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EMORY WOUND EXAM 2 PREP 2026 ALL
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED WITH EXPERT FEEDBACK |NEW AND
REVISED
1. A patient has a wound on the dorsal foot with a pale, dry, “punched-out”
appearance, minimal exudate, and severe pain with elevation. Which etiology is
most likely?
A. Venous insufficiency
B. Arterial insufficiency
C. Diabetic neuropathic ulcer
D. Pressure injury
Rationale: Arterial ulcers are often located on the toes, dorsal foot, or heels; they
are pale, dry, well-demarcated, and painful, especially with elevation (ischemic
pain). Venous ulcers are typically on the gaiter area, moist, shallow, and
associated with edema.
2. A patient with a chronic venous leg ulcer has moderate exudate and surrounding
hyperpigmentation. What is the primary treatment goal?
A. Dry the wound completely
B. Compression therapy to reduce edema and improve venous return
C. Frequent debridement with a scalpel
D. Application of a hydrocolloid dressing
Rationale: The cornerstone of venous ulcer management is compression
(bandages or stockings) to counteract venous hypertension. Dressing selection is
secondary; debridement is performed as needed but not the primary goal.
3. What is the correct order of the phases of wound healing?
A. Proliferative, inflammatory, hemostasis, remodeling
B. Hemostasis, inflammatory, proliferative, remodeling
C. Inflammatory, hemostasis, remodeling, proliferative
D. Remodeling, hemostasis, inflammatory, proliferative
Rationale: Hemostasis occurs immediately after injury, followed by
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inflammatory phase (0–3 days), proliferative phase (3–21 days), and remodeling
(21 days to 1 year). Understanding the phases guides treatment timing.
4. A deep pressure injury on the heel is covered with black, hard, dry eschar. The
patient has no signs of infection and the heel is non-palpable. What is the most
appropriate initial management?
A. Surgical debridement of the eschar immediately
B. Leave the eschar intact as a natural cover if dry, stable, and without signs
of infection (unless over a pressure point)
C. Apply a moist wound dressing to soften the eschar
D. Use enzymatic debridement daily
Rationale: Dry, stable eschar on a heel should not be rem oved if there is no
infection or drainage; it acts as a natural cover. Debridement is indicated if the
eschar is unstable, draining, or over a pressure point (e.g., sacrum).
5. A patient with diabetes has a plantar foot ulcer. The nurse probes gently and
feels bone. This finding indicates:
A. Superficial wound only
B. Deep tissue involvement with possible osteomyelitis
C. A normal finding in diabetic ulcers
D. Granulation tissue formation
Rationale: Probe-to-bone is a strong predictor of osteomyelitis in diabetic foot
ulcers. Sensitivity is high; a positive test requires further imaging (X-ray/MRI)
and likely antibiotic therapy.
6. Which topical agent is contraindicated in clean, granulating wounds because it is
cytotoxic to fibroblasts?
A. Normal saline
B. Povidone-iodine (Betadine)
C. Silver sulfadiazine
D. Medical-grade honey
Rationale: Povidone-iodine and hydrogen peroxide are cytotoxic to healing cells
(fibroblasts, keratinocytes) and should be avoided on clean granulating tissue.
They may be used selectively for infected wounds or for short periods.
7. A patient has a wound with 100% yellow slough and moderate drainage. The
nurse should select which dressing?
A. Transparent film
B. Calcium alginate or hydrofiber (for absorption plus debridement)
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C. Hydrocolloid
D. Dry gauze
Rationale: Slough requires debridement. Calcium alginate or hydrofiber absorbs
exudate and can be used with a secondary dressing; they also help with autolytic
debridement. Gauze is not ideal for moist wound healing.
8. What is the hallmark sign of wound infection beyond local colonization?
A. Pain
B. Erythema
C. Warmth
D. Purulent drainage, malodor, friable granulation tissue, or wound
breakdown
Rationale: Local signs of infection include increased pain, erythema, edema,
heat, purulent discharge, malodor, and friable (bleeding) granulation tissue.
Systemic signs (fever, leukocytosis) may be absent in chronic wounds.
9. A patient has a pressure injury on the sacrum that is full-thickness with visible
subcutaneous fat but no muscle or bone. What is the correct stage?
A. Stage 2
B. Stage 3
C. Stage 4
D. Deep tissue injury
*Rationale: Stage 3 pressure injury: full-thickness skin loss with visible
subcutaneous fat but not exposing fascia, muscle, or bone. Stage 4 exposes bone or
muscle. Unstageable if covered by slough/eschar.*
10. Which finding is most characteristic of a diabetic neuropathic ulcer?
A. Located on the lateral malleolus
B. Located on the plantar surface of the foot, often with callus border
C. Associated with significant dependent edema
D. Punched-out appearance with pale base
Rationale: Neuropathic ulcers occur on pressure points of the foot (plantar
metatarsal heads, heel) and are often surrounded by callus. They are painless
due to neuropathy, unlike arterial ulcers which are painful.
11. A patient’s surgical wound has separated edges with a small amount of
serosanguinous drainage. The nurse should document this as:
A. Dehiscence
B. Partial dehiscence (or wound separation)
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C. Evisceration
D. Normal healing
Rationale: Dehiscence is the partial or complete separation of wound edges.
Evisceration is the protrusion of internal organs. Partial separation is a wound
complication requiring medical management.
12. Which of the following is an absolute contraindication to negative pressure
wound therapy (NPWT)?
A. Wound with moderate exudate
B. Non-healing surgical wound
C. Presence of necrotic tissue with eschar
D. Diabetic foot ulcer
Rationale: NPWT should not be applied over necrotic tissue or eschar without
prior debridement, as it will not adhere properly and can worsen infection. Other
contraindications include untreated osteomyelitis, malignancy in the wound, and
exposed vessels/nerves.
13. A patient with a venous ulcer has weeping edema around the wound. What is
the priority intervention?
A. Apply a hydrogel dressing
B. Prescribe oral antibiotics
C. Initiate multilayer compression bandaging
D. Perform surgical debridement
Rationale: Compression is the mainstay for venous ulcer management; it
reduces edema and improves venous return. Dressings and debridement are
adjunctive but not primary.
14. What is the optimal moisture level for wound healing?
A. Bone dry
B. Soaking wet
C. Moist, but not macerated
D. Covered with eschar
Rationale: A moist wound environment promotes granulation, epithelialization,
and autolytic debridement. Overly wet wounds cause maceration; dry wounds
cause desiccation and cell death.
15. A nurse is assessing a dark-skinned patient for early pressure injury. What
finding is most reliable?
A. Blanchable erythema
EMORY WOUND EXAM 2 PREP 2026 ALL
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED WITH EXPERT FEEDBACK |NEW AND
REVISED
1. A patient has a wound on the dorsal foot with a pale, dry, “punched-out”
appearance, minimal exudate, and severe pain with elevation. Which etiology is
most likely?
A. Venous insufficiency
B. Arterial insufficiency
C. Diabetic neuropathic ulcer
D. Pressure injury
Rationale: Arterial ulcers are often located on the toes, dorsal foot, or heels; they
are pale, dry, well-demarcated, and painful, especially with elevation (ischemic
pain). Venous ulcers are typically on the gaiter area, moist, shallow, and
associated with edema.
2. A patient with a chronic venous leg ulcer has moderate exudate and surrounding
hyperpigmentation. What is the primary treatment goal?
A. Dry the wound completely
B. Compression therapy to reduce edema and improve venous return
C. Frequent debridement with a scalpel
D. Application of a hydrocolloid dressing
Rationale: The cornerstone of venous ulcer management is compression
(bandages or stockings) to counteract venous hypertension. Dressing selection is
secondary; debridement is performed as needed but not the primary goal.
3. What is the correct order of the phases of wound healing?
A. Proliferative, inflammatory, hemostasis, remodeling
B. Hemostasis, inflammatory, proliferative, remodeling
C. Inflammatory, hemostasis, remodeling, proliferative
D. Remodeling, hemostasis, inflammatory, proliferative
Rationale: Hemostasis occurs immediately after injury, followed by
,2|P a g e
inflammatory phase (0–3 days), proliferative phase (3–21 days), and remodeling
(21 days to 1 year). Understanding the phases guides treatment timing.
4. A deep pressure injury on the heel is covered with black, hard, dry eschar. The
patient has no signs of infection and the heel is non-palpable. What is the most
appropriate initial management?
A. Surgical debridement of the eschar immediately
B. Leave the eschar intact as a natural cover if dry, stable, and without signs
of infection (unless over a pressure point)
C. Apply a moist wound dressing to soften the eschar
D. Use enzymatic debridement daily
Rationale: Dry, stable eschar on a heel should not be rem oved if there is no
infection or drainage; it acts as a natural cover. Debridement is indicated if the
eschar is unstable, draining, or over a pressure point (e.g., sacrum).
5. A patient with diabetes has a plantar foot ulcer. The nurse probes gently and
feels bone. This finding indicates:
A. Superficial wound only
B. Deep tissue involvement with possible osteomyelitis
C. A normal finding in diabetic ulcers
D. Granulation tissue formation
Rationale: Probe-to-bone is a strong predictor of osteomyelitis in diabetic foot
ulcers. Sensitivity is high; a positive test requires further imaging (X-ray/MRI)
and likely antibiotic therapy.
6. Which topical agent is contraindicated in clean, granulating wounds because it is
cytotoxic to fibroblasts?
A. Normal saline
B. Povidone-iodine (Betadine)
C. Silver sulfadiazine
D. Medical-grade honey
Rationale: Povidone-iodine and hydrogen peroxide are cytotoxic to healing cells
(fibroblasts, keratinocytes) and should be avoided on clean granulating tissue.
They may be used selectively for infected wounds or for short periods.
7. A patient has a wound with 100% yellow slough and moderate drainage. The
nurse should select which dressing?
A. Transparent film
B. Calcium alginate or hydrofiber (for absorption plus debridement)
,3|P a g e
C. Hydrocolloid
D. Dry gauze
Rationale: Slough requires debridement. Calcium alginate or hydrofiber absorbs
exudate and can be used with a secondary dressing; they also help with autolytic
debridement. Gauze is not ideal for moist wound healing.
8. What is the hallmark sign of wound infection beyond local colonization?
A. Pain
B. Erythema
C. Warmth
D. Purulent drainage, malodor, friable granulation tissue, or wound
breakdown
Rationale: Local signs of infection include increased pain, erythema, edema,
heat, purulent discharge, malodor, and friable (bleeding) granulation tissue.
Systemic signs (fever, leukocytosis) may be absent in chronic wounds.
9. A patient has a pressure injury on the sacrum that is full-thickness with visible
subcutaneous fat but no muscle or bone. What is the correct stage?
A. Stage 2
B. Stage 3
C. Stage 4
D. Deep tissue injury
*Rationale: Stage 3 pressure injury: full-thickness skin loss with visible
subcutaneous fat but not exposing fascia, muscle, or bone. Stage 4 exposes bone or
muscle. Unstageable if covered by slough/eschar.*
10. Which finding is most characteristic of a diabetic neuropathic ulcer?
A. Located on the lateral malleolus
B. Located on the plantar surface of the foot, often with callus border
C. Associated with significant dependent edema
D. Punched-out appearance with pale base
Rationale: Neuropathic ulcers occur on pressure points of the foot (plantar
metatarsal heads, heel) and are often surrounded by callus. They are painless
due to neuropathy, unlike arterial ulcers which are painful.
11. A patient’s surgical wound has separated edges with a small amount of
serosanguinous drainage. The nurse should document this as:
A. Dehiscence
B. Partial dehiscence (or wound separation)
, 4|P a g e
C. Evisceration
D. Normal healing
Rationale: Dehiscence is the partial or complete separation of wound edges.
Evisceration is the protrusion of internal organs. Partial separation is a wound
complication requiring medical management.
12. Which of the following is an absolute contraindication to negative pressure
wound therapy (NPWT)?
A. Wound with moderate exudate
B. Non-healing surgical wound
C. Presence of necrotic tissue with eschar
D. Diabetic foot ulcer
Rationale: NPWT should not be applied over necrotic tissue or eschar without
prior debridement, as it will not adhere properly and can worsen infection. Other
contraindications include untreated osteomyelitis, malignancy in the wound, and
exposed vessels/nerves.
13. A patient with a venous ulcer has weeping edema around the wound. What is
the priority intervention?
A. Apply a hydrogel dressing
B. Prescribe oral antibiotics
C. Initiate multilayer compression bandaging
D. Perform surgical debridement
Rationale: Compression is the mainstay for venous ulcer management; it
reduces edema and improves venous return. Dressings and debridement are
adjunctive but not primary.
14. What is the optimal moisture level for wound healing?
A. Bone dry
B. Soaking wet
C. Moist, but not macerated
D. Covered with eschar
Rationale: A moist wound environment promotes granulation, epithelialization,
and autolytic debridement. Overly wet wounds cause maceration; dry wounds
cause desiccation and cell death.
15. A nurse is assessing a dark-skinned patient for early pressure injury. What
finding is most reliable?
A. Blanchable erythema
