CERTIFIED WOUND CARE NURSE
(CWCN) ADVANCED PRACTICE
EXAMINATION QUESTIONS AND
ANSWERS
1. When assessing a patient with a suspected Deep Tissue Pressure Injury (DTPI), which
characteristic is most indicative of this specific injury rather than a Stage 2 pressure injury?
A. A localized area of non-blanchable deep red, maroon, or purple discoloration.
B. A partial-thickness loss of dermis presenting as a shallow open ulcer.
C. Intact skin with non-blanchable redness of a localized area over a bony prominence.
D. The presence of a blood-filled blister due to shear forces.
Answer: A
Conceptual Explanation: DTPI is characterized by intact or non-intact skin with localized
persistent non-blanchable deep red, maroon, or purple discoloration, or epidermal
separation revealing a dark wound bed or blood-filled blister. Stage 2 involves partial-
thickness loss.
,2. A patient presents with a lower extremity ulcer located on the pretibial area. The wound is
shallow with irregular borders, significant edema, and hemosiderin staining. What is the gold
standard treatment for this condition?
A. Surgical revascularization.
B. Compression therapy.
C. Total contact casting.
D. Hyperbaric oxygen therapy.
Answer: B
Conceptual Explanation: The clinical description (irregular borders, edema, hemosiderin
staining) points to a Venous Leg Ulcer (VLU). Compression therapy is the gold standard for
managing venous hypertension, provided arterial flow is adequate.
3. An Ankle-Brachial Index (ABI) result of 0.45 is obtained for a patient with a non-healing
foot ulcer. Which of the following is the most appropriate next step?
A. Immediate referral to a vascular surgeon for evaluation.
B. Apply a transparent film dressing and monitor.
C. Initiate high-compression bandaging (30-40 mmHg).
D. Apply a hydrogel dressing to promote autolytic debridement.
Answer: A
, Conceptual Explanation: An ABI of 0.45 indicates severe arterial disease (ischemia). High
compression is contraindicated (usually avoided below 0.5), and urgent vascular
evaluation is required to assess for revascularization needs.
4. Which type of debridement is considered the fastest and most efficient for removing large
amounts of necrotic tissue or infected debris?
A. Conservative Sharp Wound Debridement (CSWD).
B. Enzymatic debridement.
C. Autolytic debridement.
D. Biological debridement (maggots).
Answer: A
Conceptual Explanation: Sharp debridement is the most rapid method for removing
devitalized tissue, especially in the presence of infection or large areas of slough/eschar,
compared to slower methods like autolysis or enzymes.
5. A wound exhibits a shiny, slimy, translucent film that is resistant to standard antimicrobial
treatments and prevents healing. This is most likely:
A. Slough.
B. Biofilm.
C. Eschar.
D. Granulation tissue.
(CWCN) ADVANCED PRACTICE
EXAMINATION QUESTIONS AND
ANSWERS
1. When assessing a patient with a suspected Deep Tissue Pressure Injury (DTPI), which
characteristic is most indicative of this specific injury rather than a Stage 2 pressure injury?
A. A localized area of non-blanchable deep red, maroon, or purple discoloration.
B. A partial-thickness loss of dermis presenting as a shallow open ulcer.
C. Intact skin with non-blanchable redness of a localized area over a bony prominence.
D. The presence of a blood-filled blister due to shear forces.
Answer: A
Conceptual Explanation: DTPI is characterized by intact or non-intact skin with localized
persistent non-blanchable deep red, maroon, or purple discoloration, or epidermal
separation revealing a dark wound bed or blood-filled blister. Stage 2 involves partial-
thickness loss.
,2. A patient presents with a lower extremity ulcer located on the pretibial area. The wound is
shallow with irregular borders, significant edema, and hemosiderin staining. What is the gold
standard treatment for this condition?
A. Surgical revascularization.
B. Compression therapy.
C. Total contact casting.
D. Hyperbaric oxygen therapy.
Answer: B
Conceptual Explanation: The clinical description (irregular borders, edema, hemosiderin
staining) points to a Venous Leg Ulcer (VLU). Compression therapy is the gold standard for
managing venous hypertension, provided arterial flow is adequate.
3. An Ankle-Brachial Index (ABI) result of 0.45 is obtained for a patient with a non-healing
foot ulcer. Which of the following is the most appropriate next step?
A. Immediate referral to a vascular surgeon for evaluation.
B. Apply a transparent film dressing and monitor.
C. Initiate high-compression bandaging (30-40 mmHg).
D. Apply a hydrogel dressing to promote autolytic debridement.
Answer: A
, Conceptual Explanation: An ABI of 0.45 indicates severe arterial disease (ischemia). High
compression is contraindicated (usually avoided below 0.5), and urgent vascular
evaluation is required to assess for revascularization needs.
4. Which type of debridement is considered the fastest and most efficient for removing large
amounts of necrotic tissue or infected debris?
A. Conservative Sharp Wound Debridement (CSWD).
B. Enzymatic debridement.
C. Autolytic debridement.
D. Biological debridement (maggots).
Answer: A
Conceptual Explanation: Sharp debridement is the most rapid method for removing
devitalized tissue, especially in the presence of infection or large areas of slough/eschar,
compared to slower methods like autolysis or enzymes.
5. A wound exhibits a shiny, slimy, translucent film that is resistant to standard antimicrobial
treatments and prevents healing. This is most likely:
A. Slough.
B. Biofilm.
C. Eschar.
D. Granulation tissue.
