During a wound assessment of an older adult in a skilled nursing facility, the nurse notes that a skin tear on the forearm shows no remaining skin flap to approximate over the wound bed. The wound bed is fully exposed with complete tissue loss. Which action best reflects appropriate clinical judgment regarding classification and documentation of this wound?

A. Apply a pressure injury stage, since tissue loss is visible: Skin tears and pressure injuries use different classification systems; avoid assigning a pressure injury stage to a skin tear. B. Classify the wound as a Category 1 skin tear, since no bleeding is present: Category/Type 1 refers to no tissue loss (flap present and approximable), not absence of bleeding. C. Document the wound as a partial-thickness injury with skin flap retained: Inaccurate for this scenario - the stem states there is complete tissue loss with no flap to approximate. D. Classify the skin tear as Category 3 due to complete loss of the epidermal flap: Many skin-tear classification systems (e.g., ISTAP) define the category for total flap loss (no skin flap) as the most severe type; documentation should reflect complete flap loss.