Watch the video version of this Q&A episode on YouTube - https://youtu.be/-1ALMrAcp_g 

A physical therapist working in a rehabilitation hospital completes the Braden Scale as a component of a patient examination. The Braden Scale is MOST often used as a risk assessment tool for which of the following integumentary conditions?

1. Neuropathic ulcers
2. Arterial insufficiency ulcers
3. Venous insufficiency ulcers
4. Pressure injuries

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A physical therapist working in a rehabilitation hospital completes the Braden Scale as a component of a patient examination. The Braden Scale is MOST often used as a risk assessment tool for which of the following integumentary conditions?

1. Neuropathic ulcers
2. Arterial insufficiency ulcers
3. Venous insufficiency ulcers
4. Pressure injuries

Braden Scale
The Braden Scale is a scoring system commonly used to assess a patient’s risk for developing pressure injuries. The Braden Scale is comprised of six risk factors: sensory perception, level of mobility, exposure to moisture, activity level, nutritional status, and exposure to friction and shear 

All risk factors are scored on a scale from 1-4, though “exposure to friction and shear” is scored on a scale from 1-3, with a total possible score of 23. The lower the score the higher the risk for developing a pressure injury.

Let’s explore each of the options:

Option 1 - Neuropathic ulcers 
Neuropathic ulcers are a secondary complication usually associated with a combination of ischemia and neuropathy. Neuropathic ulcers are most often associated with diabetes. However, any form of peripheral neuropathy poses an increased risk of wound development. 

The Wagner Ulcer Grade Classification Scale is commonly used to categorize neuropathic ulcers based on wound depth and the presence of infection.

Option 2 - Arterial insufficiency ulcers 
Arterial insufficiency ulcers are wounds that occur secondary to inadequate circulation of oxygenated blood (e.g., ischemia) often due to complicating factors such as atherosclerosis.

Option 3 - Venous insufficiency ulcers 
Venous insufficiency ulcers are wounds that occur secondary to impaired functioning of the venous system, resulting in inadequate return of blood flow and eventual tissue damage. 

Risk factors for venous insufficiency include age, family history, history of deep vein thrombosis, female gender (likely related to hormone levels of progesterone), obesity, pregnancy, and prolonged sitting or standing.

Option 4 - Pressure injuries
Pressure injuries result from sustained or prolonged pressure on tissue at levels greater than that of capillary pressure. Skin covering bony prominences is particularly susceptible to localized ischemia and tissue necrosis due to pressure.

Factors contributing to pressure injuries include shearing forces, moisture, heat, friction, medications, muscle atrophy, malnutrition, and debilitating medical conditions.

The correct answer is Option 4

Let’s explore the all student data:
14% of students selected Option 1, Neuropathic ulcers
7% of students selected Option 2, Arterial insufficiency ulcers
6% of students selected Option 3, Venous insufficiency ulcers
73% of students selected Option 4, Pressure injuries, the correct response

System Classification
This question is an Other Systems question which represents approximately 21% of all exam items.

Content Outline Classification
This question is a Physical Therapy Examination question which represents approximately 24% of all exam items.

Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.

Academic Focus Area
Looking to review related academic content? Check out pages 514-515 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!