CFCN
Complete Test Review
(Questions & Solutions)
2025
1
,1. A 62-year-old patient with long-standing diabetes presents with a 2 cm
superficial plantar ulcer at the metatarsal head, no infection or ischemia.
According to the Wagner system, this is:
A. Grade 0
B. Grade 1
C. Grade 2
D. Grade 3
ANS: B
Rationale: Wagner Grade 1 denotes a superficial ulcer through the
dermis without tendon, capsule, or bone involvement.
2. A diabetic foot ulcer shows callus formation at its edge and
surrounding hyperkeratosis. The primary benefit of debriding the callus
before dressing is to:
A. Reduce bacterial colonization
B. Normalize tissue pH
C. Redistribute plantar pressure
D. Increase protease activity
ANS: C
Rationale: Callus removal reduces focal pressure, improving offloading
and wound healing.
3. On examination, a foot ulcer has a pale, devitalized slough. Which
debridement method is CONTRAINDICATED if arterial perfusion is
severely compromised (ABI 0.45)?
A. Sharp debridement
B. Enzymatic debridement
C. Autolytic debridement
D. Mechanical (wet-to-dry) debridement
ANS: A
Rationale: Sharp debridement in critically ischemic tissue risks bleeding
2
, and further non-healing; conservative methods preferred.
4. A 70-year-old with suspected peripheral arterial disease has an ankle-
brachial index (ABI) of 0.6. This indicates:
A. Normal perfusion
B. Mild PAD
C. Moderate PAD
D. Critical limb ischemia
ANS: C
Rationale: ABI 0.41–0.79 corresponds to moderate peripheral arterial
disease.
5. During monofilament testing, the patient fails to perceive 10 g
pressure at four of ten sites. This finding suggests:
A. Normal sensation
B. Early neuropathy
C. Loss of protective sensation
D. Complete sensory loss
ANS: C
Rationale: Inability to sense 10 g at ≥4 sites indicates loss of protective
sensation and high ulceration risk.
6. A 55-year-old with Charcot neuroarthropathy exhibits a warm,
erythematous, deforming midfoot. The most appropriate initial
offloading device is:
A. Surgical shoe
B. Total contact cast
C. Removable cast walker
D. Custom orthotic insole
ANS: B
Rationale: Total contact casting provides maximal immobilization and
offloading to halt Charcot progression.
3
Complete Test Review
(Questions & Solutions)
2025
1
,1. A 62-year-old patient with long-standing diabetes presents with a 2 cm
superficial plantar ulcer at the metatarsal head, no infection or ischemia.
According to the Wagner system, this is:
A. Grade 0
B. Grade 1
C. Grade 2
D. Grade 3
ANS: B
Rationale: Wagner Grade 1 denotes a superficial ulcer through the
dermis without tendon, capsule, or bone involvement.
2. A diabetic foot ulcer shows callus formation at its edge and
surrounding hyperkeratosis. The primary benefit of debriding the callus
before dressing is to:
A. Reduce bacterial colonization
B. Normalize tissue pH
C. Redistribute plantar pressure
D. Increase protease activity
ANS: C
Rationale: Callus removal reduces focal pressure, improving offloading
and wound healing.
3. On examination, a foot ulcer has a pale, devitalized slough. Which
debridement method is CONTRAINDICATED if arterial perfusion is
severely compromised (ABI 0.45)?
A. Sharp debridement
B. Enzymatic debridement
C. Autolytic debridement
D. Mechanical (wet-to-dry) debridement
ANS: A
Rationale: Sharp debridement in critically ischemic tissue risks bleeding
2
, and further non-healing; conservative methods preferred.
4. A 70-year-old with suspected peripheral arterial disease has an ankle-
brachial index (ABI) of 0.6. This indicates:
A. Normal perfusion
B. Mild PAD
C. Moderate PAD
D. Critical limb ischemia
ANS: C
Rationale: ABI 0.41–0.79 corresponds to moderate peripheral arterial
disease.
5. During monofilament testing, the patient fails to perceive 10 g
pressure at four of ten sites. This finding suggests:
A. Normal sensation
B. Early neuropathy
C. Loss of protective sensation
D. Complete sensory loss
ANS: C
Rationale: Inability to sense 10 g at ≥4 sites indicates loss of protective
sensation and high ulceration risk.
6. A 55-year-old with Charcot neuroarthropathy exhibits a warm,
erythematous, deforming midfoot. The most appropriate initial
offloading device is:
A. Surgical shoe
B. Total contact cast
C. Removable cast walker
D. Custom orthotic insole
ANS: B
Rationale: Total contact casting provides maximal immobilization and
offloading to halt Charcot progression.
3
