Wound Care Exam-50 Questions And Verified
Answers 2026/2027 – NP/RN Exam
Overview:
This 50-question set expands to specialty areas: ostomy and peristomal skin,
enterocutaneous fistula, malignant/fungating wounds, lymphedema, plus NPWT,
infection, biofilm, burns, and NPUAP staging. Designed for WOCN, CWS, CWCN, and
NR 601 NP students. Focus on evidence-based management per WOCN, NPIAP, and
ACS guidelines. Answers are in bold Green.
Q1
A patient with an ileostomy reports skin breakdown around the stoma. The most likely
cause is:
A. Allergic reaction to adhesive
B. Effluent leakage due to poor appliance fit
C. Fungal infection
D. Pressure injury
Rationale: Ileostomy output is high volume, liquid, and enzyme-rich. Leakage is #1
cause of peristomal moisture-associated skin damage. Fit and barrier needed.
Q2
Which statement about enterocutaneous fistula management is true?
A. Always pack the tract tightly
B. Control output, protect skin, optimize nutrition
C. Apply compression
D. Use dry gauze only
Rationale: Fistula care = contain output with pouching, protect skin, NPO/TPN vs oral,
somatostatin analogs. Packing can increase output.
Q3
A malignant fungating breast wound has foul odor and light bleeding. Best topical
approach:
A. Hydrogen peroxide irrigation
B. Metronidazole gel or crushed tabs for odor, non-adherent dressing for bleeding
C. Wet-to-dry debridement
D. Betadine paint
Rationale: Metronidazole controls anaerobic odor. Non-adherent dressings prevent
trauma/bleeding. No debridement on malignant wounds.
Q4
Stage 3 lymphedema is characterized by:
A. Pitting edema that resolves overnight
B. Soft swelling only
C. Elephantiasis with skin changes, fibrosis, no pitting
D. Normal limb size
Rationale: ISL staging: Stage 0 latent, 1 pitting/reversible, 2 non-pitting/fibrosis, 3
elephantiasis with skin changes.
, Q5
A colostomy stoma should appear:
A. Pale and dry
B. Beefy red, moist, and protrude 1-3 cm
C. Purple and cold
D. Flush with skin
Rationale: Healthy stoma = red, moist, 1-3 cm. Pale = ischemia. Purple = necrosis.
Flush = risk for leakage.
Q6
Best barrier to protect peristomal skin from liquid stool:
A. Gauze
B. Alcohol-free skin barrier film + ostomy barrier ring
C. Silver cream
D. Petroleum jelly
Rationale: Barrier film + moldable ring prevents enzyme damage. Alcohol stings.
Gauze absorbs but no protection.
Q7
A high-output fistula is defined as drainage >
A. 100 mL/day
B. 200 mL/day
C. 500 mL/day
D. 1000 mL/day
Rationale: High output >500 mL/24h = fluid/electrolyte risk, poor spontaneous closure.
Q8
For a malignant wound with friable tissue, avoid:
A. Non-adherent dressings
B. Adhesive dressings and aggressive cleansing
C. Foam dressing
D. Calcium alginate
Rationale: Malignant wounds bleed easily. No adhesives, no scrubbing. Use non-
adherent, gentle irrigation.
Q9
Manual lymphatic drainage (MLD) is contraindicated in:
A. Primary lymphedema
B. Post-mastectomy lymphedema
C. Active cellulitis or DVT
D. Venous insufficiency
Rationale: MLD contraindicated in acute infection, DVT, CHF, active cancer. Used for
stable lymphedema.
Q10
A peristomal hernia is best managed by:
A. Tight binder 24/7
B. Support belt, avoid heavy lifting, refer to surgeon if symptomatic
C. Frequent appliance changes
D. Irrigation
Answers 2026/2027 – NP/RN Exam
Overview:
This 50-question set expands to specialty areas: ostomy and peristomal skin,
enterocutaneous fistula, malignant/fungating wounds, lymphedema, plus NPWT,
infection, biofilm, burns, and NPUAP staging. Designed for WOCN, CWS, CWCN, and
NR 601 NP students. Focus on evidence-based management per WOCN, NPIAP, and
ACS guidelines. Answers are in bold Green.
Q1
A patient with an ileostomy reports skin breakdown around the stoma. The most likely
cause is:
A. Allergic reaction to adhesive
B. Effluent leakage due to poor appliance fit
C. Fungal infection
D. Pressure injury
Rationale: Ileostomy output is high volume, liquid, and enzyme-rich. Leakage is #1
cause of peristomal moisture-associated skin damage. Fit and barrier needed.
Q2
Which statement about enterocutaneous fistula management is true?
A. Always pack the tract tightly
B. Control output, protect skin, optimize nutrition
C. Apply compression
D. Use dry gauze only
Rationale: Fistula care = contain output with pouching, protect skin, NPO/TPN vs oral,
somatostatin analogs. Packing can increase output.
Q3
A malignant fungating breast wound has foul odor and light bleeding. Best topical
approach:
A. Hydrogen peroxide irrigation
B. Metronidazole gel or crushed tabs for odor, non-adherent dressing for bleeding
C. Wet-to-dry debridement
D. Betadine paint
Rationale: Metronidazole controls anaerobic odor. Non-adherent dressings prevent
trauma/bleeding. No debridement on malignant wounds.
Q4
Stage 3 lymphedema is characterized by:
A. Pitting edema that resolves overnight
B. Soft swelling only
C. Elephantiasis with skin changes, fibrosis, no pitting
D. Normal limb size
Rationale: ISL staging: Stage 0 latent, 1 pitting/reversible, 2 non-pitting/fibrosis, 3
elephantiasis with skin changes.
, Q5
A colostomy stoma should appear:
A. Pale and dry
B. Beefy red, moist, and protrude 1-3 cm
C. Purple and cold
D. Flush with skin
Rationale: Healthy stoma = red, moist, 1-3 cm. Pale = ischemia. Purple = necrosis.
Flush = risk for leakage.
Q6
Best barrier to protect peristomal skin from liquid stool:
A. Gauze
B. Alcohol-free skin barrier film + ostomy barrier ring
C. Silver cream
D. Petroleum jelly
Rationale: Barrier film + moldable ring prevents enzyme damage. Alcohol stings.
Gauze absorbs but no protection.
Q7
A high-output fistula is defined as drainage >
A. 100 mL/day
B. 200 mL/day
C. 500 mL/day
D. 1000 mL/day
Rationale: High output >500 mL/24h = fluid/electrolyte risk, poor spontaneous closure.
Q8
For a malignant wound with friable tissue, avoid:
A. Non-adherent dressings
B. Adhesive dressings and aggressive cleansing
C. Foam dressing
D. Calcium alginate
Rationale: Malignant wounds bleed easily. No adhesives, no scrubbing. Use non-
adherent, gentle irrigation.
Q9
Manual lymphatic drainage (MLD) is contraindicated in:
A. Primary lymphedema
B. Post-mastectomy lymphedema
C. Active cellulitis or DVT
D. Venous insufficiency
Rationale: MLD contraindicated in acute infection, DVT, CHF, active cancer. Used for
stable lymphedema.
Q10
A peristomal hernia is best managed by:
A. Tight binder 24/7
B. Support belt, avoid heavy lifting, refer to surgeon if symptomatic
C. Frequent appliance changes
D. Irrigation
