patient with a T6 spinal cord injury develops a nonblanchable erythematous
area over the sacrum. The skin is intact, and the patient reports no pain because
of sensory impairment. Which pressure injury stage is most appropriate?
A. Stage 1
B. Stage 2
,C. Stage 3
D. Deep tissue pressure injury
Answer: A. Stage 1
Rationale: Stage 1 pressure injury is characterized by intact skin with localized
nonblanchable erythema. Lack of pain does not exclude the diagnosis,
particularly in patients with impaired sensation.
2. A patient has a shallow open ulcer with a pink-red wound bed and no visible
adipose tissue, slough, or granulation tissue. Which stage best describes the
injury?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Answer: B. Stage 2
Rationale: Stage 2 involves partial-thickness skin loss with exposed dermis. The
wound bed is typically viable and pink or red without slough or adipose tissue.
3. A patient with prolonged immobility has full-thickness skin loss over the ischial
tuberosity. Adipose tissue and granulation tissue are visible, but fascia, muscle,
tendon, cartilage, and bone are not exposed. Which stage is most appropriate?
A. Stage 2
B. Stage 3
C. Stage 4
D. Unstageable
Answer: B. Stage 3
,Rationale: Stage 3 involves full-thickness skin loss in which adipose and
granulation tissue may be visible, but exposed fascia, muscle, tendon, cartilage,
or bone are absent.
4. A wound over the sacrum contains extensive slough and eschar that completely
obscure the depth of tissue damage. Which classification is most appropriate?
A. Stage 2
B. Stage 3
C. Stage 4
D. Unstageable pressure injury
Answer: D. Unstageable pressure injury
Rationale: A pressure injury is unstageable when full-thickness skin and tissue
loss is obscured by slough or eschar such that the extent of tissue damage
cannot be confirmed.
5. A patient develops a localized area of persistent dark maroon discoloration
over the heel. The skin is intact, but the tissue is painful and warmer than
surrounding tissue. Which diagnosis is most likely?
A. Stage 1 pressure injury
B. Stage 2 pressure injury
C. Deep tissue pressure injury
D. Moisture-associated skin damage
Answer: C. Deep tissue pressure injury
Rationale: Deep tissue pressure injury may present as persistent nonblanchable
deep red, maroon, or purple discoloration with intact or disrupted skin and may
be associated with pain or temperature changes.
, 6. Which mechanical factor most directly contributes to pressure injury
development when a patient slides downward in bed?
A. Friction
B. Shear
C. Moisture
D. Vibration
Answer: B. Shear
Rationale: Shear occurs when tissues remain relatively fixed against a surface
while deeper tissues move in another direction, commonly occurring when a
patient slides down in bed with the head elevated.
7. A patient with poor mobility spends prolonged periods sitting in a wheelchair.
Which tissue characteristics most increase susceptibility to pressure injury?
A. Thick adipose tissue and high muscle mass
B. High tissue oxygenation and low metabolic demand
C. Reduced soft-tissue thickness and impaired perfusion
D. Increased skin elasticity and hydration
Answer: C. Reduced soft-tissue thickness and impaired perfusion
Rationale: Reduced soft-tissue padding increases mechanical stress over bony
prominences, while impaired perfusion reduces tissue tolerance to sustained
loading.
8. During a skin inspection, a physical therapist notes erythema over the sacrum
that does not blanch when pressure is applied. Which additional finding most
strongly supports Stage 1 pressure injury?
A. Exposed adipose tissue
B. Full-thickness tissue loss
