Page 1 of 36
wound certification exam COMPLETE NEWEST
QUESTIONS AND VERIFIED SOLUTIONS LATEST
UPDATE THIS YEAR
QUESTION: what are the extrinsic factors that impact pressure ulcers? - ANSWER-increase in
moisture, friction and shearing
QUESTION: how does friction play a role in shearing which eventually leads to pressure ulcer? -
ANSWER-friction alone causes only superfical abrasion, 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.
QUESTION: what are the intrisinc factors of pressur ulcers? - ANSWER-nutritional debilitation,
advanced age, low BP, stress, smoking, elevated body temperature
QUESTION: Aging skin undergoes what elements affecting risk for pressure ulcer? - ANSWER-
dermoepidermal junction flattens, less nutrient exchange occurs, less resistance to shearing,
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changes in sensory perception, loss of dermal thickness, increased vascular fragility; ability of
soft tisuse to distribute mechanical load w/out comprosing blood flow is impaired
QUESTION: What does nonblanching erythema indicate in the skin r/t PU? - ANSWER-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 destructon
QUESTION: why does sitting in a chair pose more of a risk in skin break down than lying? -
ANSWER-deep tissue injury or PU is likely to occur sooner sitting down because tissue
offloading over boney prominences is higher
what are 6 risk factor components of Braden Scale for pressure ulcer? - ANSWER-sensory
perception, moisture, mobility, activity, nutrition, and shear/friction
QUESTION: What is the name of the organization that developed the pressure ulcer staging? -
ANSWER-NPUAP (national pressure ulcer advisory panel)
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QUESTION: pathological effect of excessive pressure on soft tissue can be attributed by 3
factors? what are they? - ANSWER-tissue tolerance, duration of pressure, and intensity of
pressure
QUESTION: Describe what you will see in deep tissue injury? - ANSWER-purple or maroon
localized area of discolored intact skin skinor 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 bee seen
QUESTION: Describe stage I pressure ulcer? - ANSWER-Intact skin with nonblanchable redness
of 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
QUESTION: Describe stage II pressure ulcer? - ANSWER-partial-thickness wound where
epidermis and tip of dermis is lost with red-pink wound bed w/out slough. may also present as
intact or open/ruptured serum -filled blister
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QUESTION: Describe stage III pressure ulcer? - ANSWER-full-thickness wound where both
epidermis and dermis is lost and subcutaneous tissue may be visible, but deeper structures
such as muscle, bone, and tendon are not exposed; slough my be present but it doesn't obscure
depth and tunneling and undermining may be present
QUESTION: Describe stage IV pressure ulcer? - ANSWER-full-thickness wound with exposed
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 dxed at this stage, since bone
is palpable
QUESTION: Describe unstageble ulcers? - ANSWER-full-thickness wound where base of the
ulcer is covered by slough and/or eschar, obscuring depth
QUESTION: When should eschars not be removed? - ANSWER-when it's stable with dry,
adherent, and intact w/out erythema on the heel; this serves as the body's natural cover and
should not be removed.
QUESTION: Therapeutic function of pressure distribution is accomplised by what 2 factors? -
ANSWER-immersion and envelopement
4
wound certification exam COMPLETE NEWEST
QUESTIONS AND VERIFIED SOLUTIONS LATEST
UPDATE THIS YEAR
QUESTION: what are the extrinsic factors that impact pressure ulcers? - ANSWER-increase in
moisture, friction and shearing
QUESTION: how does friction play a role in shearing which eventually leads to pressure ulcer? -
ANSWER-friction alone causes only superfical abrasion, 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.
QUESTION: what are the intrisinc factors of pressur ulcers? - ANSWER-nutritional debilitation,
advanced age, low BP, stress, smoking, elevated body temperature
QUESTION: Aging skin undergoes what elements affecting risk for pressure ulcer? - ANSWER-
dermoepidermal junction flattens, less nutrient exchange occurs, less resistance to shearing,
1
, Page 2 of 36
changes in sensory perception, loss of dermal thickness, increased vascular fragility; ability of
soft tisuse to distribute mechanical load w/out comprosing blood flow is impaired
QUESTION: What does nonblanching erythema indicate in the skin r/t PU? - ANSWER-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 destructon
QUESTION: why does sitting in a chair pose more of a risk in skin break down than lying? -
ANSWER-deep tissue injury or PU is likely to occur sooner sitting down because tissue
offloading over boney prominences is higher
what are 6 risk factor components of Braden Scale for pressure ulcer? - ANSWER-sensory
perception, moisture, mobility, activity, nutrition, and shear/friction
QUESTION: What is the name of the organization that developed the pressure ulcer staging? -
ANSWER-NPUAP (national pressure ulcer advisory panel)
2
, Page 3 of 36
QUESTION: pathological effect of excessive pressure on soft tissue can be attributed by 3
factors? what are they? - ANSWER-tissue tolerance, duration of pressure, and intensity of
pressure
QUESTION: Describe what you will see in deep tissue injury? - ANSWER-purple or maroon
localized area of discolored intact skin skinor 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 bee seen
QUESTION: Describe stage I pressure ulcer? - ANSWER-Intact skin with nonblanchable redness
of 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
QUESTION: Describe stage II pressure ulcer? - ANSWER-partial-thickness wound where
epidermis and tip of dermis is lost with red-pink wound bed w/out slough. may also present as
intact or open/ruptured serum -filled blister
3
, Page 4 of 36
QUESTION: Describe stage III pressure ulcer? - ANSWER-full-thickness wound where both
epidermis and dermis is lost and subcutaneous tissue may be visible, but deeper structures
such as muscle, bone, and tendon are not exposed; slough my be present but it doesn't obscure
depth and tunneling and undermining may be present
QUESTION: Describe stage IV pressure ulcer? - ANSWER-full-thickness wound with exposed
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 dxed at this stage, since bone
is palpable
QUESTION: Describe unstageble ulcers? - ANSWER-full-thickness wound where base of the
ulcer is covered by slough and/or eschar, obscuring depth
QUESTION: When should eschars not be removed? - ANSWER-when it's stable with dry,
adherent, and intact w/out erythema on the heel; this serves as the body's natural cover and
should not be removed.
QUESTION: Therapeutic function of pressure distribution is accomplised by what 2 factors? -
ANSWER-immersion and envelopement
4
