Which of the following extends from a wound under normal issue and connects two structures,
such as the wound and an organ?
a Undermining
b fistula
c tunneling
d abscess - Answers fistula
A patient has a wound on the right hip with tunneling and fistulae. Which of the following is
MOST indicative of an abscess formation?
a Increased purulent discharge
b Increased wound pain
c Increased erythema and swelling at wound perimeter
d Erythematous, painful, swollen area 3 cm from wound perimeter - Answers d Erythematous,
painful, swollen area 3 cm from wound perimeter
Which of the following laboratory tests is the most effective to monitor acute changes in
nutritional status?
a Total protein
b Albumin
c Prealbumin
d Trasferrin - Answers c Prealbumin is used to monitor acute changes in nutritional status
because it has a half life of only 2-3 days.
On the eighth day of wound care, granulation tissue is evident about the wound perimeter, and
the wound is beginning to contract. The wound is in which of the following phases of healing?
a Proliferation
b Inflammation
c Hemostasis
d Maturation - Answers a Proliferation (days 5-20) is characterized by granulation tissue starting
to form at wound perimeter.
,Which of the following is the correct procedure for applying Eutectic Mixture of Local
Anesthetics (EMLA Cream) to a wound prior to a debridement?
a Apply a thin layer (1/8 inch thick) to the wound for 15 minutes, leaving the wound open
b Apply a thick layer (1/4 inch thick) to the wound, extending 1/2 inch past the wound onto
surrounding tissue, and cover with plastic wrap for 20-60 minutes.
c Apply a thick layer (1/4 inch thick) to the wound surface only and cover with plastic wrap for
15 minutes
d Apply a thin layer (1/8 inch thick) to the wound surface only and cover with a loose dry
dressing for 20-60 minutes - Answers b Apply a thick layer (1/4 inch thick) to the wound,
extending 1/2 inch past the wound onto surrounding tissue, and cover with plastic wrap for 20-
60 minutes.
When doing a routine dressing change for a healing decubitus ulcer on the right hip, which is the
most appropriate cleaning solution?
a Povidone-iodine solution
b Hydrogen peroxide
c Alcohol
d Normal Saline - Answers d Normal Saline
Which of the following wound irrigation devices will provide approximately 8 psi in irrigant
pressure to the wound surface?
a 35 ml syringe with 19 gauge Angiocath
b 250 ml squeeze bottle
c Bulb syringe
d 6 ml syringe with 19 gauge Angiocath - Answers a 35 ml syringe with 19 gauge Angiocath
Which of the following is the most important criterion when assessing a patient's level of wound
pain?
a Patient's behavior
b Type of wound
c Patient's report of pain
d Patient's facial expression - Answers c Patient's report of pain
,Which of the following is likely to have the MOST negative effect on wound healing for a 65 yo
woman?
a Hypoalbuminemia
b BMI of 20.2
c BMI of 28
d Vegan diet - Answers a Hypoalbuminemia (this is an indication of protein malnutrition and
may cause delayed wound healing
Which of the following is the most definitive method for obtaining a wound specimen for culture
and sensitivities?
a Tissue biopsy
b Sterile swab of wound
c Needle biopsy
d Sterile swab of discharge - Answers a Tissue biopsy
A patient with an infected abdominal wound is taking a number of drugs. Which of the following
is most likely to impair healing?
a Phenytoin
b Corticosteroid
c Prostaglandin
d Estrogen - Answers b Corticosteroid may impair wound healing by interfering with vascular
proliferation and epithelialization.
A burn extending through the dermis with obvious blistering would be classified as
a First degree
b Second degree
c Third degree
d Full thickness - Answers b Second degree
Which of the following results from smoking cigarettes?
a Vasodilation
, b Vasoconstriction
c Increased oxygen transport
d Increased oxygen tension - Answers b Vasoconstriction
When calculating the ankle-brachial index (ABI), if the ankle systolic pressure is 90 and the
brachial systolic pressure is 120, what is the ABI?
a 1.33
b 13.3
c 7.5
d 0.75 - Answers d 0.75 (the ankle pressure is divided by the brachial pressure)
Using transcutaneous oxygen pressure measurement (TCPO2), which of the following values
indicates that oxygenation is adequate for healing?
a 18 mmHg
b 20 mmHg
c 30 mmHg
d 42 mmHg - Answers d 42 mmHg ( A value of > 40 mmHg is adequate for healing)
The method of closure that involves leaving the wound open and allowing it to close naturally
through granulation and epithelialization is healing by
a Primary or first intention
b Secondary or second intention
c Tertiary or third intention
d Quaternary prevention - Answers b Secondary or second intention
A patient's laboratory results show a serum sodium of 155 mEq/L and a serum osmolality of
300 mOsm/kg. The most likely cause is
a Infection
b Overhydration
c Dehydration
d Malnutrition - Answers c Dehydration (Normal values 135-150mEq/L, Dehydration > 150mEq/L)