Certified Wound Care Nurse (CWCN) Practice Exam

Over-the-counter orthotics are most likely to cause pressure ulcers in patients with what condition?

1. Diabetes

2. Neuropathy

3. Arthritis

4. Thermal injuries

The correct answer is: Neuropathy

Over-the-counter orthotics can indeed lead to the development of pressure ulcers, particularly in patients with neuropathy. Neuropathy often results in a diminished ability to perceive pressure, pain, and other sensations in the feet and lower extremities. This lack of sensation can prevent patients from recognizing discomfort or pressure points that may form due to poorly fitting orthotics. When orthopedic supports applied do not conform well to the anatomy of the foot, they can create localized areas of increased pressure that may go unnoticed. As a result, this can compromise the integrity of the skin, especially in patients who may have additional risk factors like impaired circulation or diabetes. This is why individuals with neuropathy are at a heightened risk; they may not perceive the harm being caused until significant tissue damage, such as a pressure ulcer, has already occurred. Other conditions listed, like diabetes, arthritis, and thermal injuries, can also be associated with complications, but neuropathy specifically heightens the risk of developing pressure ulcers due to the inability to feel pressure and discomfort, making this condition particularly relevant.