Emory Wound Exam 2 — 100 Practice
Questions with Answers
Section 1: Lower Extremity Wounds —
Arterial vs. Venous (Q1–25)
1. Which location is most characteristic of a LEAD (Lower Extremity Arterial Disease) ulcer?
A) Medial malleolus
B) Distally: toes, forefoot, heel
C) Plantar surface of the foot
D) Lateral calf
Answer: B
Rationale: LEAD ulcers are typically located distally, on the toes, forefoot, or heel. Venous
ulcers are typically on the medial malleolus .
2. What is the classic pain description for a LEAD ulcer?
A) Dull ache relieved by elevation
B) Intense cramping, throbbing heaviness, and difficulty walking worsened by activity and
elevation
C) Painless
D) Sharp stabbing pain relieved by cold
Answer: B
Rationale: LEAD pain is described as intense cramping, throbbing heaviness, and difficulty
walking, worsened by activity and elevation. Nocturnal pain is also common .
3. What is the appearance of a LEAD ulcer wound bed?
A) Punched out with scant exudate, pale or necrotic wound bed
B) Shallow with moderate exudate and granulation tissue
C) Irregular edges with heavy exudate
D) Pink and moist with epithelialization
Answer: A
Rationale: LEAD ulcers appear punched out with scant exudate and a pale or necrotic wound
bed .
4. Which assessment finding is most consistent with LEAD?
,A) Diminished or absent pulses and abnormal ABI
B) Bounding pulses and warm extremities
C) Edema and hemosiderin staining
D) Painless ulcer on the plantar surface
Answer: A
Rationale: LEAD assessment findings include diminished or absent pulses, abnormal ABI,
elevation pallor, and dependent rubor .
5. What is the first-line treatment for a venous leg ulcer?
A) Surgical bypass
B) Compression therapy (e.g., compression stockings, multilayer bandages)
C) Antibiotics
D) Debridement with a scalpel
Answer: B
Rationale: Compression therapy is the first-line treatment for venous leg ulcers. It
counteracts venous hypertension and promotes venous return .
6. Compression therapy is CONTRAINDICATED in a patient with:
A) Venous insufficiency
B) Ankle-brachial index (ABI) <0.5 (severe arterial disease)
C) Edema
D) Lipodermatosclerosis
Answer: B
Rationale: Compression therapy is contraindicated when ABI is <0.5, indicating severe
arterial disease. Compressing an ischemic limb can worsen perfusion and cause tissue
necrosis .
7. A diabetic foot ulcer is most commonly located on the:
A) Medial malleolus
B) Lateral malleolus
C) Plantar surface of the foot (weight-bearing areas)
D) Toes
Answer: C
Rationale: Diabetic foot ulcers are most commonly located on the plantar surface of the foot
in weight-bearing areas, due to neuropathy and repetitive trauma .
8. The Wagner grading system for diabetic foot ulcers classifies a full-thickness ulcer with
exposed tendon or bone (no osteomyelitis) as:
, A) Grade 1
B) Grade 2
C) Grade 3
D) Grade 4
Answer: C
Rationale: Wagner Grade 3 is a full-thickness ulcer with exposed tendon or bone (no
osteomyelitis) .
9. What clinical finding distinguishes a venous ulcer from an arterial ulcer?
A) Punched-out appearance
B) Hemosiderin staining and edema
C) Absent pulses
D) Nocturnal pain
Answer: B
Rationale: Venous ulcers present with edema, hemosiderin staining (brown discoloration
from red blood cell breakdown), and are typically on the medial malleolus. Arterial ulcers are
punched out, have absent pulses, and cause nocturnal pain .
10. What is the recommended compression therapy for a patient with an ABI of 0.7?
A) No compression
B) Reduced compression (e.g., 23-30 mmHg)
C) High compression (e.g., 40 mmHg)
D) Intermittent pneumatic compression only
Answer: B
Rationale: An ABI of 0.7 indicates moderate arterial insufficiency. Reduced compression (23-
30 mmHg) may be used with caution and close monitoring. High compression is
contraindicated with ABI <0.8 .
11. What is dependent rubor?
A) Redness that appears when the leg is elevated
B) Redness that appears when the leg is in a dependent position
C) Purple discoloration of the wound bed
D) Redness around the wound edges
Answer: B
Rationale: Dependent rubor is redness that appears when the leg is in a dependent (hanging
down) position, due to reactive hyperemia from chronic ischemia in arterial disease .
12. What is elevation pallor?
Questions with Answers
Section 1: Lower Extremity Wounds —
Arterial vs. Venous (Q1–25)
1. Which location is most characteristic of a LEAD (Lower Extremity Arterial Disease) ulcer?
A) Medial malleolus
B) Distally: toes, forefoot, heel
C) Plantar surface of the foot
D) Lateral calf
Answer: B
Rationale: LEAD ulcers are typically located distally, on the toes, forefoot, or heel. Venous
ulcers are typically on the medial malleolus .
2. What is the classic pain description for a LEAD ulcer?
A) Dull ache relieved by elevation
B) Intense cramping, throbbing heaviness, and difficulty walking worsened by activity and
elevation
C) Painless
D) Sharp stabbing pain relieved by cold
Answer: B
Rationale: LEAD pain is described as intense cramping, throbbing heaviness, and difficulty
walking, worsened by activity and elevation. Nocturnal pain is also common .
3. What is the appearance of a LEAD ulcer wound bed?
A) Punched out with scant exudate, pale or necrotic wound bed
B) Shallow with moderate exudate and granulation tissue
C) Irregular edges with heavy exudate
D) Pink and moist with epithelialization
Answer: A
Rationale: LEAD ulcers appear punched out with scant exudate and a pale or necrotic wound
bed .
4. Which assessment finding is most consistent with LEAD?
,A) Diminished or absent pulses and abnormal ABI
B) Bounding pulses and warm extremities
C) Edema and hemosiderin staining
D) Painless ulcer on the plantar surface
Answer: A
Rationale: LEAD assessment findings include diminished or absent pulses, abnormal ABI,
elevation pallor, and dependent rubor .
5. What is the first-line treatment for a venous leg ulcer?
A) Surgical bypass
B) Compression therapy (e.g., compression stockings, multilayer bandages)
C) Antibiotics
D) Debridement with a scalpel
Answer: B
Rationale: Compression therapy is the first-line treatment for venous leg ulcers. It
counteracts venous hypertension and promotes venous return .
6. Compression therapy is CONTRAINDICATED in a patient with:
A) Venous insufficiency
B) Ankle-brachial index (ABI) <0.5 (severe arterial disease)
C) Edema
D) Lipodermatosclerosis
Answer: B
Rationale: Compression therapy is contraindicated when ABI is <0.5, indicating severe
arterial disease. Compressing an ischemic limb can worsen perfusion and cause tissue
necrosis .
7. A diabetic foot ulcer is most commonly located on the:
A) Medial malleolus
B) Lateral malleolus
C) Plantar surface of the foot (weight-bearing areas)
D) Toes
Answer: C
Rationale: Diabetic foot ulcers are most commonly located on the plantar surface of the foot
in weight-bearing areas, due to neuropathy and repetitive trauma .
8. The Wagner grading system for diabetic foot ulcers classifies a full-thickness ulcer with
exposed tendon or bone (no osteomyelitis) as:
, A) Grade 1
B) Grade 2
C) Grade 3
D) Grade 4
Answer: C
Rationale: Wagner Grade 3 is a full-thickness ulcer with exposed tendon or bone (no
osteomyelitis) .
9. What clinical finding distinguishes a venous ulcer from an arterial ulcer?
A) Punched-out appearance
B) Hemosiderin staining and edema
C) Absent pulses
D) Nocturnal pain
Answer: B
Rationale: Venous ulcers present with edema, hemosiderin staining (brown discoloration
from red blood cell breakdown), and are typically on the medial malleolus. Arterial ulcers are
punched out, have absent pulses, and cause nocturnal pain .
10. What is the recommended compression therapy for a patient with an ABI of 0.7?
A) No compression
B) Reduced compression (e.g., 23-30 mmHg)
C) High compression (e.g., 40 mmHg)
D) Intermittent pneumatic compression only
Answer: B
Rationale: An ABI of 0.7 indicates moderate arterial insufficiency. Reduced compression (23-
30 mmHg) may be used with caution and close monitoring. High compression is
contraindicated with ABI <0.8 .
11. What is dependent rubor?
A) Redness that appears when the leg is elevated
B) Redness that appears when the leg is in a dependent position
C) Purple discoloration of the wound bed
D) Redness around the wound edges
Answer: B
Rationale: Dependent rubor is redness that appears when the leg is in a dependent (hanging
down) position, due to reactive hyperemia from chronic ischemia in arterial disease .
12. What is elevation pallor?
