Questions and Correct
Answers | New Update
Mrs. Canfield is intubated with her HOB elevated 45 degrees. She has a
Stage 3 pressure injury on her coccyx with undermining. Which of the
following risk factors is most responsible for undermining in the pressure
injury?
a. Shear from having the head of bed elevated to 45 degrees.
b. Friction from her turning from side to side.
c. Local infection in the wound.
,d. Excess moisture in the wound bed. - ANSWER ✔✔a. Shear from
having the head of bed elevated to 45 degrees.
A patient with paraplegia is in the wound clinic to have a new seating
surface re-evaluated. You notice a serous fluid filled blister on the left
heel which you document as a pressure injury in what Stage?
a. Stage 1.
b. Stage 2.
c. Stage 3.
d. Stage 4. - ANSWER ✔✔b. Stage 2.
The care plan for the patient with a pressure risk assessment score
(Braden Scale) of 9 and on a therapeutic support surface should always
include:
a. Maintaining HOB at 45 degrees or less.
b. Reposition the patient every 2-4 hours depending upon tissue
tolerance.
c. Use an artificial sheepskin under the coccyx to prevent shear.
, d. Avoid the use of absorbent under pads in patients with incontinence. -
ANSWER ✔✔b. Reposition the patient every 2-4 hours depending
upon tissue tolerance.
Mr. Lee was found lying at home on the floor. Upon admission, he has
an intact, nonblanchable, persistent purple discoloration over the coccyx.
Which describes the classification of his pressure injury?
a. Deep tissue pressure injury.
b. Stage 1 pressure injury.
c. Unstageable.
d. Stage 3 pressure injury. - ANSWER ✔✔a. Deep tissue pressure
injury.
Mr. Peterson likes the head of the bed at 60 degrees due to shortness of
breath. Which of the following is considered a potential PRIMARY
etiologic factor in the development of a pressure injury for this patient?
a. Shear force
b. Short-term pressure force
3
COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED