CERTIFIED WOUND CARE NURSE
(CWCN) CERTIFICATION EXAM 2026
1. Which phase of wound healing is primarily characterized by the migration of fibroblasts
and the synthesis of collagen, typically occurring from day 4 to day 21?
A. Hemostasis phase
B. Proliferative phase
C. Inflammatory phase
D. Maturation phase
Answer: B
Conceptual Explanation: The proliferative phase involves granulation tissue formation,
epithelialization, and wound contraction through fibroblast activity.
2. A patient presents with a purple, localized area of discolored intact skin. The area feels
boggy and is warmer than the surrounding tissue. How should this be staged?
A. Stage 1 Pressure Injury
B. Stage 2 Pressure Injury
C. Unstageable Pressure Injury
,D. Deep Tissue Pressure Injury (DTPI)
Answer: D
Conceptual Explanation: A Deep Tissue Pressure Injury presents as a persistent non-
blanchable deep red, maroon, or purple discoloration, often caused by intense or prolonged
pressure at the bone-muscle interface.
3. When calculating the Ankle-Brachial Index (ABI), a value of 0.45 indicates which of the
following?
A. Normal arterial flow
B. Mild arterial disease
C. Severe arterial disease
D. Moderate arterial disease
Answer: C
Conceptual Explanation: An ABI value less than 0.5 is generally indicative of severe
peripheral artery disease (PAD) and high risk for limb loss.
4. Which type of debridement uses the body’s own enzymes and moisture under an occlusive
dressing to liquefy necrotic tissue?
A. Mechanical debridement
B. Biological debridement
C. Enzymatic debridement
, D. Autolytic debridement
Answer: D
Conceptual Explanation: Autolytic debridement is a selective process where endogenous
enzymes break down necrotic tissue, facilitated by moisture-retentive dressings like
hydrocolloids or transparent films.
5. Which nutritional marker is considered the most sensitive indicator of short-term protein
status changes due to its short half-life of 2 days?
A. Serum Albumin
B. Transferrin
C. Prealbumin
D. C-reactive protein
Answer: C
Conceptual Explanation: Prealbumin (transthyretin) has a half-life of 2 days, making it
more reflective of recent nutritional intake compared to albumin, which has a half-life of 20
days.
6. A venous leg ulcer is typically located in which anatomical region?
A. Lateral malleolus
B. Plantar surface of the foot
C. Medial malleolus / Gaiter area
(CWCN) CERTIFICATION EXAM 2026
1. Which phase of wound healing is primarily characterized by the migration of fibroblasts
and the synthesis of collagen, typically occurring from day 4 to day 21?
A. Hemostasis phase
B. Proliferative phase
C. Inflammatory phase
D. Maturation phase
Answer: B
Conceptual Explanation: The proliferative phase involves granulation tissue formation,
epithelialization, and wound contraction through fibroblast activity.
2. A patient presents with a purple, localized area of discolored intact skin. The area feels
boggy and is warmer than the surrounding tissue. How should this be staged?
A. Stage 1 Pressure Injury
B. Stage 2 Pressure Injury
C. Unstageable Pressure Injury
,D. Deep Tissue Pressure Injury (DTPI)
Answer: D
Conceptual Explanation: A Deep Tissue Pressure Injury presents as a persistent non-
blanchable deep red, maroon, or purple discoloration, often caused by intense or prolonged
pressure at the bone-muscle interface.
3. When calculating the Ankle-Brachial Index (ABI), a value of 0.45 indicates which of the
following?
A. Normal arterial flow
B. Mild arterial disease
C. Severe arterial disease
D. Moderate arterial disease
Answer: C
Conceptual Explanation: An ABI value less than 0.5 is generally indicative of severe
peripheral artery disease (PAD) and high risk for limb loss.
4. Which type of debridement uses the body’s own enzymes and moisture under an occlusive
dressing to liquefy necrotic tissue?
A. Mechanical debridement
B. Biological debridement
C. Enzymatic debridement
, D. Autolytic debridement
Answer: D
Conceptual Explanation: Autolytic debridement is a selective process where endogenous
enzymes break down necrotic tissue, facilitated by moisture-retentive dressings like
hydrocolloids or transparent films.
5. Which nutritional marker is considered the most sensitive indicator of short-term protein
status changes due to its short half-life of 2 days?
A. Serum Albumin
B. Transferrin
C. Prealbumin
D. C-reactive protein
Answer: C
Conceptual Explanation: Prealbumin (transthyretin) has a half-life of 2 days, making it
more reflective of recent nutritional intake compared to albumin, which has a half-life of 20
days.
6. A venous leg ulcer is typically located in which anatomical region?
A. Lateral malleolus
B. Plantar surface of the foot
C. Medial malleolus / Gaiter area
