CWCN - Certified Wound Care Nurse: Q’s And A’s
Which of the following extends from a wound under normal issue and
connects two structures, such as the wound and an organ?
a Undermining
b fistula
c tunneling
d abscess Right Ans - fistula
A patient has a wound on the right hip with tunneling and fistulae. Which of
the following is MOST indicative of an abscess formation?
a Increased purulent discharge
b Increased wound pain
c Increased erythema and swelling at wound perimeter
d Erythematous, painful, swollen area 3 cm from wound perimeter Right
Ans - d Erythematous, painful, swollen area 3 cm from wound perimeter
Which of the following laboratory tests is the most effective to monitor acute
changes in nutritional status?
a Total protein
b Albumin
c Prealbumin
d Trasferrin Right Ans - c Prealbumin is used to monitor acute changes in
nutritional status because it has a half life of only 2-3 days.
On the eighth day of wound care, granulation tissue is evident about the
wound perimeter, and the wound is beginning to contract. The wound is in
which of the following phases of healing?
a Proliferation
b Inflammation
c Hemostasis
d Maturation Right Ans - a Proliferation (days 5-20) is characterized by
granulation tissue starting to form at wound perimeter.
Which of the following is the correct procedure for applying Eutectic Mixture
of Local Anesthetics (EMLA Cream) to a wound prior to a debridement?
a Apply a thin layer (1/8 inch thick) to the wound for 15 minutes, leaving the
wound open
,b Apply a thick layer (1/4 inch thick) to the wound, extending 1/2 inch past
the wound onto surrounding tissue, and cover with plastic wrap for 20-60
minutes.
c Apply a thick layer (1/4 inch thick) to the wound surface only and cover
with plastic wrap for 15 minutes
d Apply a thin layer (1/8 inch thick) to the wound surface only and cover with
a loose dry dressing for 20-60 minutes Right Ans - b Apply a thick layer
(1/4 inch thick) to the wound, extending 1/2 inch past the wound onto
surrounding tissue, and cover with plastic wrap for 20-60 minutes.
When doing a routine dressing change for a healing decubitus ulcer on the
right hip, which is the most appropriate cleaning solution?
a Povidone-iodine solution
b Hydrogen peroxide
c Alcohol
d Normal Saline Right Ans - d Normal Saline
Which of the following wound irrigation devices will provide approximately 8
psi in irrigant pressure to the wound surface?
a 35 ml syringe with 19 gauge Angiocath
b 250 ml squeeze bottle
c Bulb syringe
d 6 ml syringe with 19 gauge Angiocath Right Ans - a 35 ml syringe with 19
gauge Angiocath
Which of the following is the most important criterion when assessing a
patient's level of wound pain?
a Patient's behavior
b Type of wound
c Patient's report of pain
d Patient's facial expression Right Ans - c Patient's report of pain
Which of the following is likely to have the MOST negative effect on wound
healing for a 65 yo woman?
a Hypoalbuminemia
b BMI of 20.2
c BMI of 28
d Vegan diet Right Ans - a Hypoalbuminemia (this is an indication of
protein malnutrition and may cause delayed wound healing
,Which of the following is the most definitive method for obtaining a wound
specimen for culture and sensitivities?
a Tissue biopsy
b Sterile swab of wound
c Needle biopsy
d Sterile swab of discharge Right Ans - a Tissue biopsy
A patient with an infected abdominal wound is taking a number of drugs.
Which of the following is most likely to impair healing?
a Phenytoin
b Corticosteroid
c Prostaglandin
d Estrogen Right Ans - b Corticosteroid may impair wound healing by
interfering with vascular proliferation and epithelialization.
A burn extending through the dermis with obvious blistering would be
classified as
a First degree
b Second degree
c Third degree
d Full thickness Right Ans - b Second degree
Which of the following results from smoking cigarettes?
a Vasodilation
b Vasoconstriction
c Increased oxygen transport
d Increased oxygen tension Right Ans - b Vasoconstriction
When calculating the ankle-brachial index (ABI), if the ankle systolic pressure
is 90 and the brachial systolic pressure is 120, what is the ABI?
a 1.33
b 13.3
c 7.5
d 0.75 Right Ans - d 0.75 (the ankle pressure is divided by the brachial
pressure)
Using transcutaneous oxygen pressure measurement (TCPO2), which of the
following values indicates that oxygenation is adequate for healing?
, a 18 mmHg
b 20 mmHg
c 30 mmHg
d 42 mmHg Right Ans - d 42 mmHg ( A value of > 40 mmHg is adequate for
healing)
The method of closure that involves leaving the wound open and allowing it to
close naturally through granulation and epithelialization is healing by
a Primary or first intention
b Secondary or second intention
c Tertiary or third intention
d Quaternary prevention Right Ans - b Secondary or second intention
A patient's laboratory results show a serum sodium of 155 mEq/L and a
serum osmolality of 300 mOsm/kg. The most likely cause is
a Infection
b Overhydration
c Dehydration
d Malnutrition Right Ans - c Dehydration (Normal values 135-150mEq/L,
Dehydration > 150mEq/L)
Autolytic debridement is most effective for
a Chronic wounds
b Large burns
c Small wounds without infection
d Necrotic wounds Right Ans - c Small wounds without infection
Enzymatic debridement requires application of enzymes
a 1-2 times daily
b 3-4 times daily
c 1-2 times weekly
d 3-4 times weekly Right Ans - a 1-2 times daily
Which of the following indicates that sharp instrument debridement must be
discontinued?
a Purulent discharge occurs
b Black eschar is removed
c Pain and bleeding occur
Which of the following extends from a wound under normal issue and
connects two structures, such as the wound and an organ?
a Undermining
b fistula
c tunneling
d abscess Right Ans - fistula
A patient has a wound on the right hip with tunneling and fistulae. Which of
the following is MOST indicative of an abscess formation?
a Increased purulent discharge
b Increased wound pain
c Increased erythema and swelling at wound perimeter
d Erythematous, painful, swollen area 3 cm from wound perimeter Right
Ans - d Erythematous, painful, swollen area 3 cm from wound perimeter
Which of the following laboratory tests is the most effective to monitor acute
changes in nutritional status?
a Total protein
b Albumin
c Prealbumin
d Trasferrin Right Ans - c Prealbumin is used to monitor acute changes in
nutritional status because it has a half life of only 2-3 days.
On the eighth day of wound care, granulation tissue is evident about the
wound perimeter, and the wound is beginning to contract. The wound is in
which of the following phases of healing?
a Proliferation
b Inflammation
c Hemostasis
d Maturation Right Ans - a Proliferation (days 5-20) is characterized by
granulation tissue starting to form at wound perimeter.
Which of the following is the correct procedure for applying Eutectic Mixture
of Local Anesthetics (EMLA Cream) to a wound prior to a debridement?
a Apply a thin layer (1/8 inch thick) to the wound for 15 minutes, leaving the
wound open
,b Apply a thick layer (1/4 inch thick) to the wound, extending 1/2 inch past
the wound onto surrounding tissue, and cover with plastic wrap for 20-60
minutes.
c Apply a thick layer (1/4 inch thick) to the wound surface only and cover
with plastic wrap for 15 minutes
d Apply a thin layer (1/8 inch thick) to the wound surface only and cover with
a loose dry dressing for 20-60 minutes Right Ans - b Apply a thick layer
(1/4 inch thick) to the wound, extending 1/2 inch past the wound onto
surrounding tissue, and cover with plastic wrap for 20-60 minutes.
When doing a routine dressing change for a healing decubitus ulcer on the
right hip, which is the most appropriate cleaning solution?
a Povidone-iodine solution
b Hydrogen peroxide
c Alcohol
d Normal Saline Right Ans - d Normal Saline
Which of the following wound irrigation devices will provide approximately 8
psi in irrigant pressure to the wound surface?
a 35 ml syringe with 19 gauge Angiocath
b 250 ml squeeze bottle
c Bulb syringe
d 6 ml syringe with 19 gauge Angiocath Right Ans - a 35 ml syringe with 19
gauge Angiocath
Which of the following is the most important criterion when assessing a
patient's level of wound pain?
a Patient's behavior
b Type of wound
c Patient's report of pain
d Patient's facial expression Right Ans - c Patient's report of pain
Which of the following is likely to have the MOST negative effect on wound
healing for a 65 yo woman?
a Hypoalbuminemia
b BMI of 20.2
c BMI of 28
d Vegan diet Right Ans - a Hypoalbuminemia (this is an indication of
protein malnutrition and may cause delayed wound healing
,Which of the following is the most definitive method for obtaining a wound
specimen for culture and sensitivities?
a Tissue biopsy
b Sterile swab of wound
c Needle biopsy
d Sterile swab of discharge Right Ans - a Tissue biopsy
A patient with an infected abdominal wound is taking a number of drugs.
Which of the following is most likely to impair healing?
a Phenytoin
b Corticosteroid
c Prostaglandin
d Estrogen Right Ans - b Corticosteroid may impair wound healing by
interfering with vascular proliferation and epithelialization.
A burn extending through the dermis with obvious blistering would be
classified as
a First degree
b Second degree
c Third degree
d Full thickness Right Ans - b Second degree
Which of the following results from smoking cigarettes?
a Vasodilation
b Vasoconstriction
c Increased oxygen transport
d Increased oxygen tension Right Ans - b Vasoconstriction
When calculating the ankle-brachial index (ABI), if the ankle systolic pressure
is 90 and the brachial systolic pressure is 120, what is the ABI?
a 1.33
b 13.3
c 7.5
d 0.75 Right Ans - d 0.75 (the ankle pressure is divided by the brachial
pressure)
Using transcutaneous oxygen pressure measurement (TCPO2), which of the
following values indicates that oxygenation is adequate for healing?
, a 18 mmHg
b 20 mmHg
c 30 mmHg
d 42 mmHg Right Ans - d 42 mmHg ( A value of > 40 mmHg is adequate for
healing)
The method of closure that involves leaving the wound open and allowing it to
close naturally through granulation and epithelialization is healing by
a Primary or first intention
b Secondary or second intention
c Tertiary or third intention
d Quaternary prevention Right Ans - b Secondary or second intention
A patient's laboratory results show a serum sodium of 155 mEq/L and a
serum osmolality of 300 mOsm/kg. The most likely cause is
a Infection
b Overhydration
c Dehydration
d Malnutrition Right Ans - c Dehydration (Normal values 135-150mEq/L,
Dehydration > 150mEq/L)
Autolytic debridement is most effective for
a Chronic wounds
b Large burns
c Small wounds without infection
d Necrotic wounds Right Ans - c Small wounds without infection
Enzymatic debridement requires application of enzymes
a 1-2 times daily
b 3-4 times daily
c 1-2 times weekly
d 3-4 times weekly Right Ans - a 1-2 times daily
Which of the following indicates that sharp instrument debridement must be
discontinued?
a Purulent discharge occurs
b Black eschar is removed
c Pain and bleeding occur
