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

Which of the following is a major risk factor for skin breakdown?

1. Moderate hydration

2. Compromised sensation or level of consciousness

3. Regular physical activity

4. High nutritional intake

The correct answer is: Compromised sensation or level of consciousness

Compromised sensation or level of consciousness is a significant risk factor for skin breakdown because it can lead to an individual's inability to perceive pressure, moisture, or pain. Such impairments can prevent the timely response to uncomfortable stimuli that commonly herald impending skin damage, such as prolonged pressure, which can result in pressure ulcers. When someone cannot feel pain or pressure, they may remain in a position for prolonged periods, increasing the risk of skin deterioration. In contrast, moderate hydration supports skin integrity, and regular physical activity promotes circulation and can enhance overall skin health. A high nutritional intake is beneficial as well, as proper nutrition supports skin repair and maintenance. Thus, while hydration, activity, and nutrition contribute positively to skin health, compromised sensation or consciousness directly undermines an individual’s ability to protect their skin from injury, making it a critical risk factor for skin breakdown.