Module 1 NDNQI Pressure Injuries
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Pressure Injury - CORRECT ANSWER - localized damage to the skin and underlying soft
tissue usually over a bony prominence or related to a medical or other device.
The injury can present as intact skin or an open ulcer and may be painful. The injury occurs as a
result of intense and/or prolonged pressure or pressure in combination with shear. The tolerance
of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion,
co-morbidities and condition of the soft tissue.
Pressure - CORRECT ANSWER - Pressure is the force (per unit area) exerted
perpendicular to the skin surface. Pressure damages the skin and underlying tissues by
(1) directly deforming and damaging tissue;
(2) compressing small blood vessels hindering blood flow and nutrient supply and
(3) through ischemia-reperfusion injury. When pressure is redistributed over a greater surface
area, the pressure is less intense in any one area.
Shear stress - CORRECT ANSWER - Shear stress is the force (per unit area) exerted
parallel to the tissue.
Shear strain - CORRECT ANSWER - Shear strain is the actual distortion or deformation
of tissue as a result of shear stress. Some shear strain occurs at rest. Shear strain is intensified in
certain clinical situations (e.g., raising the head of the bed > 30 degrees; dragging rather than
lifting while repositioning). One layer of tissue slides over another deforming adipose and
muscle tissue and disrupting blood flow.
Stage 1 Pressure Injury - CORRECT ANSWER - Intact skin with a localized area of non-
blanchable erythema, which may appear differently in darkly pigmented skin. Presence of
blanchable erythema or changes in sensation, temperature, or firmness may precede visual
changes. Color changes do not include purple or maroon discoloration; these may indicate deep
tissue pressure injury.
, Slough - CORRECT ANSWER - Whitish dead tissue
Eschar - CORRECT ANSWER - Dead tissue like a scab that sheds or falls off from
healthy skin. It's caused by burns and pressure wounds
Eschar is typically tan, brown, or black, and may be crusty
Blanch Test - CORRECT ANSWER - Blanch Test: Apply light pressure. Skin should
blanch or lighten. Release. Skin should return to normal color due to normal reactive hyperemia.
Blanchable: Skin blanches with pressure. Color returns immediately with release.
Non-blanchable: No blanch, persistent redness in lightly pigmented skin.
Stage 2 Pressure Injury - CORRECT ANSWER - Partial thickness skin loss with exposed
dermis.
The wound bed is viable, pink or red, moist, and may also present as an intact or ruptured serum-
filled blister.
Adipose (fat) is not visible and deeper tissues are not visible.
Granulation tissue, slough and eschar are not present.
These injuries commonly result from adverse microclimate and shear in the skin over the pelvis
and shear in the heel.
Stage 3 Pressure Injury - CORRECT ANSWER - Full thickness loss of skin,
adipose (fat) is visible in the ulcer and granulation tissue and epibole (rolled wound edges) are
often present.
Slough and/or eschar may be visible. The depth of tissue damage varies by anatomical location;
areas of significant adiposity can develop deep wounds.
Undermining and tunneling may occur.
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Pressure Injury - CORRECT ANSWER - localized damage to the skin and underlying soft
tissue usually over a bony prominence or related to a medical or other device.
The injury can present as intact skin or an open ulcer and may be painful. The injury occurs as a
result of intense and/or prolonged pressure or pressure in combination with shear. The tolerance
of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion,
co-morbidities and condition of the soft tissue.
Pressure - CORRECT ANSWER - Pressure is the force (per unit area) exerted
perpendicular to the skin surface. Pressure damages the skin and underlying tissues by
(1) directly deforming and damaging tissue;
(2) compressing small blood vessels hindering blood flow and nutrient supply and
(3) through ischemia-reperfusion injury. When pressure is redistributed over a greater surface
area, the pressure is less intense in any one area.
Shear stress - CORRECT ANSWER - Shear stress is the force (per unit area) exerted
parallel to the tissue.
Shear strain - CORRECT ANSWER - Shear strain is the actual distortion or deformation
of tissue as a result of shear stress. Some shear strain occurs at rest. Shear strain is intensified in
certain clinical situations (e.g., raising the head of the bed > 30 degrees; dragging rather than
lifting while repositioning). One layer of tissue slides over another deforming adipose and
muscle tissue and disrupting blood flow.
Stage 1 Pressure Injury - CORRECT ANSWER - Intact skin with a localized area of non-
blanchable erythema, which may appear differently in darkly pigmented skin. Presence of
blanchable erythema or changes in sensation, temperature, or firmness may precede visual
changes. Color changes do not include purple or maroon discoloration; these may indicate deep
tissue pressure injury.
, Slough - CORRECT ANSWER - Whitish dead tissue
Eschar - CORRECT ANSWER - Dead tissue like a scab that sheds or falls off from
healthy skin. It's caused by burns and pressure wounds
Eschar is typically tan, brown, or black, and may be crusty
Blanch Test - CORRECT ANSWER - Blanch Test: Apply light pressure. Skin should
blanch or lighten. Release. Skin should return to normal color due to normal reactive hyperemia.
Blanchable: Skin blanches with pressure. Color returns immediately with release.
Non-blanchable: No blanch, persistent redness in lightly pigmented skin.
Stage 2 Pressure Injury - CORRECT ANSWER - Partial thickness skin loss with exposed
dermis.
The wound bed is viable, pink or red, moist, and may also present as an intact or ruptured serum-
filled blister.
Adipose (fat) is not visible and deeper tissues are not visible.
Granulation tissue, slough and eschar are not present.
These injuries commonly result from adverse microclimate and shear in the skin over the pelvis
and shear in the heel.
Stage 3 Pressure Injury - CORRECT ANSWER - Full thickness loss of skin,
adipose (fat) is visible in the ulcer and granulation tissue and epibole (rolled wound edges) are
often present.
Slough and/or eschar may be visible. The depth of tissue damage varies by anatomical location;
areas of significant adiposity can develop deep wounds.
Undermining and tunneling may occur.
