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NDNQI Pressure Injury Training – Case Study Scenarios (2025/2026) | 18 Realistic Exam Cases with Answers | Hospital vs Community-Acquired Injuries, Staging, ICU/Step-Down Transfers

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This document presents 18 highly detailed clinical case studies with fully verified answers and rationales, tailored for training and assessment within the NDNQI (National Database of Nursing Quality Indicators) Pressure Injury Survey program for the 2025/2026 academic year. Developed in alignment with updated NDNQI guidelines, these realistic scenarios are essential for nursing students, clinical educators, and healthcare professionals involved in wound care, quality improvement, or hospital reporting procedures. Each case explores patient admissions across various units—ICU, step-down, rehab, pediatrics, NICU, surgical, orthopedic, and trauma—with emphasis on: Accurate classification of pressure injuries: Community-acquired, hospital-acquired, and unit-acquired Correct staging of injuries: Stage 1–4, unstageable, and deep tissue pressure injuries Documentation audit & reasoning: Admission assessments, transfers, pre-existing wounds, and development timelines Medicare classification rules: How transitions to rehab affect pressure injury origin designation Device-related injuries: Including oxygen tubing, leg braces, and CPAP masks Critical thinking in clinical judgment: Evaluating skin integrity across complex and multi-day hospitalizations Patient age spectrum: Cases range from neonates and pediatric patients to geriatric patients in various acuity settings This training document is ideal for: BSN and RN students in wound care or medical-surgical nursing Clinical nurse educators and preceptors Hospital staff preparing for NDNQI participation or audits Nursing quality improvement teams Healthcare professionals in compliance, documentation, or risk management roles With thorough justifications for each answer, this case-based learning tool sharpens learners’ ability to apply NDNQI standards in real-world chart review and bedside scenarios, making it a high-impact resource for mastering pressure injury identification and reporting accuracy. Keywords: NDNQI training, pressure injury scenarios, case study answers, hospital-acquired pressure injury, community-acquired pressure injury, unit-acquired injuries, pressure injury staging, wound care education, ICU skin assessment, device-related pressure wounds, NICU injury survey, Medicare rehab classification, nursing quality indicators, skin integrity documentation, nursing exam prep, RN clinical judgment, Stage 1 to Stage 4 wounds, deep tissue injury, CPAP pressure injury, medical surgical nursing

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NDNIQI Pressure Injury Training Case
Study Scenarios 2025/2026 Exam
Questions with 100% Correct Answers |
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An 81 Y/O female was admitted to the oncology unit with metastatic cancer

for pain control. On day 4 of hospitalization, she suffered circulatory

complications and she was transferred to the step down unit. The pressure

injury survey was conducted on day 5 of hospitalization and her family

verbally consented to have her included in the pressure injury survey. The

survey team found a large Stage 1 area of nonblanchable redness over her

right ischial tuberosity.




Review of her hospital admission assessment record revealed her skin was

warm, dry, and intact. The skin assessment documented on arrival to the

step down unit noted a small Stage 1 pressure injury at this site.

,For the pressure injury survey, this would be reported as:

a. Community Acquired Pressure Injury

b. Hospital Acquired Pressure Injury Only

c. Hospital Acquired and Unit Acquired Pressure Injury - 🧠 ANSWER

✔✔Hospital Acquired Pressure Injury Only




Reasoning:

No pressure injury was identified at this site on the admission assessment

record. Therefore, the pressure injury developed after the patient was

admitted to the hospital and it is a hospital acquired pressure injury.




Review of the patient's record on transfer to the step down unit revealed

the presence of a Stage 1 pressure injury at this site. Therefore, the

pressure injury was present upon arrival to the unit and it is not a unit

acquired pressure injury even though the area was larger since arrival to

the unit.

, An 88 Y/O male was admitted with urosepsis to the step down unit from a

local long term care facility. On day 3 he was transferred to the medical-

surgical unit. The pressure injury survey was conducted on day 4 of

hospitalization and the survey team saw an unstageable pressure injury on

the back of his head.




Review of the hospital admission assessment record revealed his skin was

very warm and dry with a pressure injury documented at this site. The skin

assessment documented on arrival to the medical-surgical unit also noted a

pressure injury at this site.




For the pressure injury survey, this would be reported as:

a. Community Acquired Pressure Injury

b. Hospital Acquired Pressure Injury Only

c. Hospital Acquired and Unit Acquired Pressure Injury - 🧠 ANSWER

✔✔Community Acquired Pressure Injury




Reasoning:

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