WTA PRATICE QUESTIONS WITH
COMPLETE SOLUTIONS
TRUE OR FALSE
___ Normal pH of skin is alkaline. - correct answer ✔✔ F
The pH of normal, healthy skin is slightly acid, not alkaline.
TRUE OR FALSE
___ Dermis is normally acid and dry - correct answer ✔✔ F
Dermis is the inner most layer of skin that is naturally moist and slightly acid.
TRUE OR FALSE
___ Epidermis can regenerate - correct answer ✔✔ T
Epidermis is the outer layer of skin, composed of stratified squamous epithelial cells, which can
reproduce/regenerate to replace lost cells.
TRUE OR FALSE
___ Subcutaneous tissue is the 3rd layer of the skin. - correct answer ✔✔ F
Subcutaneous tissue is not a layer of skin. Only the epidermis and dermis comprise the skin.
Subcutaneous tissue is fatty tissue/adipose tissue underneath the skin that provides padding
and protection.
Muscle tissue is more susceptible to pressure injury than skin. - correct answer ✔✔ T
Muscle tissue is highly vascular with a higher metabolic rate and therefore is more susceptible
than skin to effects of prolonged pressure. Muscle is also not capable of
reproduction/regeneration.
,Identify anatomical differences that increase the risk of skin tears among newborns and the
elderly. __________ - correct answer ✔✔ Rete pegs and rete ridges are epidermal protrusions
that project down into the dermis to interlock with the dermal papillae to provide strength and
stability of the skin layers and prevent skin tears. Without the interlocking of the epidermis to
the dermis, or if there is flattening of this junction, the epidermis can easily be torn away from
the dermis. This interlocking feature has not yet formed in the newborn, and is lost in the
elderly; this results in reduced cohesion between the epidermis and dermis, and increased risk
for skin tears. There is decreased cohesion between the epidermis and dermis in the very young
and in the elderly.
TRUE OR FALSE
___ Pressure applied to the skin causes the greatest amount of pressure at the epidermis. -
correct answer ✔✔ F
Pressure extends from the surface in a pressure gradient with the highest pressure at the
bone/tissue interface rather than at the skin surface. Pressure usually results in full thickness
damage.
TRUE OR FALSE
___ Partial thickness (superficial) breakdown can be caused by friction or maceration - correct
answer ✔✔ T
Superficial partial thickness skin ulcers are loss of epidermis and possible partial loss of the
dermis. The damage occurs from top down in superficial injuries. Overhydrated skin is more
susceptible to injury and friction where the top layers of skin can be damaged or abraded from
excess rubbing of skin (such as elbows/heels) on /or against external surfaces.
TRUE OR FALSE
___ Pressure ulcers/injuries are caused by ischemia. - correct answer ✔✔ T
Tissues need intermittent blood flow. Compression of tissue between a bone and external
surface/cast/splint or device, compresses blood vessels and can cut off the blood flow to tissue
resulting in ischemia that causes tissue damage and, if prolonged, ulceration
, TRUE OR FALSE
___ Maceration toughens the skin. - correct answer ✔✔ F
Maceration causes cellular edema, which makes the cell more vulnerable to breakdown.
Healthy skin is "cool and dry"; macerated skin is "at risk".
Name 2 preventive interventions for skin tears: - correct answer ✔✔ For patients with/ or at risk
for skin tears, caution should be used with their skin at all times to avoid injury and damage.
Aggressive, adhesive products/tapes/dressings should be avoided when at all possible.
Dressings can be secured with roller gauze or wraps instead of tapes. If taping cannot be
avoided, skin sealants or protective dressings can be placed on the skin prior to application of
the tape to prevent stripping of the skin on removal. Patients' skin should be treated/handled
gently at all times to prevent injury. Emollients should be routinely applied to help keep skin
supple to resist injury. Protective sleeves, garments or clothes can provide a protective layer
over the skin to prevent injury. Staff should use lift sheets or lift products for transfers and avoid
grasping patients by their limbs.
Which of the following represents appropriate goals for topical management of a skin tear with
total flap loss?
A. Debridement necrotic tissue; treatment infection; management exudate
B. Establishment open wound edges; maintenance moist wound surface; prevention infection
C. Avoidance further trauma; absorption exudate; maintenance moist wound surface
D. Wicking of tunnels; prevention infection; creation dry wound surface - correct answer ✔✔ C
Goals are to prevent additional damage - thus dressings with aggressive adhesives must be
avoided. In addition, it is important to absorb any exudate since chronic wound fluid impairs the
repair process, and to maintain a moist wound surface, in order to maintain cell viability and
promote cell migration. There are a number of dressing protocols that can be used to
implement these key principles.
List at least two dressings that could be used appropriately for skin tear management. - correct
answer ✔✔ Appropriate dressings for skin tears with partial or total flap loss would include:
--Gentle adhesive foam dressings: these dressings provide exudate control, a moist wound
surface, and atraumatic removal.
COMPLETE SOLUTIONS
TRUE OR FALSE
___ Normal pH of skin is alkaline. - correct answer ✔✔ F
The pH of normal, healthy skin is slightly acid, not alkaline.
TRUE OR FALSE
___ Dermis is normally acid and dry - correct answer ✔✔ F
Dermis is the inner most layer of skin that is naturally moist and slightly acid.
TRUE OR FALSE
___ Epidermis can regenerate - correct answer ✔✔ T
Epidermis is the outer layer of skin, composed of stratified squamous epithelial cells, which can
reproduce/regenerate to replace lost cells.
TRUE OR FALSE
___ Subcutaneous tissue is the 3rd layer of the skin. - correct answer ✔✔ F
Subcutaneous tissue is not a layer of skin. Only the epidermis and dermis comprise the skin.
Subcutaneous tissue is fatty tissue/adipose tissue underneath the skin that provides padding
and protection.
Muscle tissue is more susceptible to pressure injury than skin. - correct answer ✔✔ T
Muscle tissue is highly vascular with a higher metabolic rate and therefore is more susceptible
than skin to effects of prolonged pressure. Muscle is also not capable of
reproduction/regeneration.
,Identify anatomical differences that increase the risk of skin tears among newborns and the
elderly. __________ - correct answer ✔✔ Rete pegs and rete ridges are epidermal protrusions
that project down into the dermis to interlock with the dermal papillae to provide strength and
stability of the skin layers and prevent skin tears. Without the interlocking of the epidermis to
the dermis, or if there is flattening of this junction, the epidermis can easily be torn away from
the dermis. This interlocking feature has not yet formed in the newborn, and is lost in the
elderly; this results in reduced cohesion between the epidermis and dermis, and increased risk
for skin tears. There is decreased cohesion between the epidermis and dermis in the very young
and in the elderly.
TRUE OR FALSE
___ Pressure applied to the skin causes the greatest amount of pressure at the epidermis. -
correct answer ✔✔ F
Pressure extends from the surface in a pressure gradient with the highest pressure at the
bone/tissue interface rather than at the skin surface. Pressure usually results in full thickness
damage.
TRUE OR FALSE
___ Partial thickness (superficial) breakdown can be caused by friction or maceration - correct
answer ✔✔ T
Superficial partial thickness skin ulcers are loss of epidermis and possible partial loss of the
dermis. The damage occurs from top down in superficial injuries. Overhydrated skin is more
susceptible to injury and friction where the top layers of skin can be damaged or abraded from
excess rubbing of skin (such as elbows/heels) on /or against external surfaces.
TRUE OR FALSE
___ Pressure ulcers/injuries are caused by ischemia. - correct answer ✔✔ T
Tissues need intermittent blood flow. Compression of tissue between a bone and external
surface/cast/splint or device, compresses blood vessels and can cut off the blood flow to tissue
resulting in ischemia that causes tissue damage and, if prolonged, ulceration
, TRUE OR FALSE
___ Maceration toughens the skin. - correct answer ✔✔ F
Maceration causes cellular edema, which makes the cell more vulnerable to breakdown.
Healthy skin is "cool and dry"; macerated skin is "at risk".
Name 2 preventive interventions for skin tears: - correct answer ✔✔ For patients with/ or at risk
for skin tears, caution should be used with their skin at all times to avoid injury and damage.
Aggressive, adhesive products/tapes/dressings should be avoided when at all possible.
Dressings can be secured with roller gauze or wraps instead of tapes. If taping cannot be
avoided, skin sealants or protective dressings can be placed on the skin prior to application of
the tape to prevent stripping of the skin on removal. Patients' skin should be treated/handled
gently at all times to prevent injury. Emollients should be routinely applied to help keep skin
supple to resist injury. Protective sleeves, garments or clothes can provide a protective layer
over the skin to prevent injury. Staff should use lift sheets or lift products for transfers and avoid
grasping patients by their limbs.
Which of the following represents appropriate goals for topical management of a skin tear with
total flap loss?
A. Debridement necrotic tissue; treatment infection; management exudate
B. Establishment open wound edges; maintenance moist wound surface; prevention infection
C. Avoidance further trauma; absorption exudate; maintenance moist wound surface
D. Wicking of tunnels; prevention infection; creation dry wound surface - correct answer ✔✔ C
Goals are to prevent additional damage - thus dressings with aggressive adhesives must be
avoided. In addition, it is important to absorb any exudate since chronic wound fluid impairs the
repair process, and to maintain a moist wound surface, in order to maintain cell viability and
promote cell migration. There are a number of dressing protocols that can be used to
implement these key principles.
List at least two dressings that could be used appropriately for skin tear management. - correct
answer ✔✔ Appropriate dressings for skin tears with partial or total flap loss would include:
--Gentle adhesive foam dressings: these dressings provide exudate control, a moist wound
surface, and atraumatic removal.
