, Question 1
A wound with a 4 cm diameter and 1.2 cm depth, 100% covered in adherent
yellow slough, moderate serosanguineous drainage, and no signs of infection.
Which wound bed preparation strategy is most appropriate as the initial
intervention?
A. Apply a hydrocolloid dressing changed every 7 days to promote
autolytic debridement.
B. Perform sharp surgical debridement immediately to achieve a 100%
granulated wound bed.
C. Initiate conservative sharp debridement of the slough followed by a
hydrofiber dressing with silver.
D. Use a calcium alginate dressing changed daily to manage drainage and
debride the slough.
Correct Answer: C - Initiate conservative sharp debridement of
the slough followed by a hydrofiber dressing with silver.
RATIONALE
Conservative sharp debridement removes the adherent slough that
impedes healing, and a hydrofiber with silver addresses the moderate
drainage while providing antimicrobial coverage; this is the most
efficient initial step. Hydrocolloid (A) is insufficient for moderate
drainage and slough. Immediate surgical debridement (B) is overly
aggressive without infection. Calcium alginate (D) manages drainage
but does not effectively debride slough.
Question 2
A patient with a new end colostomy has a peristomal skin area with a 2 cm
circumferential area of denuded, moist, red skin immediately adjacent to the
stoma. The stoma is viable and the pouching system currently leaks every 24
hours. Which intervention best addresses the underlying cause?
A. Apply a skin barrier powder to the denuded area and seal with a
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, no-sting barrier film.
B. Change to a convex pouching system to improve the seal and prevent
leakage.
C. Use a larger pouching system opening to avoid pressure on the
peristomal skin.
D. Apply a hydrocolloid skin barrier ring directly over the denuded skin.
Correct Answer: B - Change to a convex pouching system to
improve the seal and prevent leakage.
RATIONALE
The denuded skin is likely moisture-associated skin damage from
leakage; improving the seal with convexity addresses the root cause.
Skin barrier powder (A) treats the symptom but does not prevent
further leakage. A larger opening (C) would worsen leakage. A
hydrocolloid ring (D) may not adhere to moist denuded skin and does
not correct the seal.
Question 3
Which statement accurately reflects the current evidence regarding the use of
prophylactic dressings for pressure injury prevention on the sacrum in
high-risk patients?
A. Prophylactic dressings are not recommended due to lack of evidence.
B. Only transparent films should be used for prophylaxis on the sacrum.
C. Multi-layer silicone foam dressings reduce the incidence of pressure
injuries when used as part of a comprehensive prevention protocol.
D. Prophylactic dressings should be used only after a Stage 1 pressure
injury develops.
Correct Answer: C - Multi-layer silicone foam dressings reduce
the incidence of pressure injuries when used as part of a
comprehensive prevention protocol.
Page 3
, RATIONALE
Current international guidelines support multi-layer silicone foam
dressings on the sacrum and heels as an adjunct to comprehensive
prevention. Transparent films (B) do not provide sufficient pressure
redistribution. Prophylactic dressings are not for treatment after injury
(D).
Question 4
A patient with an ileal conduit has a stoma that is retracted and sits below the
skin surface. The peristomal skin is intact but the pouching system leaks within
12 hours. Which pouching system modification is most appropriate?
A. Use a flat, one-piece pouching system with a larger opening.
B. Apply a convex pouching system with a belt to apply pressure and
improve the seal.
C. Use a two-piece system with a flat barrier and no belt.
D. Apply a skin barrier ring around the stoma and use a flat pouching
system.
Correct Answer: B - Apply a convex pouching system with a belt
to apply pressure and improve the seal.
RATIONALE
A retracted stoma requires convexity to push the peristomal skin up
around the stoma and create a seal; a belt helps maintain pressure. Flat
systems (A, C) will not accommodate the retraction. A barrier ring
alone (D) does not correct the retraction.
Question 5
Which of the following best describes the mechanism of action of negative
pressure wound therapy (NPWT) in promoting wound healing?
A. It primarily reduces bacterial bioburden through continuous irrigation.
B. It applies positive pressure to the wound bed to stimulate granulation
tissue.
Page 4
A wound with a 4 cm diameter and 1.2 cm depth, 100% covered in adherent
yellow slough, moderate serosanguineous drainage, and no signs of infection.
Which wound bed preparation strategy is most appropriate as the initial
intervention?
A. Apply a hydrocolloid dressing changed every 7 days to promote
autolytic debridement.
B. Perform sharp surgical debridement immediately to achieve a 100%
granulated wound bed.
C. Initiate conservative sharp debridement of the slough followed by a
hydrofiber dressing with silver.
D. Use a calcium alginate dressing changed daily to manage drainage and
debride the slough.
Correct Answer: C - Initiate conservative sharp debridement of
the slough followed by a hydrofiber dressing with silver.
RATIONALE
Conservative sharp debridement removes the adherent slough that
impedes healing, and a hydrofiber with silver addresses the moderate
drainage while providing antimicrobial coverage; this is the most
efficient initial step. Hydrocolloid (A) is insufficient for moderate
drainage and slough. Immediate surgical debridement (B) is overly
aggressive without infection. Calcium alginate (D) manages drainage
but does not effectively debride slough.
Question 2
A patient with a new end colostomy has a peristomal skin area with a 2 cm
circumferential area of denuded, moist, red skin immediately adjacent to the
stoma. The stoma is viable and the pouching system currently leaks every 24
hours. Which intervention best addresses the underlying cause?
A. Apply a skin barrier powder to the denuded area and seal with a
Page 2
, no-sting barrier film.
B. Change to a convex pouching system to improve the seal and prevent
leakage.
C. Use a larger pouching system opening to avoid pressure on the
peristomal skin.
D. Apply a hydrocolloid skin barrier ring directly over the denuded skin.
Correct Answer: B - Change to a convex pouching system to
improve the seal and prevent leakage.
RATIONALE
The denuded skin is likely moisture-associated skin damage from
leakage; improving the seal with convexity addresses the root cause.
Skin barrier powder (A) treats the symptom but does not prevent
further leakage. A larger opening (C) would worsen leakage. A
hydrocolloid ring (D) may not adhere to moist denuded skin and does
not correct the seal.
Question 3
Which statement accurately reflects the current evidence regarding the use of
prophylactic dressings for pressure injury prevention on the sacrum in
high-risk patients?
A. Prophylactic dressings are not recommended due to lack of evidence.
B. Only transparent films should be used for prophylaxis on the sacrum.
C. Multi-layer silicone foam dressings reduce the incidence of pressure
injuries when used as part of a comprehensive prevention protocol.
D. Prophylactic dressings should be used only after a Stage 1 pressure
injury develops.
Correct Answer: C - Multi-layer silicone foam dressings reduce
the incidence of pressure injuries when used as part of a
comprehensive prevention protocol.
Page 3
, RATIONALE
Current international guidelines support multi-layer silicone foam
dressings on the sacrum and heels as an adjunct to comprehensive
prevention. Transparent films (B) do not provide sufficient pressure
redistribution. Prophylactic dressings are not for treatment after injury
(D).
Question 4
A patient with an ileal conduit has a stoma that is retracted and sits below the
skin surface. The peristomal skin is intact but the pouching system leaks within
12 hours. Which pouching system modification is most appropriate?
A. Use a flat, one-piece pouching system with a larger opening.
B. Apply a convex pouching system with a belt to apply pressure and
improve the seal.
C. Use a two-piece system with a flat barrier and no belt.
D. Apply a skin barrier ring around the stoma and use a flat pouching
system.
Correct Answer: B - Apply a convex pouching system with a belt
to apply pressure and improve the seal.
RATIONALE
A retracted stoma requires convexity to push the peristomal skin up
around the stoma and create a seal; a belt helps maintain pressure. Flat
systems (A, C) will not accommodate the retraction. A barrier ring
alone (D) does not correct the retraction.
Question 5
Which of the following best describes the mechanism of action of negative
pressure wound therapy (NPWT) in promoting wound healing?
A. It primarily reduces bacterial bioburden through continuous irrigation.
B. It applies positive pressure to the wound bed to stimulate granulation
tissue.
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