WOUND CERTIFICATION Exam Study Questions 2025
Exam Questions and Corresponding Answers with
Surety of 100% Pass Mark.
what are 6 risk factor components of Braden Scale for pressure
ulcer?
sensory perception, moisture, mobility, activity, nutrition, and shear/friction
What is the name of the organization that developed the pressure
ulcer staging?
NPUAP (national pressure ulcer advisory panel)
pathological effect of excessive pressure on soft tissue can be
attributed by 3 factors? what are they?
tissue tolerance, duration of pressure, and intensity of pressure
what are the extrinsic factors that impact pressure ulcers?
increase in moisture, friction and shearing
how does friction play a role in shearing which eventually leads to
pressure ulcer?
friction alone causes only superfical abrasion, but with gravity it plays a
synergistic effect leading to shearing. When gravity pushes down on the
body and resistance (friction) between the patient and surface is exerted,
shearing occurs. because skin does not freely move, primary effect of
shearing occurs at the deeper fascial level.
what are the intrisinc factors of pressur ulcers?
nutritional debilitation, advanced age, low BP, stress, smoking, elevated
body temperature
Aging skin undergoes what elements affecting risk for pressure
ulcer?
dermoepidermal junction flattens, less nutrient exchange occurs, less
resistance to shearing, changes in sensory perception, loss of dermal
thickness, increased vascular fragility; ability of soft tisuse to distribute
mechanical load w/out comprosing blood flow is impaired
What does nonblanching erythema indicate in the skin r/t PU?
when pressure is applied to the erythematic area skin becomes white
(blanched), but once relieved, erythema returns -indicating blood flow;
,however in nonblanching erythema, skin does not blanche-indicating
impaired blood flow-suggesting tissue destructon
why does sitting in a chair pose more of a risk in skin break down
than lying?
deep tissue injury or PU is likely to occur sooner sitting down because
tissue offloading over boney prominences is higher
Describe what you will see in deep tissue injury?
purple or maroon localized area of discolored intact skin skinor blood filled
blister; may be preceded by painful, firm, mushy, or boggy; skin may be
warmer to cooler in adjacent tissue. In dark skin, thin blister or eschar over
a dark wound bed may bee seen
Describe stage I pressure ulcer?
Intact skin with nonblanchable redness of localized area. Will not see
blanching in dark skin, but changes in skin tissue consistency (firm vs
boggy when palpated), sensation (pain), and warmer or cooler temperature
may differ from surrounding area
Describe stage II pressure ulcer?
partial-thickness wound where epidermis and tip of dermis is lost with red-
pink wound bed w/out slough. may also present as intact or open/ruptured
serum -filled blister
Describe stage III pressure ulcer?
full-thickness wound where both epidermis and dermis is lost and
subcutaneous tissue may be visible, but deeper structures such as muscle,
bone, and tendon are not exposed; slough my be present but it doesn't
obscure depth and tunneling and undermining may be present
Describe stage IV pressure ulcer?
full-thickness wound with exposed bone,tendon, and muscle; slough or
eschar may be seen in some parts of the wound bed. you will often see
tunneling and undermining. Osteomyelitis may be dxed at this stage, since
bone is palpable
Describe unstageble ulcers?
full-thickness wound where base of the ulcer is covered by slough and/or
eschar, obscuring depth
When should eschars not be removed?
when it's stable with dry, adherent, and intact w/out erythema on the heel;
this serves as the body's natural cover and should not be removed.
, Therapeutic function of pressure distribution is accomplised by what
2 factors?
immersion and envelopement
Define immersion?
depth of penetration or skining into surgace allowing pressure to be spread
out over surrounding area rather than directly over boney prominence
Define envelopement?
is the ability of support surface to conform to irregularities without causing
substantial increase in pressure
what is bottoming out?
this occurs when depth of penetration or sinking is excessive, allowing
increased pressure to concentrate over boney prominences
what factors contribute to bottoming out?
weight, disproportion of weight and size such as amputation, tendency to
keep HOB >30 degrees, inappropriate support surface settings
When should you consider reactive support surface with features and
components such as low air loss, alternating pressure, viscous or air
fluids?
for patients who cannot effectively position off their wound, have PUs in
multiple turning surfaces, or have PUs that fail to improve despite optimal
comprehensive management
When should active support surface be considered?
when effective positioning is determined by an MD to be medically
contraindicated
What is the difference between an active and reactive support
surfaces/
active support surface is a powered mattress or overlay that changes it's
load- distribution with or without applied load; pressure is redistributed
across the body by inflating and deflating the cells of alternating zones.
conversely a reactive support surface moves or changes load-distribution
properties only in response to applied load, such as the patient's body.
When are active support surfaces appropriate?
when manual frequent repositioning is not possible
when are reactive support surfaces appropriate?
for pressure ulcer prevention
what is a benefit in low air loss feature and when is it
contraindicated?
Exam Questions and Corresponding Answers with
Surety of 100% Pass Mark.
what are 6 risk factor components of Braden Scale for pressure
ulcer?
sensory perception, moisture, mobility, activity, nutrition, and shear/friction
What is the name of the organization that developed the pressure
ulcer staging?
NPUAP (national pressure ulcer advisory panel)
pathological effect of excessive pressure on soft tissue can be
attributed by 3 factors? what are they?
tissue tolerance, duration of pressure, and intensity of pressure
what are the extrinsic factors that impact pressure ulcers?
increase in moisture, friction and shearing
how does friction play a role in shearing which eventually leads to
pressure ulcer?
friction alone causes only superfical abrasion, but with gravity it plays a
synergistic effect leading to shearing. When gravity pushes down on the
body and resistance (friction) between the patient and surface is exerted,
shearing occurs. because skin does not freely move, primary effect of
shearing occurs at the deeper fascial level.
what are the intrisinc factors of pressur ulcers?
nutritional debilitation, advanced age, low BP, stress, smoking, elevated
body temperature
Aging skin undergoes what elements affecting risk for pressure
ulcer?
dermoepidermal junction flattens, less nutrient exchange occurs, less
resistance to shearing, changes in sensory perception, loss of dermal
thickness, increased vascular fragility; ability of soft tisuse to distribute
mechanical load w/out comprosing blood flow is impaired
What does nonblanching erythema indicate in the skin r/t PU?
when pressure is applied to the erythematic area skin becomes white
(blanched), but once relieved, erythema returns -indicating blood flow;
,however in nonblanching erythema, skin does not blanche-indicating
impaired blood flow-suggesting tissue destructon
why does sitting in a chair pose more of a risk in skin break down
than lying?
deep tissue injury or PU is likely to occur sooner sitting down because
tissue offloading over boney prominences is higher
Describe what you will see in deep tissue injury?
purple or maroon localized area of discolored intact skin skinor blood filled
blister; may be preceded by painful, firm, mushy, or boggy; skin may be
warmer to cooler in adjacent tissue. In dark skin, thin blister or eschar over
a dark wound bed may bee seen
Describe stage I pressure ulcer?
Intact skin with nonblanchable redness of localized area. Will not see
blanching in dark skin, but changes in skin tissue consistency (firm vs
boggy when palpated), sensation (pain), and warmer or cooler temperature
may differ from surrounding area
Describe stage II pressure ulcer?
partial-thickness wound where epidermis and tip of dermis is lost with red-
pink wound bed w/out slough. may also present as intact or open/ruptured
serum -filled blister
Describe stage III pressure ulcer?
full-thickness wound where both epidermis and dermis is lost and
subcutaneous tissue may be visible, but deeper structures such as muscle,
bone, and tendon are not exposed; slough my be present but it doesn't
obscure depth and tunneling and undermining may be present
Describe stage IV pressure ulcer?
full-thickness wound with exposed bone,tendon, and muscle; slough or
eschar may be seen in some parts of the wound bed. you will often see
tunneling and undermining. Osteomyelitis may be dxed at this stage, since
bone is palpable
Describe unstageble ulcers?
full-thickness wound where base of the ulcer is covered by slough and/or
eschar, obscuring depth
When should eschars not be removed?
when it's stable with dry, adherent, and intact w/out erythema on the heel;
this serves as the body's natural cover and should not be removed.
, Therapeutic function of pressure distribution is accomplised by what
2 factors?
immersion and envelopement
Define immersion?
depth of penetration or skining into surgace allowing pressure to be spread
out over surrounding area rather than directly over boney prominence
Define envelopement?
is the ability of support surface to conform to irregularities without causing
substantial increase in pressure
what is bottoming out?
this occurs when depth of penetration or sinking is excessive, allowing
increased pressure to concentrate over boney prominences
what factors contribute to bottoming out?
weight, disproportion of weight and size such as amputation, tendency to
keep HOB >30 degrees, inappropriate support surface settings
When should you consider reactive support surface with features and
components such as low air loss, alternating pressure, viscous or air
fluids?
for patients who cannot effectively position off their wound, have PUs in
multiple turning surfaces, or have PUs that fail to improve despite optimal
comprehensive management
When should active support surface be considered?
when effective positioning is determined by an MD to be medically
contraindicated
What is the difference between an active and reactive support
surfaces/
active support surface is a powered mattress or overlay that changes it's
load- distribution with or without applied load; pressure is redistributed
across the body by inflating and deflating the cells of alternating zones.
conversely a reactive support surface moves or changes load-distribution
properties only in response to applied load, such as the patient's body.
When are active support surfaces appropriate?
when manual frequent repositioning is not possible
when are reactive support surfaces appropriate?
for pressure ulcer prevention
what is a benefit in low air loss feature and when is it
contraindicated?
