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A nurse is collecting data on a client.
Which of the following findings increase the client's risk of a pressure injury?

BMI of 20.

Peripheral neuropathy.

Immobility.

Hypoperfusion.

Prealbumin level of 16 mg/dL.

Answer and Explanation

Correct Answer : B,C,D

Choice A rationale:

A BMI of 20 is within the normal range (18.5-24.9), so it does not increase the risk of pressure injuries.

Choice B rationale:

Peripheral neuropathy can lead to decreased sensation, increasing the risk of pressure injuries as the person may not feel discomfort from prolonged pressure.

Choice C rationale:

Immobility is a major risk factor for pressure injuries as it increases the duration of pressure on certain areas of the body.

Choice D rationale:

Hypoperfusion, or reduced blood flow, can lead to tissue damage and increase the risk of pressure injuries.

Choice E rationale:

A prealbumin level of 16 mg/dL is within the normal range (15-36 mg/dL), so it does not increase the risk of pressure injuries.

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Correct Answer is C

Explanation

Choice A rationale:

Wrapping the dressing in a clear plastic bag and discarding it in the bedside trash receptacle is incorrect because it does not follow proper biohazardous waste disposal protocols.

Choice B rationale:

Double bagging the dressing, labeling it “biohazard,” and sending it for decontamination is incorrect because it is not the standard procedure for disposing of soiled dressings.

Choice C rationale:

Placing the dressing in a biohazardous waste container is the correct method for disposing of soiled dressings.

Choice D rationale:

Discarding the dressing in the bedside trash receptacle is incorrect because it does not follow proper biohazardous waste disposal protocols.

A. Abdominal pads. B. Hydrogel. C. Wet-to-dry. D. Dry gauze.

Correct Answer is B

Explanation

Choice A rationale:

Abdominal pads are not designed to minimize pain during dressing changes.

Choice B rationale:

Hydrogel dressings are known to minimize pain during dressing changes.

Choice C rationale:

Wet-to-dry dressings can cause discomfort during dressing changes.

Choice D rationale:

Dry gauze can stick to the wound bed and cause pain during dressing changes.

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A nurse is collecting data on a client.Which of the following findings increase the client's risk of a pressure injury?

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Correct Answer is C

Explanation

Correct Answer is B

Explanation

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A nurse is collecting data on a client.
Which of the following findings increase the client's risk of a pressure injury?