What factor(s) place a person at risk for developing cancer? (Select all that apply)

Choice A reason: Stage 1 pressure ulcers present with intact skin showing non-blanchable redness, typically over bony prominences, due to localized ischemia from sustained pressure. No skin loss or blistering occurs, as the epidermis remains intact, indicating early tissue stress without ulceration. This does not match the described blister and skin loss, making it incorrect.

Choice B reason: Stage 4 pressure ulcers involve full-thickness tissue loss, exposing underlying structures like muscle, bone, or tendons. Severe necrosis and deep tissue damage occur due to prolonged pressure, disrupting blood supply extensively. The described superficial skin loss with a blister does not involve such deep structures, ruling out Stage 4.

Choice C reason: Stage 3 pressure ulcers feature full-thickness skin loss, extending into subcutaneous tissue but not to muscle or bone. They may show undermining or tunneling due to tissue necrosis. The described blister with top-layer skin loss suggests partial-thickness damage, not deep enough for Stage 3, making this choice incorrect.

Choice D reason: Stage 2 pressure ulcers involve partial-thickness skin loss, affecting the epidermis and possibly dermis, often appearing as a shallow ulcer or fluid-filled blister. The blister and loss of the top skin layer described indicate damage beyond redness but not full-thickness, aligning perfectly with Stage 2 characteristics, making this the correct choice.

Choice A reason: Increased skin pigmentation is associated with Addison’s disease due to elevated ACTH stimulating melanocytes. Cushing syndrome, caused by excess cortisol, typically causes skin thinning and bruising, not hyperpigmentation. The excess cortisol does not directly affect melanin production, making this choice incorrect.

Choice B reason: Cushing syndrome leads to weight gain, not weight loss, due to cortisol’s promotion of fat deposition in central areas (e.g., abdomen, face). Increased appetite and altered metabolism contribute to obesity, not weight loss, making this choice incorrect as it contradicts the metabolic effects of hypercortisolism.

Choice C reason: Cushing syndrome often causes hypertension, not decreased blood pressure, due to cortisol’s mineralocorticoid effects, increasing sodium retention and vascular resistance. Decreased blood pressure is more associated with adrenal insufficiency, making this choice incorrect as it does not align with Cushing syndrome’s pathophysiology.

Choice D reason: Cushing syndrome, characterized by excess cortisol, suppresses the immune system by inhibiting inflammatory responses and reducing lymphocyte activity. This increases susceptibility to infections and impairs wound healing, making decreased immune response a hallmark complication, which is why this choice is correct.