CFCN Certification Exam Prep 2026 Updated
Practice Questions Comprehensive Foot Care Nursing
Review Detailed Explanations, Verified Answers,
Complete Success Workbook
Exam Blueprint Reference: The Certified Foot Care Nurse (CFCN®)
examination, administered by the Wound, Ostomy and Continence Nursing
Certification Board (WOCNCB), consists of approximately 120–150 multiple-
choice questions across three domains: Assessment and Care Planning (32.5%),
Prevention, Intervention, and Treatment (41.7%), and Education, Professional
Practice, and Referral (25.8%).
DOMAIN 1: ASSESSMENT AND CARE PLANNING — 32.5%
Questions 1–32
Question 1
A 65-year-old patient with diabetes presents for a comprehensive foot assessment.
Which artery is the primary blood supply to the dorsum of the foot?
A. Posterior tibial artery
B. Dorsalis pedis artery
C. Peroneal artery
D. Popliteal artery
Answer: B. Dorsalis pedis artery
Rationale: The dorsalis pedis artery is the continuation of the anterior tibial artery
and serves as the primary blood supply to the dorsum (top) of the foot. It is
palpated between the first and second metatarsal bones. The posterior tibial artery
supplies the plantar aspect of the foot, the peroneal artery supplies the lateral lower
leg, and the popliteal artery is located behind the knee.
,Question 2
A patient with diabetes is being evaluated for peripheral neuropathy. The nurse
performs a Semmes-Weinstein monofilament test using a 10-gram filament. At
how many sites should the monofilament be applied on each foot?
A. 5 sites
B. 8 sites
C. 10 sites
D. 15 sites
Answer: C. 10 sites
Rationale: The 10-gram Semmes-Weinstein monofilament test should be applied
at 10 sites on each foot to assess protective sensation. Sites include the plantar
aspects of the first, third, and fifth toes; the first, third, and fifth metatarsal heads;
the medial and lateral midfoot; the heel; and the dorsum between the first and
second toes. Inability to detect the monofilament at any site indicates loss of
protective sensation and increased ulcer risk.
Question 3
A nurse is performing a focused lower extremity assessment. Which of the
following is a key indicator of adequate arterial perfusion?
A. Capillary refill time greater than 3 seconds
B. Hair loss on the toes
C. Bounding dorsalis pedis pulses
D. Cool, pale skin
Answer: C. Bounding dorsalis pedis pulses
Rationale: Palpable, strong pulses (dorsalis pedis and posterior tibial) are key
indicators of adequate arterial perfusion. Abnormal findings indicating poor
perfusion include capillary refill time > 3 seconds, hair loss, cool skin temperature,
pallor, and dependent rubor.
Question 4
A patient with a history of peripheral artery disease (PAD) presents with foot pain
,that worsens with elevation and improves with dependency. This pattern is
characteristic of:
A. Neuropathic pain
B. Claudication
C. Rest pain
D. Venous insufficiency
Answer: C. Rest pain
Rationale: Rest pain in PAD is often described as a burning or aching pain in the
foot that worsens with elevation (when gravity reduces blood flow) and improves
when the foot is dependent (hanging down, which increases perfusion).
Claudication is muscle pain with activity. Neuropathic pain is typically burning or
shooting. Venous insufficiency causes aching and heaviness that improves with
elevation.
Question 5
When assessing a patient for peripheral neuropathy, which test evaluates vibration
sensation?
A. Semmes-Weinstein monofilament
B. 128-Hz tuning fork
C. Pinprick test
D. Ankle-brachial index (ABI)
Answer: B. 128-Hz tuning fork
Rationale: A 128-Hz tuning fork is used to assess vibration sensation, typically
applied to the bony prominence of the great toe or medial malleolus. The Semmes-
Weinstein monofilament tests light touch/pressure sensation. Pinprick tests pain
sensation. ABI assesses vascular status.
Question 6
A patient with diabetes presents with a warm, erythematous, edematous foot
without an open wound. The foot has bounding pulses and the patient denies
trauma. Which condition should the nurse suspect FIRST?
, A. Deep vein thrombosis
B. Cellulitis
C. Acute Charcot neuroarthropathy
D. Gout flare
Answer: C. Acute Charcot neuroarthropathy
Rationale: Acute Charcot neuroarthropathy (Charcot foot) should be the primary
suspicion in a diabetic patient with a warm, swollen, erythematous foot with intact
pulses and no wound or trauma history. This inflammatory condition involves
progressive bone and joint destruction in patients with peripheral neuropathy. Early
recognition is critical to prevent permanent deformity. A skin temperature
difference of > 2°C compared to the contralateral foot supports the diagnosis.
Question 7
The nurse is assessing a patient's lower extremities for venous insufficiency.
Which finding is most consistent with chronic venous disease?
A. Hair loss on the toes
B. Thickened, hyperpigmented skin with edema
C. Pallor with elevation
D. Decreased dorsalis pedis pulse
Answer: B. Thickened, hyperpigmented skin with edema
Rationale: Chronic venous insufficiency typically presents with edema,
hyperpigmentation (brownish discoloration from hemosiderin deposition), stasis
dermatitis, and thickened, fibrotic skin (lipodermatosclerosis). Hair loss, pallor
with elevation, and decreased pulses are more consistent with arterial
insufficiency.
Question 8
Which of the following medications is MOST likely to increase the risk of
peripheral neuropathy affecting the feet?
A. Metformin
B. Lisinopril
Practice Questions Comprehensive Foot Care Nursing
Review Detailed Explanations, Verified Answers,
Complete Success Workbook
Exam Blueprint Reference: The Certified Foot Care Nurse (CFCN®)
examination, administered by the Wound, Ostomy and Continence Nursing
Certification Board (WOCNCB), consists of approximately 120–150 multiple-
choice questions across three domains: Assessment and Care Planning (32.5%),
Prevention, Intervention, and Treatment (41.7%), and Education, Professional
Practice, and Referral (25.8%).
DOMAIN 1: ASSESSMENT AND CARE PLANNING — 32.5%
Questions 1–32
Question 1
A 65-year-old patient with diabetes presents for a comprehensive foot assessment.
Which artery is the primary blood supply to the dorsum of the foot?
A. Posterior tibial artery
B. Dorsalis pedis artery
C. Peroneal artery
D. Popliteal artery
Answer: B. Dorsalis pedis artery
Rationale: The dorsalis pedis artery is the continuation of the anterior tibial artery
and serves as the primary blood supply to the dorsum (top) of the foot. It is
palpated between the first and second metatarsal bones. The posterior tibial artery
supplies the plantar aspect of the foot, the peroneal artery supplies the lateral lower
leg, and the popliteal artery is located behind the knee.
,Question 2
A patient with diabetes is being evaluated for peripheral neuropathy. The nurse
performs a Semmes-Weinstein monofilament test using a 10-gram filament. At
how many sites should the monofilament be applied on each foot?
A. 5 sites
B. 8 sites
C. 10 sites
D. 15 sites
Answer: C. 10 sites
Rationale: The 10-gram Semmes-Weinstein monofilament test should be applied
at 10 sites on each foot to assess protective sensation. Sites include the plantar
aspects of the first, third, and fifth toes; the first, third, and fifth metatarsal heads;
the medial and lateral midfoot; the heel; and the dorsum between the first and
second toes. Inability to detect the monofilament at any site indicates loss of
protective sensation and increased ulcer risk.
Question 3
A nurse is performing a focused lower extremity assessment. Which of the
following is a key indicator of adequate arterial perfusion?
A. Capillary refill time greater than 3 seconds
B. Hair loss on the toes
C. Bounding dorsalis pedis pulses
D. Cool, pale skin
Answer: C. Bounding dorsalis pedis pulses
Rationale: Palpable, strong pulses (dorsalis pedis and posterior tibial) are key
indicators of adequate arterial perfusion. Abnormal findings indicating poor
perfusion include capillary refill time > 3 seconds, hair loss, cool skin temperature,
pallor, and dependent rubor.
Question 4
A patient with a history of peripheral artery disease (PAD) presents with foot pain
,that worsens with elevation and improves with dependency. This pattern is
characteristic of:
A. Neuropathic pain
B. Claudication
C. Rest pain
D. Venous insufficiency
Answer: C. Rest pain
Rationale: Rest pain in PAD is often described as a burning or aching pain in the
foot that worsens with elevation (when gravity reduces blood flow) and improves
when the foot is dependent (hanging down, which increases perfusion).
Claudication is muscle pain with activity. Neuropathic pain is typically burning or
shooting. Venous insufficiency causes aching and heaviness that improves with
elevation.
Question 5
When assessing a patient for peripheral neuropathy, which test evaluates vibration
sensation?
A. Semmes-Weinstein monofilament
B. 128-Hz tuning fork
C. Pinprick test
D. Ankle-brachial index (ABI)
Answer: B. 128-Hz tuning fork
Rationale: A 128-Hz tuning fork is used to assess vibration sensation, typically
applied to the bony prominence of the great toe or medial malleolus. The Semmes-
Weinstein monofilament tests light touch/pressure sensation. Pinprick tests pain
sensation. ABI assesses vascular status.
Question 6
A patient with diabetes presents with a warm, erythematous, edematous foot
without an open wound. The foot has bounding pulses and the patient denies
trauma. Which condition should the nurse suspect FIRST?
, A. Deep vein thrombosis
B. Cellulitis
C. Acute Charcot neuroarthropathy
D. Gout flare
Answer: C. Acute Charcot neuroarthropathy
Rationale: Acute Charcot neuroarthropathy (Charcot foot) should be the primary
suspicion in a diabetic patient with a warm, swollen, erythematous foot with intact
pulses and no wound or trauma history. This inflammatory condition involves
progressive bone and joint destruction in patients with peripheral neuropathy. Early
recognition is critical to prevent permanent deformity. A skin temperature
difference of > 2°C compared to the contralateral foot supports the diagnosis.
Question 7
The nurse is assessing a patient's lower extremities for venous insufficiency.
Which finding is most consistent with chronic venous disease?
A. Hair loss on the toes
B. Thickened, hyperpigmented skin with edema
C. Pallor with elevation
D. Decreased dorsalis pedis pulse
Answer: B. Thickened, hyperpigmented skin with edema
Rationale: Chronic venous insufficiency typically presents with edema,
hyperpigmentation (brownish discoloration from hemosiderin deposition), stasis
dermatitis, and thickened, fibrotic skin (lipodermatosclerosis). Hair loss, pallor
with elevation, and decreased pulses are more consistent with arterial
insufficiency.
Question 8
Which of the following medications is MOST likely to increase the risk of
peripheral neuropathy affecting the feet?
A. Metformin
B. Lisinopril
