FREE LPN Wound Care and Pressure Injury Staging Questions and Answers

Question 1

An LPN is assessing a client's pressure injury over the sacrum. The wound bed shows full-thickness tissue loss with visible subcutaneous fat, but bone, tendon, and muscle are not exposed. How should the LPN stage this injury?

Accepted Answer

Stage 3

Answer

A Stage 3 pressure injury is defined as full-thickness skin and tissue loss where adipose (fat) is visible in the ulcer, but bone, tendon, or muscle are not exposed. Slough or eschar may be present but do not obscure the depth of tissue loss. This stage represents a deep crater.

Question 2

A client has an area of intact skin on the heel that is red and does not blanch when pressed. The LPN would document this finding as which stage of pressure injury?

Accepted Answer

Stage 1

Answer

A Stage 1 pressure injury is characterized by intact skin with a localized area of non-blanchable erythema (redness). The area may be painful, firm, soft, warmer, or cooler compared to adjacent tissue. This indicates underlying tissue damage from pressure.

Question 3

An LPN is preparing to irrigate a client's surgical wound. Which technique demonstrates proper procedure?

Accepted Answer

Directing the flow of solution from the top to the bottom of the wound.

Answer

Wound irrigation should always proceed from the least contaminated area to the most contaminated area to prevent spreading microorganisms into cleaner parts of the wound. This is often described as cleaning from 'clean to dirty' or from the center of the wound outward.

Question 4

A pressure injury on a client's coccyx is completely covered by hard, dry, black eschar. How should this wound be staged?

Accepted Answer

Unstageable

Answer

An unstageable pressure injury is characterized by full-thickness skin and tissue loss in which the extent of the damage cannot be confirmed because it is obscured by slough or eschar. The eschar must be removed to expose the base of the wound before it can be accurately staged.

Question 5

An LPN is contributing to the plan of care for an immobile client at high risk for developing pressure injuries. What is a priority nursing intervention?

Accepted Answer

Repositioning the client at least every 2 hours.

Answer

Repositioning is a critical intervention to relieve pressure over bony prominences and restore blood flow to the tissues. A turning schedule of at least every 2 hours is the standard of care for preventing pressure injury development in at-risk, immobile clients.

LPN - Licensed Practical Nurse Practice Test

LPN - Licensed Practical Nurse Practice Test

FREE LPN Wound Care and Pressure Injury Staging Questions and Answers