CERTIFIED WOUND CARE NURSE
(CWCN) COMPREHENSIVE EXAM PREP
2026/2027
1. During the proliferative phase of wound healing, which cell type is primarily responsible for
the synthesis of collagen and the formation of the extracellular matrix?
A. Neutrophils
B. Macrophages
C. Fibroblasts
D. Keratinocytes
Answer: C
Conceptual Explanation: Fibroblasts are the key cells in the proliferative phase,
responsible for collagen synthesis and organizing the extracellular matrix to provide
structural integrity.
2. A patient presents with a full-thickness wound where the base is covered by slough and
eschar. The depth cannot be visualized. According to NPIAP guidelines, how should this be
staged?
A. Stage 3 Pressure Injury
,B. Unstageable Pressure Injury
C. Stage 4 Pressure Injury
D. Deep Tissue Pressure Injury
Answer: B
Conceptual Explanation: A pressure injury is classified as unstageable when the extent of
tissue damage cannot be determined because it is obscured by slough or eschar.
3. An Ankle-Brachial Index (ABI) of 0.45 indicates which of the following conditions?
A. Moderate to severe arterial insufficiency
B. Mild peripheral artery disease
C. Normal arterial flow
D. Vascular calcification
Answer: A
Conceptual Explanation: An ABI between 0.41 and 0.90 suggests mild to moderate PAD,
while a value below 0.50 usually indicates severe arterial disease and critical limb
ischemia.
4. Which type of debridement utilizes the body’s own enzymes and moisture under an
occlusive or semi-occlusive dressing to liquefy non-viable tissue?
A. Biological debridement
B. Enzymatic debridement
, C. Autolytic debridement
D. Mechanical debridement
Answer: C
Conceptual Explanation: Autolytic debridement uses the body’s own moisture and
endogenous enzymes (like collagenase) to break down necrotic tissue under a moisture-
retentive dressing.
5. Which of the following dressings is most appropriate for a heavily exudating venous leg
ulcer?
A. Hydrogel sheet
B. Calcium alginate
C. Transparent film
D. Hydrocolloid wafer
Answer: B
Conceptual Explanation: Alginates are highly absorbent and derived from seaweed,
making them ideal for managing moderate to heavy exudate.
6. A localized area of non-blanchable erythema of intact skin is classified as:
A. Deep Tissue Pressure Injury
B. Reactive hyperemia
C. Stage 2 Pressure Injury
(CWCN) COMPREHENSIVE EXAM PREP
2026/2027
1. During the proliferative phase of wound healing, which cell type is primarily responsible for
the synthesis of collagen and the formation of the extracellular matrix?
A. Neutrophils
B. Macrophages
C. Fibroblasts
D. Keratinocytes
Answer: C
Conceptual Explanation: Fibroblasts are the key cells in the proliferative phase,
responsible for collagen synthesis and organizing the extracellular matrix to provide
structural integrity.
2. A patient presents with a full-thickness wound where the base is covered by slough and
eschar. The depth cannot be visualized. According to NPIAP guidelines, how should this be
staged?
A. Stage 3 Pressure Injury
,B. Unstageable Pressure Injury
C. Stage 4 Pressure Injury
D. Deep Tissue Pressure Injury
Answer: B
Conceptual Explanation: A pressure injury is classified as unstageable when the extent of
tissue damage cannot be determined because it is obscured by slough or eschar.
3. An Ankle-Brachial Index (ABI) of 0.45 indicates which of the following conditions?
A. Moderate to severe arterial insufficiency
B. Mild peripheral artery disease
C. Normal arterial flow
D. Vascular calcification
Answer: A
Conceptual Explanation: An ABI between 0.41 and 0.90 suggests mild to moderate PAD,
while a value below 0.50 usually indicates severe arterial disease and critical limb
ischemia.
4. Which type of debridement utilizes the body’s own enzymes and moisture under an
occlusive or semi-occlusive dressing to liquefy non-viable tissue?
A. Biological debridement
B. Enzymatic debridement
, C. Autolytic debridement
D. Mechanical debridement
Answer: C
Conceptual Explanation: Autolytic debridement uses the body’s own moisture and
endogenous enzymes (like collagenase) to break down necrotic tissue under a moisture-
retentive dressing.
5. Which of the following dressings is most appropriate for a heavily exudating venous leg
ulcer?
A. Hydrogel sheet
B. Calcium alginate
C. Transparent film
D. Hydrocolloid wafer
Answer: B
Conceptual Explanation: Alginates are highly absorbent and derived from seaweed,
making them ideal for managing moderate to heavy exudate.
6. A localized area of non-blanchable erythema of intact skin is classified as:
A. Deep Tissue Pressure Injury
B. Reactive hyperemia
C. Stage 2 Pressure Injury
