Wound Care Certification Exam Study Guide
Vesicle Similar to pustule but may be a cavity or filled with clear, serous, hemorrhagic, or
pustular fluid
Pustule Elevation of skin containing pus, <0.5 cm
Macule Flat area different in color from surrounding tissue (<0.5 cm)
Papule small, solid, raised lesion on surface of the skin
Yeast infection key characteristics Tender, pruritic maculopapular rash with characteristic satelite lesions
May be caused by exposure to moisture (e.g. diaphoresis, incontinence, skin folds),
poor glcyemic control, steroid or abx use, immune compromise
What are the phases of wound healing? Hemostasis (blood clot formation)
Inflammatory phase (chemotaxis, migration of WBCs, macrophages, fibroblasts)
Proliferation (formation of provisional matrix, synthesis of collagen and collagen
matrix, migration and proliferation of keratinocytes)
Maturation/Remodeling (wound closure, scar formation)
Partial thickness vs full thickness Partial = epidermis or dermis involved
Full = adipose tissue or deeper
How do you treat a patient with pressure injuries to both Use pressure redistribution mattress or lateral rotation low air-loss mattress
trochanters and sacrum?
Role of protein in wound healing Protein is necessary for formation for collagen, connective tissue that is critical to
wound healing
Role of hydration in wound healing Maintains skin barrier, enables epithelial migration during epithelialization phase of
wound healing, improves perfusion and reduces blood viscosity
Role of zinc in wound healing Collagen formation, protein synthesis, cell membrane and host defenses
Stuvia 2025-2026
, Wound Care Certification Exam Study Guide
How and when is a wound culture performed? - How: 5-second swab (Levine technique--currently the most commonly
recommended technique): wound bed flushed with normal saline to remove exudate
and normal skin flora (e.g. staph epidermidis); sterile swab moistened with saline;
one-square centimeter area of viable tissue swabbed for 5 seconds with enough
force to produce exudate. Provides organism identification and sensitivity data.
Punch biopsy culture: #3 dermal punch or sterile scissors used to obtain tissue
sample that is sent to lab—lab grinds the sample and mixes it with diluent to form
fluid that is used to determine colony counts as well as to ID organisms and
sensitivities.
Advantage: quantitative and qualitative data so can use to diagnose infection.
Disadvantage: more expensive; many nurses not covered to do this type of culture;
many labs unable to process this type of specimen
- When: wounds associated with S/S of soft tissue infection (erythema, especially
erythema extending >2 cm beyond wound edge; induration; foul-smelling exudate;
pain); clean wounds that show no progress in healing for 2 consecutive weeks
despite appropriate management (quantitative culture recommended) prior to skin
graft/flap/placement human skin equivalent
How are malignant wounds managed? Odor, exudate control, and control of bleeding; strategies shown in limited studies to
be beneficial in odor control include topical metronidazole, medical grade honey,
polyhexanide, and silver dressings. Anecdotal reports suggest that Dakin solution
may also be of benefit.
What does the Braden Scale measure? Sensory perception, moisture, activity, mobility, nutrition, friction and shear
Lower the number, higher the risk; scale from 4-23
less than 17 = risk for pressure ulcers
Lymphedema symptoms The affected limb, in part of whole, is typically swollen and hypertrophied, with
thickened and fibrotic skin; usually painless, may be accompanied by episodes of
lymphangitis and cellulitis
Most common in patient with past history radical surgery for cancer involving
removal of lymph nodes/interruption lymphatic pathways OR patient with
longstanding venous disease (get changes in soft tissue that affect lymphatics);
progressively unresponsive to simple measures such as elevation; also
characterized by skin changes (development cobblestone appearance to skin
caused by papillomatous outgrowths and by nonpitting edema)
Deep dry wound dressing recommendations Donating moisture
Deep wet wound dressing recommendations Wicking/absorbing
Shallow wet wound dressing recommendations Wicking/absorbing
Shallow dry wound dressing recommendations Donating moisture
Lower extremity arterial disease (LEAD) pathogenesis Arterial: primary risk factors include diabetes mellitus; hyperlipidemia and
cardiovascular or cerebrovascular disease; hypertension; smoking; age >70.
Additional risk factors include chronic kidney disease and family history; the roles of
elevated homocysteine levels, ethnicity, and chronic inflammatory conditions are
under investigation.
Stuvia 2025-2026
Vesicle Similar to pustule but may be a cavity or filled with clear, serous, hemorrhagic, or
pustular fluid
Pustule Elevation of skin containing pus, <0.5 cm
Macule Flat area different in color from surrounding tissue (<0.5 cm)
Papule small, solid, raised lesion on surface of the skin
Yeast infection key characteristics Tender, pruritic maculopapular rash with characteristic satelite lesions
May be caused by exposure to moisture (e.g. diaphoresis, incontinence, skin folds),
poor glcyemic control, steroid or abx use, immune compromise
What are the phases of wound healing? Hemostasis (blood clot formation)
Inflammatory phase (chemotaxis, migration of WBCs, macrophages, fibroblasts)
Proliferation (formation of provisional matrix, synthesis of collagen and collagen
matrix, migration and proliferation of keratinocytes)
Maturation/Remodeling (wound closure, scar formation)
Partial thickness vs full thickness Partial = epidermis or dermis involved
Full = adipose tissue or deeper
How do you treat a patient with pressure injuries to both Use pressure redistribution mattress or lateral rotation low air-loss mattress
trochanters and sacrum?
Role of protein in wound healing Protein is necessary for formation for collagen, connective tissue that is critical to
wound healing
Role of hydration in wound healing Maintains skin barrier, enables epithelial migration during epithelialization phase of
wound healing, improves perfusion and reduces blood viscosity
Role of zinc in wound healing Collagen formation, protein synthesis, cell membrane and host defenses
Stuvia 2025-2026
, Wound Care Certification Exam Study Guide
How and when is a wound culture performed? - How: 5-second swab (Levine technique--currently the most commonly
recommended technique): wound bed flushed with normal saline to remove exudate
and normal skin flora (e.g. staph epidermidis); sterile swab moistened with saline;
one-square centimeter area of viable tissue swabbed for 5 seconds with enough
force to produce exudate. Provides organism identification and sensitivity data.
Punch biopsy culture: #3 dermal punch or sterile scissors used to obtain tissue
sample that is sent to lab—lab grinds the sample and mixes it with diluent to form
fluid that is used to determine colony counts as well as to ID organisms and
sensitivities.
Advantage: quantitative and qualitative data so can use to diagnose infection.
Disadvantage: more expensive; many nurses not covered to do this type of culture;
many labs unable to process this type of specimen
- When: wounds associated with S/S of soft tissue infection (erythema, especially
erythema extending >2 cm beyond wound edge; induration; foul-smelling exudate;
pain); clean wounds that show no progress in healing for 2 consecutive weeks
despite appropriate management (quantitative culture recommended) prior to skin
graft/flap/placement human skin equivalent
How are malignant wounds managed? Odor, exudate control, and control of bleeding; strategies shown in limited studies to
be beneficial in odor control include topical metronidazole, medical grade honey,
polyhexanide, and silver dressings. Anecdotal reports suggest that Dakin solution
may also be of benefit.
What does the Braden Scale measure? Sensory perception, moisture, activity, mobility, nutrition, friction and shear
Lower the number, higher the risk; scale from 4-23
less than 17 = risk for pressure ulcers
Lymphedema symptoms The affected limb, in part of whole, is typically swollen and hypertrophied, with
thickened and fibrotic skin; usually painless, may be accompanied by episodes of
lymphangitis and cellulitis
Most common in patient with past history radical surgery for cancer involving
removal of lymph nodes/interruption lymphatic pathways OR patient with
longstanding venous disease (get changes in soft tissue that affect lymphatics);
progressively unresponsive to simple measures such as elevation; also
characterized by skin changes (development cobblestone appearance to skin
caused by papillomatous outgrowths and by nonpitting edema)
Deep dry wound dressing recommendations Donating moisture
Deep wet wound dressing recommendations Wicking/absorbing
Shallow wet wound dressing recommendations Wicking/absorbing
Shallow dry wound dressing recommendations Donating moisture
Lower extremity arterial disease (LEAD) pathogenesis Arterial: primary risk factors include diabetes mellitus; hyperlipidemia and
cardiovascular or cerebrovascular disease; hypertension; smoking; age >70.
Additional risk factors include chronic kidney disease and family history; the roles of
elevated homocysteine levels, ethnicity, and chronic inflammatory conditions are
under investigation.
Stuvia 2025-2026
