CNA Skin Care and Pressure Injury Prevention 4 — Questions and Answers
Question 1: A resident has been lying in the same position for 2 hours. When you reposition them, you notice a reddened area on the sacrum that does NOT blanch when pressed. This finding indicates:
- Stage 2 pressure injury with open skin
- Stage 1 pressure injury or deep tissue injury (Correct answer)
- Normal skin response to pressure
- Superficial skin tear
Correct answer: Stage 1 pressure injury or deep tissue injury
Non-blanchable erythema is the hallmark of a Stage 1 pressure injury and may also indicate deep tissue pressure injury.
Question 2: Which of the following best describes the purpose of using a draw sheet when repositioning a resident in bed?
- To keep the resident warm during repositioning
- To reduce friction and shear forces on the skin (Correct answer)
- To prevent the resident from falling out of bed
- To absorb moisture from incontinence
Correct answer: To reduce friction and shear forces on the skin
A draw sheet allows caregivers to lift and move a resident rather than dragging them, which reduces friction and shear that damage skin.
Question 3: A resident with diabetes has dry, cracked skin on both feet. The CNA should:
- Apply lotion between the toes to keep them moisturized
- Apply lotion to the feet but avoid the areas between the toes (Correct answer)
- Soak the feet for 30 minutes daily to rehydrate the skin
- Apply a medicated powder between the toes
Correct answer: Apply lotion to the feet but avoid the areas between the toes
Moisture trapped between the toes promotes fungal growth and maceration; lotion should be applied to the foot surface but not between the toes.
Question 4: When performing perineal care on an incontinent resident, the PRIMARY reason for thorough cleaning and drying is to:
- Improve the resident's comfort and dignity only
- Prevent moisture-associated skin damage and pressure injury development (Correct answer)
- Follow the facility's routine schedule regardless of soiling
- Reduce odor for other residents and staff
Correct answer: Prevent moisture-associated skin damage and pressure injury development
Prolonged moisture from urine or stool breaks down skin integrity, dramatically increasing pressure injury risk.
Question 5: A CNA notices that a resident's heels are resting directly on the mattress. The most appropriate intervention is to:
- Place a pillow lengthwise under the calves to float the heels (Correct answer)
- Apply donut-shaped heel protectors to redistribute pressure
- Elevate the head of the bed to shift weight off the heels
- Massage the heels vigorously to improve circulation
Correct answer: Place a pillow lengthwise under the calves to float the heels
Placing a pillow under the calves suspends the heels completely off the mattress, eliminating pressure on this high-risk bony prominence.
Question 6: Which statement about massaging bony prominences is CORRECT according to current pressure injury prevention guidelines?
- Massage increases blood flow and should be done at every repositioning
- Massage over bony prominences is contraindicated because it can damage fragile tissue (Correct answer)
- Gentle circular massage is safe if the skin is intact
- Massage is only contraindicated when the skin is broken
Correct answer: Massage over bony prominences is contraindicated because it can damage fragile tissue
Current guidelines advise against massaging bony prominences because it can cause additional tissue trauma to already compromised areas.
Question 7: A resident is admitted with a Stage 2 pressure injury (shallow open wound) on the coccyx. As the CNA, your role includes:
- Selecting and applying the appropriate wound dressing independently
- Documenting the wound measurements in the medical record
- Reporting any changes in wound appearance to the nurse and following the care plan (Correct answer)
- Debriding necrotic tissue during routine bathing
Correct answer: Reporting any changes in wound appearance to the nurse and following the care plan
CNAs observe and report wound changes to the nurse and follow the established care plan; wound assessment, dressing selection, and debridement are outside the CNA scope of practice.
CNA Skin Care and Pressure Injury Prevention 4
A resident has been lying in the same position for 2 hours.
When you reposition them, you notice a reddened area on the sacrum that does NOT blanch when pressed.
This finding indicates: