omprehensive Study Guide Wound
C
Certification Exam
hisWound Certification Exam Study Guideis a comprehensive featuring
T
197 questions and answers. It meticulously covers critical aspects of wound care,
including pressure ulcer staging (Braden Scale, NPUAP), wound assessment
(LEAD, ABI, TcPO2, SLP), various wound types (venous, neuropathic, arterial,
infectious, neoplastic), wound healing mechanisms (primary, secondary, tertiary
intention), and detailed wound management principles (TIME acronym,
debridement methods, dressings, infection control, pain management, nutritional
support). This guide is an invaluable resource for preparing for wound care
certification.
. What are 6 risk factor components of the Braden Scale for pressure
1
ulcer?sensory perception, moisture, mobility, activity,nutrition, and shear/friction
. What is the name of the organization that developed the pressure ulcer
2
staging?NPUAP (National Pressure Ulcer Advisory Panel)
. Pathological effect of excessive pressure on soft tissue can be attributed
3
by 3 factors? What are they?tissue tolerance, durationof pressure, and
intensity of pressure
. What are the extrinsic factors that impact pressure ulcers?increase in
4
moisture, friction, and shearing
, . How does friction play a role in shearing which eventually leads to
5
pressure ulcer?Friction alone causes only superficialabrasion, but with gravity
it plays a synergistic effect leading to shearing. When gravity pushes down on the
body and resistance (friction) between the patient and surface is exerted,
shearing occurs. Because skin does not freely move, primary effect of shearing
occurs at the deeper fascial level.
. What are the intrinsic factors of pressure ulcers?nutritional debilitation,
6
advanced age, low BP, stress, smoking, elevated body temperature
. Aging skin undergoes what elements affecting risk for pressure ulcer?
7
Dermoepidermal junction flattens, less nutrient exchange occurs, less resistance
to shearing, changes in sensory perception, loss of dermal thickness, increased
vascular fragility; ability of soft tissue to distribute mechanical load without
compromising blood flow is impaired.
. What does nonblanching erythema indicate in the skin related to PU?
8
When pressure is applied to the erythematic area skin becomes white
(blanched), but once relieved, erythema returns - indicating blood flow; however
in nonblanching erythema, skin does not blanche - indicating impaired blood flow
- suggesting tissue destruction.
. Why does sitting in a chair pose more of a risk in skin breakdown than
9
lying?Deep tissue injury or PU is likely to occursooner sitting down because
tissue offloading over bony prominences is higher.
0. Describe what you will see in deep tissue injury?Purple or maroon
1
localized area of discolored intact skin or blood filled blister; may be preceded by
painful, firm, mushy, or boggy; skin may be warmer to cooler in adjacent tissue.
In dark skin, thin blister or eschar over a dark wound bed may be seen.
1. Describe Stage I pressure ulcer?Intact skin withnonblanchable redness of
1
localized area. Will not see blanching in dark skin, but changes in skin tissue
consistency (firm vs boggy when palpated), sensation (pain), and warmer or
cooler temperature may differ from surrounding area.
2. Describe Stage II pressure ulcer?Partial-thicknesswound where epidermis
1
and tip of dermis is lost with red-pink wound bed without slough. May also
present as intact or open/ruptured serum -filled blister.
3. Describe Stage III pressure ulcer?Full-thicknesswound where both
1
epidermis and dermis is lost and subcutaneous tissue may be visible, but deeper
structures such as muscle, bone, and tendon are not exposed; slough may be
, resent but it doesn't obscure depth and tunneling and undermining may be
p
present.
4. Describe Stage IV pressure ulcer?Full-thickness wound with exposed
1
bone, tendon, and muscle; slough or eschar may be seen in some parts of the
wound bed. You will often see tunneling and undermining. Osteomyelitis may be
diagnosed at this stage, since bone is palpable.
5. Describe unstageable ulcers?Full-thickness wound where base of the
1
ulcer is covered by slough and/or eschar, obscuring depth.
6. When should eschars not be removed?When it'sstable with dry,
1
adherent, and intact without erythema on the heel; this serves as the body's
natural cover and should not be removed.
7. Therapeutic function of pressure distribution is accomplished by what 2
1
factors?Immersion and envelopment.
8. Define immersion?Depth of penetration or sinkinginto surface allowing
1
pressure to be spread out over surrounding area rather than directly over bony
prominence.
9. Define envelopment?Is the ability of supportsurface to conform to
1
irregularities without causing substantial increase in pressure.
0. What is bottoming out?This occurs when depthof penetration or sinking is
2
excessive, allowing increased pressure to concentrate over bony prominences.
1. What factors contribute to bottoming out?Weight,disproportion of weight
2
and size such as amputation, tendency to keep HOB >30 degrees, inappropriate
support surface settings.
2. When should you consider reactive support surface with features and
2
components such as low air loss, alternating pressure, viscous or air
fluids?For patients who cannot effectively positionoff their wound, have PUs in
multiple turning surfaces, or have PUs that fail to improve despite optimal
comprehensive management.
3. When should active support surface be considered?When effective
2
positioning is determined by an MD to be medically contraindicated.
4. What is the difference between an active and reactive support
2
surfaces?Active support surface is a powered mattressor overlay that changes
C
Certification Exam
hisWound Certification Exam Study Guideis a comprehensive featuring
T
197 questions and answers. It meticulously covers critical aspects of wound care,
including pressure ulcer staging (Braden Scale, NPUAP), wound assessment
(LEAD, ABI, TcPO2, SLP), various wound types (venous, neuropathic, arterial,
infectious, neoplastic), wound healing mechanisms (primary, secondary, tertiary
intention), and detailed wound management principles (TIME acronym,
debridement methods, dressings, infection control, pain management, nutritional
support). This guide is an invaluable resource for preparing for wound care
certification.
. What are 6 risk factor components of the Braden Scale for pressure
1
ulcer?sensory perception, moisture, mobility, activity,nutrition, and shear/friction
. What is the name of the organization that developed the pressure ulcer
2
staging?NPUAP (National Pressure Ulcer Advisory Panel)
. Pathological effect of excessive pressure on soft tissue can be attributed
3
by 3 factors? What are they?tissue tolerance, durationof pressure, and
intensity of pressure
. What are the extrinsic factors that impact pressure ulcers?increase in
4
moisture, friction, and shearing
, . How does friction play a role in shearing which eventually leads to
5
pressure ulcer?Friction alone causes only superficialabrasion, but with gravity
it plays a synergistic effect leading to shearing. When gravity pushes down on the
body and resistance (friction) between the patient and surface is exerted,
shearing occurs. Because skin does not freely move, primary effect of shearing
occurs at the deeper fascial level.
. What are the intrinsic factors of pressure ulcers?nutritional debilitation,
6
advanced age, low BP, stress, smoking, elevated body temperature
. Aging skin undergoes what elements affecting risk for pressure ulcer?
7
Dermoepidermal junction flattens, less nutrient exchange occurs, less resistance
to shearing, changes in sensory perception, loss of dermal thickness, increased
vascular fragility; ability of soft tissue to distribute mechanical load without
compromising blood flow is impaired.
. What does nonblanching erythema indicate in the skin related to PU?
8
When pressure is applied to the erythematic area skin becomes white
(blanched), but once relieved, erythema returns - indicating blood flow; however
in nonblanching erythema, skin does not blanche - indicating impaired blood flow
- suggesting tissue destruction.
. Why does sitting in a chair pose more of a risk in skin breakdown than
9
lying?Deep tissue injury or PU is likely to occursooner sitting down because
tissue offloading over bony prominences is higher.
0. Describe what you will see in deep tissue injury?Purple or maroon
1
localized area of discolored intact skin or blood filled blister; may be preceded by
painful, firm, mushy, or boggy; skin may be warmer to cooler in adjacent tissue.
In dark skin, thin blister or eschar over a dark wound bed may be seen.
1. Describe Stage I pressure ulcer?Intact skin withnonblanchable redness of
1
localized area. Will not see blanching in dark skin, but changes in skin tissue
consistency (firm vs boggy when palpated), sensation (pain), and warmer or
cooler temperature may differ from surrounding area.
2. Describe Stage II pressure ulcer?Partial-thicknesswound where epidermis
1
and tip of dermis is lost with red-pink wound bed without slough. May also
present as intact or open/ruptured serum -filled blister.
3. Describe Stage III pressure ulcer?Full-thicknesswound where both
1
epidermis and dermis is lost and subcutaneous tissue may be visible, but deeper
structures such as muscle, bone, and tendon are not exposed; slough may be
, resent but it doesn't obscure depth and tunneling and undermining may be
p
present.
4. Describe Stage IV pressure ulcer?Full-thickness wound with exposed
1
bone, tendon, and muscle; slough or eschar may be seen in some parts of the
wound bed. You will often see tunneling and undermining. Osteomyelitis may be
diagnosed at this stage, since bone is palpable.
5. Describe unstageable ulcers?Full-thickness wound where base of the
1
ulcer is covered by slough and/or eschar, obscuring depth.
6. When should eschars not be removed?When it'sstable with dry,
1
adherent, and intact without erythema on the heel; this serves as the body's
natural cover and should not be removed.
7. Therapeutic function of pressure distribution is accomplished by what 2
1
factors?Immersion and envelopment.
8. Define immersion?Depth of penetration or sinkinginto surface allowing
1
pressure to be spread out over surrounding area rather than directly over bony
prominence.
9. Define envelopment?Is the ability of supportsurface to conform to
1
irregularities without causing substantial increase in pressure.
0. What is bottoming out?This occurs when depthof penetration or sinking is
2
excessive, allowing increased pressure to concentrate over bony prominences.
1. What factors contribute to bottoming out?Weight,disproportion of weight
2
and size such as amputation, tendency to keep HOB >30 degrees, inappropriate
support surface settings.
2. When should you consider reactive support surface with features and
2
components such as low air loss, alternating pressure, viscous or air
fluids?For patients who cannot effectively positionoff their wound, have PUs in
multiple turning surfaces, or have PUs that fail to improve despite optimal
comprehensive management.
3. When should active support surface be considered?When effective
2
positioning is determined by an MD to be medically contraindicated.
4. What is the difference between an active and reactive support
2
surfaces?Active support surface is a powered mattressor overlay that changes
