Certified Wound Care Nurse (CWCN) Practice Exam

Which patient has the highest potential for heel pressure ulcer formation?

1. Bedbound adult with a feeding tube

2. An elderly patient hospitalized for hip fracture repair

3. Trauma patient on backboard

4. Paraplegic wheelchair-bound patient

The correct answer is: Bedbound adult with a feeding tube

The bedbound adult with a feeding tube has the highest potential for heel pressure ulcer formation due to several critical factors. Being bedbound significantly increases the risk of prolonged pressure on specific body areas, especially the heels, which are often in contact with the bed surface. Pressure ulcers, particularly in the heel region, occur when there is sustained pressure that impairs blood flow to the skin and underlying tissues. In the case of a bedbound patient, the lack of movement can lead to skin breakdown over bony prominences such as the heels. Additionally, the presence of a feeding tube may contribute to limitations in mobility and repositioning, thereby increasing the likelihood of pressure ulcer development. Regular repositioning and pressure relief are essential interventions to mitigate this risk, but if the patient is unable to change positions frequently due to their condition, this enhances the risk for heel ulceration. Other options, such as the elderly patient recovering from a hip fracture or the trauma patient on a backboard, also present risks for pressure ulcers, but they might benefit from more frequent monitoring and potential repositioning during their recovery process. The paraplegic wheelchair-bound patient can manage pressure relief by transferring or repositioning in their wheelchair, reducing their overall risk compared to a completely immobile individual.