Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

What factor predominantly causes pressure injuries?

1. Inadequate nutrition

2. Prolonged/intense pressure

3. Excessive moisture

4. Inactivity

The correct answer is: Prolonged/intense pressure

The predominant cause of pressure injuries is prolonged or intense pressure on the skin. When an individual remains in one position for an extended period, blood flow to the tissues is restricted, leading to tissue ischemia and potential necrosis. This condition is especially concerning over bony prominences where the tissue is more vulnerable to injury from pressure. The critical factor here is that sustained pressure can impede circulation, which can then result in skin breakdown and the formation of pressure ulcers. While inadequate nutrition, excessive moisture, and inactivity can contribute to the development of pressure injuries or exacerbate existing ones, they do not serve as the primary cause. Nutrition, for instance, plays a vital role in tissue health and wound healing; however, it cannot create an injury without the presence of pressure. Similarly, excessive moisture can lead to maceration and make skin more susceptible, but again, without pressure, an injury cannot develop. Inactivity can lead to reduced mobility, which may increase the risk of pressure injuries; however, it is the lasting pressure that directly elicits the injury itself. Thus, the core factor leading to the formation of pressure injuries is the prolonged or intense pressure exerted on the skin.