CNA Skin Care and Pressure Injury Prevention 5 — Questions and Answers
Question 1: A resident who uses a wheelchair spends most of the day seated. To reduce pressure injury risk, the CNA should encourage or assist with:
- Remaining seated to avoid fall risk during transfers
- Weight shifts or brief standing every 15–30 minutes (Correct answer)
- Sitting on a standard foam cushion rather than a pressure-redistribution cushion
- Keeping the footrests elevated to shift weight to the thighs
Correct answer: Weight shifts or brief standing every 15–30 minutes
Performing pressure-relieving weight shifts every 15–30 minutes while seated significantly reduces sustained pressure on the ischial tuberosities.
Question 2: When bathing a resident, a CNA notices a purple, bruise-like area on the inner ankle that feels boggy and is painful to touch with intact skin. The CNA should:
- Apply warm compresses to the area to promote healing
- Document it as a bruise and continue the bath
- Report the finding to the nurse immediately as it may be a deep tissue pressure injury (Correct answer)
- Cover it with a bandage and recheck in 24 hours
Correct answer: Report the finding to the nurse immediately as it may be a deep tissue pressure injury
Purple or maroon intact skin with bogginess or pain suggests a deep tissue pressure injury (DTPI), which must be reported promptly for assessment and intervention.
Question 3: Which nutritional deficiency is most closely associated with impaired wound healing and increased pressure injury risk?
- Vitamin D deficiency
- Protein deficiency (Correct answer)
- Calcium deficiency
- Iron deficiency
Correct answer: Protein deficiency
Protein is essential for tissue repair and maintenance of skin integrity; protein deficiency significantly impairs wound healing and increases pressure injury risk.
Question 4: A resident is placed in the side-lying position. To prevent a pressure injury from developing on the hip (trochanter), the CNA should position the resident at:
- 90-degree lateral (full side-lying)
- 30-degree lateral tilt using pillows for support (Correct answer)
- 45-degree semi-Fowler position
- Flat supine with legs slightly apart
Correct answer: 30-degree lateral tilt using pillows for support
The 30-degree lateral tilt distributes body weight over a larger area, avoiding direct pressure on the trochanter compared to a full 90-degree side-lying position.
Question 5: A resident's skin appears pale, cool, and mottled over the right hip after being repositioned. These findings most likely indicate:
- Healthy skin responding to a change in position
- Compromised blood flow and possible pressure-related tissue damage (Correct answer)
- An allergic reaction to laundry detergent
- Normal aging changes in skin pigmentation
Correct answer: Compromised blood flow and possible pressure-related tissue damage
Pallor, coolness, and mottling over a bony prominence after sustained pressure suggest ischemia and potential tissue injury requiring immediate reporting.
Question 6: When applying a moisture barrier cream to a resident with incontinence, which action is CORRECT?
- Apply a thick layer vigorously rubbing it into the skin to maximize absorption
- Apply a thin, even layer gently to clean, dry skin without rubbing (Correct answer)
- Apply only after skin breakdown has already occurred
- Mix the barrier cream with powder for better protection
Correct answer: Apply a thin, even layer gently to clean, dry skin without rubbing
A thin, gentle application of moisture barrier cream to clean, dry skin protects it without causing friction trauma from vigorous rubbing.
Question 7: The Braden Scale is used in nursing facilities primarily to:
- Measure a resident's pain level during wound care
- Assess a resident's risk for developing pressure injuries (Correct answer)
- Grade the severity of an existing pressure injury
- Evaluate a resident's nutritional status
Correct answer: Assess a resident's risk for developing pressure injuries
The Braden Scale scores six subscales (sensory perception, moisture, activity, mobility, nutrition, and friction/shear) to identify residents at risk for pressure injury development.
CNA Skin Care and Pressure Injury Prevention 5
A resident who uses a wheelchair spends most of the day seated.
To reduce pressure injury risk, the CNA should encourage or assist with: