ATI LPN Fundamentals Final Proctored Exam
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ATI LPN Fundamentals Final Proctored Exam
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Question: 1 of 100Ati lpn fundamentals final proctored exam
During a bath, the nurse notices redness and a potential pressure ulcer on the client's sacral area. What should the nurse do next?
Explanation
A. Apply a topical ointment and continue with the bath: Applying ointment without further assessment or orders can mask skin changes and delay appropriate intervention. Early pressure injury management requires evaluation and interdisciplinary planning rather than routine topical treatment. B. Cover the area with a bandage to prevent infection: Covering the area without assessment, staging, or provider notification may be inappropriate and could worsen skin breakdown. Dressing selection depends on the stage of the pressure injury and underlying skin integrity. C. Document the findings and report to the healthcare provider: Redness over the sacral area may indicate a stage 1 pressure injury and requires prompt documentation and reporting. This allows for early interventions such as pressure redistribution, skin protection, and care plan updates before major damage occurs. D. Ignore it since it is a common issue in bedridden clients: Pressure injuries are never expected or acceptable findings. Ignoring early signs increases the risk of progression to deeper tissue injury and serious complications.
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