CWCN LATEST 2026 TEST PAPER QUESTIONS AND
SOLUTIONS RATED A+
✔✔becaplermin (Regranex) - ✔✔Peripheral diabetic ulcers can be treated with
______________________ if the ulcers extend into subcutaneous tissue or deeper with
adequate perfusion. This medication is a growth factor derived from human platelets.
✔✔malignancy - ✔✔becaplermin (Regranex) is contraindicated in pressure and stasis
ulcers, as well as sutured/stapled wounds. This medication is associated with increased
death from _________________.
✔✔hypergranulation - ✔✔Hydrocolloid dressings increase risk of anaerobic infection
and _____________________.
✔✔chemical cauterization - ✔✔This procedure is used to control minor bleeding, treat
hypertrophic or heavily contaminated granulation tissue or closed nonproliferative
wound edges.
✔✔False. - ✔✔True or False: Granulation tissue contains nerve endings
✔✔osteomyelitis - ✔✔A nonhealing or exposed bone in the wound bed and/ indicates
______________ and necessitates referral to the orthopedic surgeon and infectious
disease.
✔✔1-2 - ✔✔Enzymatic (chemical) debridement requires application of enzymes _____
times daily and is most effective for a wound with necrosis and eschar.
✔✔critical limb ischemia - ✔✔The following clinical indicators suggest ________
_______ ________________.
-ABI <0.4
-chronic rest pain
-ulcers or gangrene
-ankle pressure < 50 mm Hg
-TcPo2 < 30 mm Hg
✔✔Atrophie blanche - ✔✔a smooth, thin, white plaque with a hyperpigmented border,
often "speckled" with tortuous vessels, occurring near the ankle or foot. Indicates lower
extremity venous disease.
✔✔LEAD, vasculitis - ✔✔Purpura or petechiae are most often associated with which
disorders?
,✔✔intermittent claudication - ✔✔a symptom that describes muscle pain on mild exertion
(ache, cramp, numbness or sense of fatigue), classically in the calf muscle, which
occurs during exercise, such as walking, and is relieved by a short period of rest.
✔✔arterial - ✔✔intermittent claudication is associated with lower extremity
______________ disease. It typically stars when a vessel is more than 50% occluded.
✔✔vasculitis - ✔✔The general signs of ____________ are fever, myalgias, arthralgias,
and malaise. Patients may describe a vague, flulike illness. Peripheral neuropathy may
also be present.
✔✔Hydrocolloid - ✔✔This dressing forms a viscous gel in the wound bed, enhancing
moist wound healing and reducing local pH. It promotes autolysis of avascular tissue. It
is impermeable to fluids and semipermeable to gas and water vapor. It is indicated for
wounds without depth and low to moderate exudate, specifically for clean Stage II and
III pressure ulcers. It is not indicated for infected wounds.
✔✔collagen - ✔✔______________ dressings chemically bind to MMPs, reducing the
number of proteases in chronic wounds. They are nonadhesive, nonocclusive primary
dressings. They are indicated for full-thickness wounds with or without depth and non-
infected wounds. Can be used on granular or nonviable tissue, specifically Stage III or
IV pressure ulcers. Indicated for wounds with light to moderate exudate.
✔✔Apligraf - ✔✔Venous ulcers of over one month duration that have no responded to
standard care (infection control, debridement, compression, ect.) can be treated with
________________, an allogenic living cellular bilayered culture-tissue product.
✔✔Apligraf - ✔✔If a diabetic foot ulcer is of at least 3 weeks duration, extends through
the dermis without tendon/muscle/joint/bone exposure, and has not responded to
standard care, it is a candidate for treatment with _______________.
✔✔0.6-0.8 - ✔✔If a patient has mixed arterial-venous disease and an ABI between
______ and ______, reduced/modified compression therapy should be used (23-30 mm
Hg). This is to prevent increased ischemia in the limb.
✔✔color duplex ultrasonography - ✔✔________________________________ is the
gold standard of diagnosing venous disease.
✔✔biopsy - ✔✔If hypertrophic granulation tissue on a wound has not improved with
silver nitrate treatment, a ____________ should be taken.
✔✔lipedema - ✔✔A syndrome of bilateral adipose deposition almost always seen in
lower extremities of overweight/obese women. Usually presents with large/fatty legs or
buttocks and ends at the ankles. Nonpitting edema with negative Stemmer sign (except
at ankle). May also bring tenderness, aching, and bruising.
, ✔✔Stemmer's sign - ✔✔a thickened fold of skin at the base of the second toe or second
finger that can be gently pinched and lifted. The presence of this sign is most often an
early diagnostic indication of primary lymphedema; however, it can also develop later in
secondary lymphedema. A positive test result is present when this skin cannot be lifted.
This is considered to be an indication of the presence of lymphedema.
✔✔lymphedema - ✔✔Nonpitting edema with massive enlargement and distortion of
limb, plus a cobblestone-like texture, ulceration, induration, and a leathery appearance
of skin is indicative of ____________________.
✔✔mechanical - ✔✔_________________ debridement is contraindicated for pyoderma
gangrenosum.
✔✔troughing - ✔✔The application of a skin barrier wafer to the skin surrounding a
fistula and skin barrier paste to the edges, then placing a thin film dressing around the
fistula opening before applying an ostomy pouch. This is appropriate for fistulas in the
posterior aspect of an abdominal wound.
✔✔abscess - ✔✔A complex fistula Type 1 is associated with ___________ and multiple
organ involvement.
✔✔simple - ✔✔This type of fistula has a short, direct tract, no associated abscess, and
no other organ involvement.
✔✔Type 2 (enteroatmospheric fistula or EAF) - ✔✔A ____________ complex fistula
opens into the base of a disrupted wound.
✔✔sepsis - ✔✔What is the major cause of death in patients with enteric fistulas?
✔✔1 L - ✔✔Proton pump inhibitors are given to fistula patients to minimize intestinal
output. The goal is to achieve fistula output less than _______ per day and effluent pH
greater than 6.
✔✔Loperamide - ✔✔Medications that slow intestinal transit are the priority for reducing
fistula output. _____________ is the most effective medication and should be taken 30
minutes before meals if the patient is not NPO.
✔✔Octreotide - ✔✔________________ is a medication that may be used to inhibit
gastric, biliary, pancreatic, and salivary secretions and reduce GI motility when other
medications for fistulas have failed. It is usually given 3x/day subcutaneously.
✔✔trough - ✔✔When fistulas are contained within the depressions of a wound such that
a routine pouching system fails, a __________ procedure might be useful.
SOLUTIONS RATED A+
✔✔becaplermin (Regranex) - ✔✔Peripheral diabetic ulcers can be treated with
______________________ if the ulcers extend into subcutaneous tissue or deeper with
adequate perfusion. This medication is a growth factor derived from human platelets.
✔✔malignancy - ✔✔becaplermin (Regranex) is contraindicated in pressure and stasis
ulcers, as well as sutured/stapled wounds. This medication is associated with increased
death from _________________.
✔✔hypergranulation - ✔✔Hydrocolloid dressings increase risk of anaerobic infection
and _____________________.
✔✔chemical cauterization - ✔✔This procedure is used to control minor bleeding, treat
hypertrophic or heavily contaminated granulation tissue or closed nonproliferative
wound edges.
✔✔False. - ✔✔True or False: Granulation tissue contains nerve endings
✔✔osteomyelitis - ✔✔A nonhealing or exposed bone in the wound bed and/ indicates
______________ and necessitates referral to the orthopedic surgeon and infectious
disease.
✔✔1-2 - ✔✔Enzymatic (chemical) debridement requires application of enzymes _____
times daily and is most effective for a wound with necrosis and eschar.
✔✔critical limb ischemia - ✔✔The following clinical indicators suggest ________
_______ ________________.
-ABI <0.4
-chronic rest pain
-ulcers or gangrene
-ankle pressure < 50 mm Hg
-TcPo2 < 30 mm Hg
✔✔Atrophie blanche - ✔✔a smooth, thin, white plaque with a hyperpigmented border,
often "speckled" with tortuous vessels, occurring near the ankle or foot. Indicates lower
extremity venous disease.
✔✔LEAD, vasculitis - ✔✔Purpura or petechiae are most often associated with which
disorders?
,✔✔intermittent claudication - ✔✔a symptom that describes muscle pain on mild exertion
(ache, cramp, numbness or sense of fatigue), classically in the calf muscle, which
occurs during exercise, such as walking, and is relieved by a short period of rest.
✔✔arterial - ✔✔intermittent claudication is associated with lower extremity
______________ disease. It typically stars when a vessel is more than 50% occluded.
✔✔vasculitis - ✔✔The general signs of ____________ are fever, myalgias, arthralgias,
and malaise. Patients may describe a vague, flulike illness. Peripheral neuropathy may
also be present.
✔✔Hydrocolloid - ✔✔This dressing forms a viscous gel in the wound bed, enhancing
moist wound healing and reducing local pH. It promotes autolysis of avascular tissue. It
is impermeable to fluids and semipermeable to gas and water vapor. It is indicated for
wounds without depth and low to moderate exudate, specifically for clean Stage II and
III pressure ulcers. It is not indicated for infected wounds.
✔✔collagen - ✔✔______________ dressings chemically bind to MMPs, reducing the
number of proteases in chronic wounds. They are nonadhesive, nonocclusive primary
dressings. They are indicated for full-thickness wounds with or without depth and non-
infected wounds. Can be used on granular or nonviable tissue, specifically Stage III or
IV pressure ulcers. Indicated for wounds with light to moderate exudate.
✔✔Apligraf - ✔✔Venous ulcers of over one month duration that have no responded to
standard care (infection control, debridement, compression, ect.) can be treated with
________________, an allogenic living cellular bilayered culture-tissue product.
✔✔Apligraf - ✔✔If a diabetic foot ulcer is of at least 3 weeks duration, extends through
the dermis without tendon/muscle/joint/bone exposure, and has not responded to
standard care, it is a candidate for treatment with _______________.
✔✔0.6-0.8 - ✔✔If a patient has mixed arterial-venous disease and an ABI between
______ and ______, reduced/modified compression therapy should be used (23-30 mm
Hg). This is to prevent increased ischemia in the limb.
✔✔color duplex ultrasonography - ✔✔________________________________ is the
gold standard of diagnosing venous disease.
✔✔biopsy - ✔✔If hypertrophic granulation tissue on a wound has not improved with
silver nitrate treatment, a ____________ should be taken.
✔✔lipedema - ✔✔A syndrome of bilateral adipose deposition almost always seen in
lower extremities of overweight/obese women. Usually presents with large/fatty legs or
buttocks and ends at the ankles. Nonpitting edema with negative Stemmer sign (except
at ankle). May also bring tenderness, aching, and bruising.
, ✔✔Stemmer's sign - ✔✔a thickened fold of skin at the base of the second toe or second
finger that can be gently pinched and lifted. The presence of this sign is most often an
early diagnostic indication of primary lymphedema; however, it can also develop later in
secondary lymphedema. A positive test result is present when this skin cannot be lifted.
This is considered to be an indication of the presence of lymphedema.
✔✔lymphedema - ✔✔Nonpitting edema with massive enlargement and distortion of
limb, plus a cobblestone-like texture, ulceration, induration, and a leathery appearance
of skin is indicative of ____________________.
✔✔mechanical - ✔✔_________________ debridement is contraindicated for pyoderma
gangrenosum.
✔✔troughing - ✔✔The application of a skin barrier wafer to the skin surrounding a
fistula and skin barrier paste to the edges, then placing a thin film dressing around the
fistula opening before applying an ostomy pouch. This is appropriate for fistulas in the
posterior aspect of an abdominal wound.
✔✔abscess - ✔✔A complex fistula Type 1 is associated with ___________ and multiple
organ involvement.
✔✔simple - ✔✔This type of fistula has a short, direct tract, no associated abscess, and
no other organ involvement.
✔✔Type 2 (enteroatmospheric fistula or EAF) - ✔✔A ____________ complex fistula
opens into the base of a disrupted wound.
✔✔sepsis - ✔✔What is the major cause of death in patients with enteric fistulas?
✔✔1 L - ✔✔Proton pump inhibitors are given to fistula patients to minimize intestinal
output. The goal is to achieve fistula output less than _______ per day and effluent pH
greater than 6.
✔✔Loperamide - ✔✔Medications that slow intestinal transit are the priority for reducing
fistula output. _____________ is the most effective medication and should be taken 30
minutes before meals if the patient is not NPO.
✔✔Octreotide - ✔✔________________ is a medication that may be used to inhibit
gastric, biliary, pancreatic, and salivary secretions and reduce GI motility when other
medications for fistulas have failed. It is usually given 3x/day subcutaneously.
✔✔trough - ✔✔When fistulas are contained within the depressions of a wound such that
a routine pouching system fails, a __________ procedure might be useful.
