Final answer:
The most concerning finding when assessing skin over a bony prominence is signs of a bedsore, which are caused by constant pressure and can lead to necrosis and potentially fatal infections if untreated.
Step-by-step explanation:
When a nurse assesses an area of skin over a bony prominence, the most concerning finding would be signs indicative of a bedsore, or decubitis ulcer. This condition is most concerning because it is caused by constant, long-term, unrelieved pressure that cuts off blood flow to the affected area, potentially leading to necrosis (tissue death).
Signs of a serious bedsore include the skin being elevated, firm, and growing, particularly if the area is also discolored, blistered, or has a putrid smell indicating infection, as in cases of severe infection like necrotizing fasciitis. Untreated bedsores can become fatal if infected, making early detection and treatment critical.