A nurse is assessing a group of clients at risk of developing a pressure injury. The nurse should identify that which of the following clients is at the greatest risk?

A. A postoperative orthopedic client is at risk but is typically turned regularly and receives postoperative care. B. A client post-myocardial infarction may have decreased activity but usually remains aware and continent, lowering the risk. C. Incontinence increases moisture and skin maceration, while immobility and cognitive impairment from dementia reduce repositioning ability — both key factors in pressure injury development. D. A T-tube affects bile drainage, not skin integrity, unless mobility is severely restricted.