SMS Pressure Injury Prevention and Skin Integrity 2 — Questions and Answers
Question 1: A foam cushion loses its pressure-relieving properties over time primarily due to:
- Increase in foam density
- Foam fatigue and compression set, reducing its ability to rebound (Correct answer)
- Changes in the client's weight
- Exposure to ultraviolet light
Correct answer: Foam fatigue and compression set, reducing its ability to rebound
Foam undergoes compression set over time, where it no longer fully rebounds, reducing its ability to redistribute pressure effectively.
Question 2: Which type of wheelchair cushion uses a fluid-filled bladder to distribute pressure?
- Foam cushion
- Air-filled or gel cushion (Correct answer)
- Solid insert cushion
- Honeycomb polymer cushion
Correct answer: Air-filled or gel cushion
Air-filled and gel cushions use fluid (air or viscous gel) to distribute pressure across a wider surface area through fluid dynamics.
Question 3: When performing a push-up pressure relief in a manual wheelchair, the client typically:
- Leans forward over the lap tray
- Extends the elbows to lift the buttocks off the seat surface (Correct answer)
- Reclines the chair back fully
- Tilts the chair backward
Correct answer: Extends the elbows to lift the buttocks off the seat surface
A push-up pressure relief involves the client placing hands on the armrests or wheels and extending the elbows to lift the body off the seat, relieving ischial pressure.
Question 4: Moisture from incontinence increases the risk of pressure injury development primarily by:
- Cooling the skin and reducing blood flow
- Softening the skin (maceration) and increasing friction and shear susceptibility (Correct answer)
- Increasing tissue oxygen levels
- Reducing the effect of pressure on the skin
Correct answer: Softening the skin (maceration) and increasing friction and shear susceptibility
Moisture from incontinence causes maceration of the skin, making it more susceptible to friction, shear, and breakdown under pressure.
Question 5: A 'deep tissue pressure injury' (DTPI) in wheelchair users most commonly occurs over which anatomical area?
- Sacrum
- Ischial tuberosities (Correct answer)
- Greater trochanters
- Medial malleoli
Correct answer: Ischial tuberosities
The ischial tuberosities bear the greatest pressure during sitting, making them the most common site for deep tissue pressure injuries in wheelchair users.
Question 6: When a client with a new pressure injury needs to continue wheelchair use, the SMS clinician's FIRST priority should be:
- Prescribe a new power wheelchair
- Eliminate or significantly redistribute pressure at the wound site (Correct answer)
- Apply a wound dressing and continue the current seating system
- Refer to a wound care specialist without changing the seating
Correct answer: Eliminate or significantly redistribute pressure at the wound site
The seating system must be urgently modified to eliminate or redistribute pressure at the wound site to allow healing while allowing continued mobility.
SMS Pressure Injury Prevention and Skin Integrity 2
A foam cushion loses its pressure-relieving properties over time primarily due to: