National Physical Therapy Examination (NPTE) Practice Exam

After a kidney transplant, what is the most appropriate initial agent to use on a patient with a Stage 3 pressure injury?

1. Povidone-iodine solution

2. Sterile normal saline

3. Silver sulfadiazine cream

4. Zinc oxide cream

The correct answer is: Sterile normal saline

The most appropriate initial agent for treating a Stage 3 pressure injury, especially in a patient who has undergone a kidney transplant, is sterile normal saline. This choice is ideal because sterile normal saline is effective for wound cleansing, helping to remove debris and bacteria from the wound without causing additional tissue damage. In the context of managing pressure injuries, especially in immunocompromised patients, the aim is to maintain a moist wound environment and minimize infection risks. Sterile normal saline is gentle and reduces the risk of introducing pathogens or causing irritation, which is particularly important for a patient who may have a compromised immune response following a transplant. Other options, such as povidone-iodine solution, silver sulfadiazine cream, and zinc oxide cream, may not be as suitable for initial management. Povidone-iodine can be cytotoxic to fibroblasts and may impede wound healing if used excessively. Silver sulfadiazine is often reserved for more severe burns or infected wounds and can inhibit healing as well. Zinc oxide cream is primarily used for barrier protection in superficial skin irritations and is typically not the first choice for an open pressure injury like a Stage 3. In summary, sterile normal saline serves the dual purpose of cleansing while promoting