FLORIDA BOARD OF NURSING WOUND
CARE NURSING CERTIFICATION EXAM
WITH ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1. A nurse assesses a patient with a pressure injury over the sacrum.
The wound has full-thickness skin loss, and adipose tissue and
granulation tissue are visible. There is no exposed fascia, muscle,
tendon, cartilage, or bone. Which stage should the nurse document?
A. Stage 1 pressure injury
B. Stage 2 pressure injury
C. Stage 3 pressure injury
D. Stage 4 pressure injury
Answer: C. Stage 3 pressure injury
Rationale: Stage 3 pressure injury involves full-thickness skin loss in
which adipose tissue and granulation tissue may be visible. Epibole
and undermining may occur. However, fascia, muscle, tendon,
cartilage, and bone are not exposed or directly palpable.
2. A patient has intact skin over the heel with persistent, non-
blanchable erythema. The area is painful, warmer than surrounding
tissue, and the patient reports tenderness when pressure is applied.
Which finding is most consistent with a Stage 1 pressure injury?
A. Partial-thickness skin loss with exposed dermis
B. Non-blanchable erythema of intact skin
1
,C. Full-thickness tissue loss with visible adipose
D. Exposed tendon with extensive undermining
Answer: B. Non-blanchable erythema of intact skin
Rationale: Stage 1 pressure injury is characterized by intact skin with
localized non-blanchable erythema. Changes in temperature, firmness,
moisture, or sensation may accompany the discoloration.
3. A patient with diabetes has a plantar ulcer beneath the first
metatarsal head. The wound is surrounded by thick callused tissue.
Which intervention is most important for promoting healing?
A. Apply additional pressure over the ulcer
B. Maintain strict bed rest indefinitely
C. Offload pressure from the ulcer
D. Apply hydrogen peroxide daily
Answer: C. Offload pressure from the ulcer
Rationale: Neuropathic diabetic foot ulcers are strongly associated
with repetitive mechanical pressure. Effective offloading reduces
tissue stress and is a central component of treatment.
4. During assessment of a chronic wound, the nurse observes black,
dry, firmly adherent tissue completely covering the wound bed. The
depth of tissue damage cannot be determined. How should the
wound be classified?
A. Stage 2
B. Stage 3
C. Stage 4
D. Unstageable pressure injury
Answer: D. Unstageable pressure injury
2
,Rationale: A pressure injury is unstageable when full-thickness skin
and tissue loss is obscured by slough or eschar to the extent that the
actual depth cannot be confirmed. Once the covering is removed, the
underlying stage may become apparent.
5. A patient with a sacral pressure injury has exposed adipose tissue
and extensive undermining. The nurse can palpate exposed bone at
the deepest portion of the wound. Which stage is most appropriate?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Answer: D. Stage 4
Rationale: Stage 4 pressure injury involves full-thickness skin and
tissue loss with exposed or directly palpable fascia, muscle, tendon,
cartilage, or bone.
6. A nurse is assessing a wound for infection. Which finding is most
concerning for a localized wound infection?
A. Small amount of clear serous drainage
B. Healthy granulation tissue
C. Increasing erythema, warmth, pain, and purulent drainage
D. Slightly moist wound bed
Answer: C. Increasing erythema, warmth, pain, and purulent
drainage
Rationale: Increasing pain, erythema, warmth, edema, purulent
drainage, odor, and delayed healing can indicate infection. The trend
3
, in findings is particularly important when evaluating a chronic
wound.
7. A patient with a venous leg ulcer has edema of the lower
extremity, hemosiderin staining, and an ulcer near the medial ankle.
Which intervention is generally central to management when
significant arterial disease has been excluded?
A. Compression therapy
B. Complete immobilization
C. Routine application of alcohol
D. Keeping the leg continuously dependent
Answer: A. Compression therapy
Rationale: Venous hypertension contributes substantially to venous
leg ulcer formation. Compression reduces edema and venous
hypertension and is a cornerstone of venous ulcer management when
arterial perfusion is adequate.
8. Before applying high-level compression to a patient with a lower-
extremity ulcer, which assessment is particularly important?
A. Pupil response
B. Ankle-brachial index or another arterial perfusion assessment
C. Bowel sounds
D. Hearing acuity
Answer: B. Ankle-brachial index or another arterial perfusion
assessment
Rationale: Compression can compromise circulation in patients with
significant peripheral arterial disease. Arterial perfusion should
4
CARE NURSING CERTIFICATION EXAM
WITH ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1. A nurse assesses a patient with a pressure injury over the sacrum.
The wound has full-thickness skin loss, and adipose tissue and
granulation tissue are visible. There is no exposed fascia, muscle,
tendon, cartilage, or bone. Which stage should the nurse document?
A. Stage 1 pressure injury
B. Stage 2 pressure injury
C. Stage 3 pressure injury
D. Stage 4 pressure injury
Answer: C. Stage 3 pressure injury
Rationale: Stage 3 pressure injury involves full-thickness skin loss in
which adipose tissue and granulation tissue may be visible. Epibole
and undermining may occur. However, fascia, muscle, tendon,
cartilage, and bone are not exposed or directly palpable.
2. A patient has intact skin over the heel with persistent, non-
blanchable erythema. The area is painful, warmer than surrounding
tissue, and the patient reports tenderness when pressure is applied.
Which finding is most consistent with a Stage 1 pressure injury?
A. Partial-thickness skin loss with exposed dermis
B. Non-blanchable erythema of intact skin
1
,C. Full-thickness tissue loss with visible adipose
D. Exposed tendon with extensive undermining
Answer: B. Non-blanchable erythema of intact skin
Rationale: Stage 1 pressure injury is characterized by intact skin with
localized non-blanchable erythema. Changes in temperature, firmness,
moisture, or sensation may accompany the discoloration.
3. A patient with diabetes has a plantar ulcer beneath the first
metatarsal head. The wound is surrounded by thick callused tissue.
Which intervention is most important for promoting healing?
A. Apply additional pressure over the ulcer
B. Maintain strict bed rest indefinitely
C. Offload pressure from the ulcer
D. Apply hydrogen peroxide daily
Answer: C. Offload pressure from the ulcer
Rationale: Neuropathic diabetic foot ulcers are strongly associated
with repetitive mechanical pressure. Effective offloading reduces
tissue stress and is a central component of treatment.
4. During assessment of a chronic wound, the nurse observes black,
dry, firmly adherent tissue completely covering the wound bed. The
depth of tissue damage cannot be determined. How should the
wound be classified?
A. Stage 2
B. Stage 3
C. Stage 4
D. Unstageable pressure injury
Answer: D. Unstageable pressure injury
2
,Rationale: A pressure injury is unstageable when full-thickness skin
and tissue loss is obscured by slough or eschar to the extent that the
actual depth cannot be confirmed. Once the covering is removed, the
underlying stage may become apparent.
5. A patient with a sacral pressure injury has exposed adipose tissue
and extensive undermining. The nurse can palpate exposed bone at
the deepest portion of the wound. Which stage is most appropriate?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Answer: D. Stage 4
Rationale: Stage 4 pressure injury involves full-thickness skin and
tissue loss with exposed or directly palpable fascia, muscle, tendon,
cartilage, or bone.
6. A nurse is assessing a wound for infection. Which finding is most
concerning for a localized wound infection?
A. Small amount of clear serous drainage
B. Healthy granulation tissue
C. Increasing erythema, warmth, pain, and purulent drainage
D. Slightly moist wound bed
Answer: C. Increasing erythema, warmth, pain, and purulent
drainage
Rationale: Increasing pain, erythema, warmth, edema, purulent
drainage, odor, and delayed healing can indicate infection. The trend
3
, in findings is particularly important when evaluating a chronic
wound.
7. A patient with a venous leg ulcer has edema of the lower
extremity, hemosiderin staining, and an ulcer near the medial ankle.
Which intervention is generally central to management when
significant arterial disease has been excluded?
A. Compression therapy
B. Complete immobilization
C. Routine application of alcohol
D. Keeping the leg continuously dependent
Answer: A. Compression therapy
Rationale: Venous hypertension contributes substantially to venous
leg ulcer formation. Compression reduces edema and venous
hypertension and is a cornerstone of venous ulcer management when
arterial perfusion is adequate.
8. Before applying high-level compression to a patient with a lower-
extremity ulcer, which assessment is particularly important?
A. Pupil response
B. Ankle-brachial index or another arterial perfusion assessment
C. Bowel sounds
D. Hearing acuity
Answer: B. Ankle-brachial index or another arterial perfusion
assessment
Rationale: Compression can compromise circulation in patients with
significant peripheral arterial disease. Arterial perfusion should
4
