The nurse is caring for a group of clients. Which client should the nurse identify as having the greatest risk of developing a pressure ulcer?

A. A 69-year-old client with hypertension who can turn and reposition independently has good mobility, which is a key protective factor against pressure ulcer development. While age and comorbidities like hypertension can slightly increase risk, independent mobility significantly reduces the likelihood of pressure injury. Therefore, this client is at lower risk. B. A 76-year-old client with dementia who requires assistance with all activities of daily living (ADLs) is at greatest risk. Risk factors for pressure ulcers include advanced age, immobility, sensory impairment, incontinence, malnutrition, and cognitive deficits. This client is both older and dependent for all ADLs, meaning prolonged pressure on bony prominences is likely, and the client may be unable to communicate discomfort or reposition independently, making them highly susceptible to skin breakdown. C. A 45-year-old client who is ambulatory and admitted for a broken arm maintains mobility and can still shift weight, reducing pressure over bony areas. Age is lower, and there are no additional risk factors for pressure ulcers, making this client low risk. D. A 56-year-old client postoperative day two and in a chair after knee replacement may have temporary immobility, but they are likely able to adjust position in the chair and are generally younger with intact mobility otherwise. Postoperative clients are at moderate risk, but not as high as a fully dependent older adult with dementia.