CWCA NEWEST 2026/2027 EXAM WITH QUESTIONS AND CORRECT
ANSWERS ALREADY GRADED A+ AND 100% GUARANTEE PASS
what are 6 risk factor components of Braden Scale for pressure ulcer? - ANSWER sensory perception,
moisture, mobility, activity, nutrition, and shear/friction
What is the name of the organization that developed the pressure ulcer staging? - ANSWER NPUAP
(national pressure ulcer advisory panel)
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
what are the extrinsic factors that impact pressure ulcers? - ANSWER increase in moisture, friction
and shearing
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.
what are the intrisinc factors of pressur ulcers? - ANSWER nutritional debilitation, advanced age, low
BP, stress, smoking, elevated body temperature
Aging skin undergoes what elements affecting risk for pressure ulcer? - ANSWER dermoepidermal
junction flattens, less nutrient exchange occurs, less resistance to shearing, 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
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
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
,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
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
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
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
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
Describe unstageble ulcers? - ANSWER full-thickness wound where base of the ulcer is covered by
slough and/or eschar, obscuring depth
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.
Therapeutic function of pressure distribution is accomplised by what 2 factors? - ANSWER immersion
and envelopement
Define immersion? - ANSWER depth of penetration or skining into surgace allowing pressure to be
spread out over surrounding area rather than directly over boney prominence
Define envelopement? - ANSWER is the ability of support surface to conform to irregularities without
causing substantial increase in pressure
, what is bottoming out? - ANSWER this occurs when depth of penetration or sinking is excessive,
allowing increased pressure to concentrate over boney prominences
what factors contribute to bottoming out? - ANSWER weight, disproportion of weight and size such
as amputation, tendency to keep HOB >30 degrees, inappropriate support surface settings
When should you consider reactive support surface with features and components such as low air
loss, alternating pressure, viscous or air fluids? - ANSWER for patients who cannot effectively position
off their wound, have PUs in multiple turning surfaces, or have PUs that fail to improve despite
optimal comprehensive management
When should active support surface be considered? - ANSWER when effective positioning is
determined by an MD to be medically contraindicated
What is the difference between an active and reactive support surfaces/ - ANSWER active support
surface is a powered mattress or overlay that changes it's load- distribution with or without applied
load; pressure is redistributed across the body by inflating and deflating the cells of alternating
zones. conversely a reactive support surface moves or changes load-distribution properties only in
response to applied load, such as the patient's body.
When are active support surfaces appropriate? - ANSWER when manual frequent repositioning is not
possible
when are reactive support surfaces appropriate? - ANSWER for pressure ulcer prevention
what is a benefit in low air loss feature and when is it contraindicated? - ANSWER low air loss assists
in managing mositure. It is contraindicated in patients with unstable spine and it puts patients at risk
for entrapment
when is an air fluidized feature integrated in bed systems appropriate? - ANSWER for patients with
multiple stage III or Iv pressure ulcers, burns, myocutaneous skin flap
for what kind of patients are traditional air-fluidized bed not recommended? - ANSWER pulmonary
diseases or unstable spine patients
ANSWERS ALREADY GRADED A+ AND 100% GUARANTEE PASS
what are 6 risk factor components of Braden Scale for pressure ulcer? - ANSWER sensory perception,
moisture, mobility, activity, nutrition, and shear/friction
What is the name of the organization that developed the pressure ulcer staging? - ANSWER NPUAP
(national pressure ulcer advisory panel)
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
what are the extrinsic factors that impact pressure ulcers? - ANSWER increase in moisture, friction
and shearing
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.
what are the intrisinc factors of pressur ulcers? - ANSWER nutritional debilitation, advanced age, low
BP, stress, smoking, elevated body temperature
Aging skin undergoes what elements affecting risk for pressure ulcer? - ANSWER dermoepidermal
junction flattens, less nutrient exchange occurs, less resistance to shearing, 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
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
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
,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
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
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
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
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
Describe unstageble ulcers? - ANSWER full-thickness wound where base of the ulcer is covered by
slough and/or eschar, obscuring depth
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.
Therapeutic function of pressure distribution is accomplised by what 2 factors? - ANSWER immersion
and envelopement
Define immersion? - ANSWER depth of penetration or skining into surgace allowing pressure to be
spread out over surrounding area rather than directly over boney prominence
Define envelopement? - ANSWER is the ability of support surface to conform to irregularities without
causing substantial increase in pressure
, what is bottoming out? - ANSWER this occurs when depth of penetration or sinking is excessive,
allowing increased pressure to concentrate over boney prominences
what factors contribute to bottoming out? - ANSWER weight, disproportion of weight and size such
as amputation, tendency to keep HOB >30 degrees, inappropriate support surface settings
When should you consider reactive support surface with features and components such as low air
loss, alternating pressure, viscous or air fluids? - ANSWER for patients who cannot effectively position
off their wound, have PUs in multiple turning surfaces, or have PUs that fail to improve despite
optimal comprehensive management
When should active support surface be considered? - ANSWER when effective positioning is
determined by an MD to be medically contraindicated
What is the difference between an active and reactive support surfaces/ - ANSWER active support
surface is a powered mattress or overlay that changes it's load- distribution with or without applied
load; pressure is redistributed across the body by inflating and deflating the cells of alternating
zones. conversely a reactive support surface moves or changes load-distribution properties only in
response to applied load, such as the patient's body.
When are active support surfaces appropriate? - ANSWER when manual frequent repositioning is not
possible
when are reactive support surfaces appropriate? - ANSWER for pressure ulcer prevention
what is a benefit in low air loss feature and when is it contraindicated? - ANSWER low air loss assists
in managing mositure. It is contraindicated in patients with unstable spine and it puts patients at risk
for entrapment
when is an air fluidized feature integrated in bed systems appropriate? - ANSWER for patients with
multiple stage III or Iv pressure ulcers, burns, myocutaneous skin flap
for what kind of patients are traditional air-fluidized bed not recommended? - ANSWER pulmonary
diseases or unstable spine patients
