Certified Wound Ostomy Nurse (CWON) Practice Test

What is the primary method for reducing shear in patients?

1. Limit head of bed elevation

2. Increase patient mobility

3. Apply topical ointments

4. Encourage frequent position changes

The correct answer is: Limit head of bed elevation

Limiting head of bed elevation is a crucial method for reducing shear in patients, particularly for those who are immobile or have limited mobility. When the head of the bed is elevated, the body can slide down the bed due to gravity, resulting in shear forces that can compromise the skin and underlying tissues. Reducing the elevation helps maintain the patient's position while minimizing the risk of shear injuries, especially in vulnerable areas such as the sacrum and heels. In contrast, increasing patient mobility and encouraging frequent position changes can also help reduce the risk of pressure injuries, but they might not directly target the issue of shear if the head of the bed is still elevated. While applying topical ointments can support skin integrity and hydration, they do not address the mechanical forces at play that lead to shear. Therefore, controlling the elevation of the head of the bed is a direct intervention with the specific intention of reducing those harmful shear forces on the skin.