WOCN Wound Exam Questions With Correct
Verified Solutions 100% Guaranteed Pass Latest
Update 2025
**Question :Goals of wound assessment - **Answer** :1. Determine
etiologic factors
2. Assess systemic factors/comorbidities
3. Assess wound to determine phase of healing
4. Determine goals of topical therapy
**Question :Why does hyperglycemia affect wound healing? - **Answer**
:Impairs leukocyte function and negatively impacts collagen syntehesis,
development of tensile strength, epithelial resurfacing
**Question :What BG parameters should be maintained for wound healing? -
**Answer** :BG <180 for leukocyte function; <140 for healing
A1C <7 for most, <8 if hx of severe hypoglycemia, advanced comorbidities,
limited life expectancy
**Question :Why is nutrition relevant to wound healing? - **Answer**
:Muscle or SubQ wasting increases risk of pressure/shear damage
malnourished pt unable to synthesize and cross-link collagen normally
protein deficiency increases risk of infection
**Question :What effect do low zinc levels have on wound healing? -
**Answer** :compromise collagen synthesis/crosslinking
**Question :What amino acids are essential for collagen synthesis?
What is the effect of stress on these amino acids? - **Answer** :Glutamine
and l-arginine
Not adequately produced during times of physiologic stress
,**Question :What weight trend suggests nutritional deficiency? -
**Answer** :Unplanned weight loss =>2.5% of usual weight in 30 days or
=>10% within 180 days
BMI <18.5
**Question :What serum albumin level indicates malnutrition? -
**Answer** :<3.5 g/dl
**Question :What serum transferrin level indicates malnutrition? -
**Answer** :<100mg/dl
**Question :What serum prealbumin level indicates malnutrition? -
**Answer** :<19.5
**Question :What total lymphocyte count level indicates malnutrition? -
**Answer** :<1500
**Question :What are s/s of nutritional deficits? - **Answer** :skin rashes,
cracks in mucous membranes, edema, muscle and subQ tissue wasting,
nonhealing wounds, dry/pluckable hair, dry flaky itchy skin
**Question :What is the suggested caloric intake? - **Answer** :30-35
cal/kg body weight
**Question :What is the suggested protein intake? - **Answer** :1.25-1.5
g/kg body weight
**Question :What is the suggested fluid intake? - **Answer** :30ml per kg
(unless fluid restriction indicated)
**Question :How do you assess perfusion/oxygenation? - **Answer**
:capillary refill, pulses, presence/absence of edema, TcpO2 levels (at least 40),
color of wound bed (bright pink/red), ABI for lower extremity ulcers, systolic
bp/episodes of hypotension, vasopressor administration
, **Question :How do you assess for immunosuppression? - **Answer**
:Comorbidities/therapies such as HIV, steroid tehrapy in doses >30mg/day for
>30 days, and/or chemo resulting in neutropenia; high dose NSAIDs
**Question :What comorbidities compromise wound healing? -
**Answer** :renal failure, liver failure, multisystem trauma, smoking,
advanced age
**Question :What are the layers of the skin - **Answer** :Epidermis
Basement Membrane Zone
Dermis
Subcutaneous Tissue
Muscle/Fascia/Bone
**Question :What are the layers of the epidermis? - **Answer** :Stratum
corneum - keratinocytes filled with keratin
Stratum lucidum - only in palms/soles, thick areas
Stratum granulosum - odland bodies secrete ceramides, lipophilic
Stratum spinosum - desmosomes (cell to cell junctions)
Stratum germinativum - dermal-epidermal junction
**Question :What is the Basement Membrane Zone? - **Answer**
:Dermal-epidermal junction
**Question :What are the components of the dermis? - **Answer**
:Papillary dermis: papillae interlock with rete ridges, capillary loops, sensitive
to point pressure
Reticular dermis: mostly type 1 collagen, vasculars, and lymphatics
**Question :What structures of the skin can regenerate? - **Answer**
:Epidermis and parts of the dermis
**Question :What structures of the skin heal by scar formation? -
**Answer** :Epidermal appendages, Subcutaneous tissue/fascia/muscle
, **Question :How is newborn skin different? - **Answer** :No scars up to
2nd trimester
30% thinner skin
Faster epidermal turnover
**Question :How is premature infant skin different? - **Answer** :Very
thin, increased fluid loss, functional stratum corneum at 30-32 weeks
**Question :What problems may arise with infant skin? - **Answer**
:increased permeability, increased MARSI risk, extravasation, diaper dermatitis
**Question :How do you mitigate MARSI risk in infants/elderly? -
**Answer** :avoid tape or use hydrocolloid base or silicone adhesive, no
alcohol removers only mineral oil, petroleum, silicone (preferred), and citrus)
**Question :How do you mitigate extravasation in an infant? - **Answer**
:Hyaluronidase
OR
phentolamine if vasoconstrictor
**Question :How do you mitigate diaper dermatitis? - **Answer** :Higher
pH
Use petroleum base for mild erythema and zinc oxide for denuded skin
sever denudation - carboxymethylcellulose/petrolatum/zinc oxide (Ilex)
**Question :What bathing considerations must you take for premature
infants? - **Answer** :<30 weeks bathe with water only for 2 weeks
**Question :What are common issues with older skin? - **Answer**
:Thinner, collagen shrinks and causes wrinkles
Rete ridges and dermal papillae flatten - increased risk for tears/stripping
Reduced sebaceous and sweat glands - dry skin
Erratic/decreased melanin production
Decreased sensation - increased trauma risk
Loss of SubQ tissue - increased shear and decreased insulation
Verified Solutions 100% Guaranteed Pass Latest
Update 2025
**Question :Goals of wound assessment - **Answer** :1. Determine
etiologic factors
2. Assess systemic factors/comorbidities
3. Assess wound to determine phase of healing
4. Determine goals of topical therapy
**Question :Why does hyperglycemia affect wound healing? - **Answer**
:Impairs leukocyte function and negatively impacts collagen syntehesis,
development of tensile strength, epithelial resurfacing
**Question :What BG parameters should be maintained for wound healing? -
**Answer** :BG <180 for leukocyte function; <140 for healing
A1C <7 for most, <8 if hx of severe hypoglycemia, advanced comorbidities,
limited life expectancy
**Question :Why is nutrition relevant to wound healing? - **Answer**
:Muscle or SubQ wasting increases risk of pressure/shear damage
malnourished pt unable to synthesize and cross-link collagen normally
protein deficiency increases risk of infection
**Question :What effect do low zinc levels have on wound healing? -
**Answer** :compromise collagen synthesis/crosslinking
**Question :What amino acids are essential for collagen synthesis?
What is the effect of stress on these amino acids? - **Answer** :Glutamine
and l-arginine
Not adequately produced during times of physiologic stress
,**Question :What weight trend suggests nutritional deficiency? -
**Answer** :Unplanned weight loss =>2.5% of usual weight in 30 days or
=>10% within 180 days
BMI <18.5
**Question :What serum albumin level indicates malnutrition? -
**Answer** :<3.5 g/dl
**Question :What serum transferrin level indicates malnutrition? -
**Answer** :<100mg/dl
**Question :What serum prealbumin level indicates malnutrition? -
**Answer** :<19.5
**Question :What total lymphocyte count level indicates malnutrition? -
**Answer** :<1500
**Question :What are s/s of nutritional deficits? - **Answer** :skin rashes,
cracks in mucous membranes, edema, muscle and subQ tissue wasting,
nonhealing wounds, dry/pluckable hair, dry flaky itchy skin
**Question :What is the suggested caloric intake? - **Answer** :30-35
cal/kg body weight
**Question :What is the suggested protein intake? - **Answer** :1.25-1.5
g/kg body weight
**Question :What is the suggested fluid intake? - **Answer** :30ml per kg
(unless fluid restriction indicated)
**Question :How do you assess perfusion/oxygenation? - **Answer**
:capillary refill, pulses, presence/absence of edema, TcpO2 levels (at least 40),
color of wound bed (bright pink/red), ABI for lower extremity ulcers, systolic
bp/episodes of hypotension, vasopressor administration
, **Question :How do you assess for immunosuppression? - **Answer**
:Comorbidities/therapies such as HIV, steroid tehrapy in doses >30mg/day for
>30 days, and/or chemo resulting in neutropenia; high dose NSAIDs
**Question :What comorbidities compromise wound healing? -
**Answer** :renal failure, liver failure, multisystem trauma, smoking,
advanced age
**Question :What are the layers of the skin - **Answer** :Epidermis
Basement Membrane Zone
Dermis
Subcutaneous Tissue
Muscle/Fascia/Bone
**Question :What are the layers of the epidermis? - **Answer** :Stratum
corneum - keratinocytes filled with keratin
Stratum lucidum - only in palms/soles, thick areas
Stratum granulosum - odland bodies secrete ceramides, lipophilic
Stratum spinosum - desmosomes (cell to cell junctions)
Stratum germinativum - dermal-epidermal junction
**Question :What is the Basement Membrane Zone? - **Answer**
:Dermal-epidermal junction
**Question :What are the components of the dermis? - **Answer**
:Papillary dermis: papillae interlock with rete ridges, capillary loops, sensitive
to point pressure
Reticular dermis: mostly type 1 collagen, vasculars, and lymphatics
**Question :What structures of the skin can regenerate? - **Answer**
:Epidermis and parts of the dermis
**Question :What structures of the skin heal by scar formation? -
**Answer** :Epidermal appendages, Subcutaneous tissue/fascia/muscle
, **Question :How is newborn skin different? - **Answer** :No scars up to
2nd trimester
30% thinner skin
Faster epidermal turnover
**Question :How is premature infant skin different? - **Answer** :Very
thin, increased fluid loss, functional stratum corneum at 30-32 weeks
**Question :What problems may arise with infant skin? - **Answer**
:increased permeability, increased MARSI risk, extravasation, diaper dermatitis
**Question :How do you mitigate MARSI risk in infants/elderly? -
**Answer** :avoid tape or use hydrocolloid base or silicone adhesive, no
alcohol removers only mineral oil, petroleum, silicone (preferred), and citrus)
**Question :How do you mitigate extravasation in an infant? - **Answer**
:Hyaluronidase
OR
phentolamine if vasoconstrictor
**Question :How do you mitigate diaper dermatitis? - **Answer** :Higher
pH
Use petroleum base for mild erythema and zinc oxide for denuded skin
sever denudation - carboxymethylcellulose/petrolatum/zinc oxide (Ilex)
**Question :What bathing considerations must you take for premature
infants? - **Answer** :<30 weeks bathe with water only for 2 weeks
**Question :What are common issues with older skin? - **Answer**
:Thinner, collagen shrinks and causes wrinkles
Rete ridges and dermal papillae flatten - increased risk for tears/stripping
Reduced sebaceous and sweat glands - dry skin
Erratic/decreased melanin production
Decreased sensation - increased trauma risk
Loss of SubQ tissue - increased shear and decreased insulation
