CERTIFIED WOUND CARE NURSE
(CWCN) MASTERY EXAM 2026
1. Which phase of wound healing is characterized by the presence of myofibroblasts and
wound contraction?
A. Inflammatory phase
B. Hemostasis phase
C. Proliferation phase
D. Maturation phase
Answer: C
Conceptual Explanation: During the proliferation phase, myofibroblasts are responsible
for wound contraction, and granulation tissue is formed.
2. A patient presents with a full-thickness pressure injury covered by 90% yellow slough.
What is the correct staging for this wound?
A. Stage 3
B. Stage 4
C. Deep Tissue Pressure Injury
,D. Unstageable
Answer: D
Conceptual Explanation: If the extent of tissue damage cannot be confirmed because it is
obscured by slough or eschar, the injury is classified as Unstageable.
3. Which of the following objective findings is most indicative of an arterial ulcer rather than
a venous ulcer?
A. Diminished or absent pedal pulses
B. Hemosiderin staining on the lower leg
C. Irregular wound margins and heavy exudate
D. Warm skin temperature
Answer: A
Conceptual Explanation: Arterial ulcers are caused by inadequate blood supply, leading to
cold skin and absent or weak pulses, whereas venous ulcers typically have pulses and
heavy drainage.
4. What is the primary purpose of applying an enzymatic debrider to a necrotic wound?
A. To provide mechanical friction to remove tissue
B. To break down collagen that anchors necrotic tissue to the wound bed
C. To increase the oxygenation level in the local tissue
D. To serve as a moisture barrier against incontinence
, Answer: B
Conceptual Explanation: Enzymatic debriders (like Santyl) specifically target and degrade
collagen that binds dead tissue to the living wound bed.
5. When using Negative Pressure Wound Therapy (NPWT), the presence of bright red blood in
the tubing indicates which immediate action?
A. Change the canister and continue therapy
B. Reduce the pressure setting by 25 mmHg
C. Turn off the suction and apply direct pressure to the wound
D. Reinforce the seal with extra film
Answer: C
Conceptual Explanation: Active bleeding is a complication of NPWT; the pump must be
stopped immediately to assess the source and apply pressure.
6. A patient with a diabetic foot ulcer has an Ankle-Brachial Index (ABI) of 0.45. Which
intervention is contraindicated?
A. Offloading the foot
B. High-level compression therapy
C. Moist wound healing
D. Referral to vascular surgery
Answer: B
(CWCN) MASTERY EXAM 2026
1. Which phase of wound healing is characterized by the presence of myofibroblasts and
wound contraction?
A. Inflammatory phase
B. Hemostasis phase
C. Proliferation phase
D. Maturation phase
Answer: C
Conceptual Explanation: During the proliferation phase, myofibroblasts are responsible
for wound contraction, and granulation tissue is formed.
2. A patient presents with a full-thickness pressure injury covered by 90% yellow slough.
What is the correct staging for this wound?
A. Stage 3
B. Stage 4
C. Deep Tissue Pressure Injury
,D. Unstageable
Answer: D
Conceptual Explanation: If the extent of tissue damage cannot be confirmed because it is
obscured by slough or eschar, the injury is classified as Unstageable.
3. Which of the following objective findings is most indicative of an arterial ulcer rather than
a venous ulcer?
A. Diminished or absent pedal pulses
B. Hemosiderin staining on the lower leg
C. Irregular wound margins and heavy exudate
D. Warm skin temperature
Answer: A
Conceptual Explanation: Arterial ulcers are caused by inadequate blood supply, leading to
cold skin and absent or weak pulses, whereas venous ulcers typically have pulses and
heavy drainage.
4. What is the primary purpose of applying an enzymatic debrider to a necrotic wound?
A. To provide mechanical friction to remove tissue
B. To break down collagen that anchors necrotic tissue to the wound bed
C. To increase the oxygenation level in the local tissue
D. To serve as a moisture barrier against incontinence
, Answer: B
Conceptual Explanation: Enzymatic debriders (like Santyl) specifically target and degrade
collagen that binds dead tissue to the living wound bed.
5. When using Negative Pressure Wound Therapy (NPWT), the presence of bright red blood in
the tubing indicates which immediate action?
A. Change the canister and continue therapy
B. Reduce the pressure setting by 25 mmHg
C. Turn off the suction and apply direct pressure to the wound
D. Reinforce the seal with extra film
Answer: C
Conceptual Explanation: Active bleeding is a complication of NPWT; the pump must be
stopped immediately to assess the source and apply pressure.
6. A patient with a diabetic foot ulcer has an Ankle-Brachial Index (ABI) of 0.45. Which
intervention is contraindicated?
A. Offloading the foot
B. High-level compression therapy
C. Moist wound healing
D. Referral to vascular surgery
Answer: B
