EMORY WOUND EXAM #1 COMPREHENSIVE REVIEW: SKIN ANATOMY, PRESSURE INJURIES, WOUND HEALING & MANAGEMENT 200+ PRACTICE QUESTIONS WITH DETAILED EXPLANATIONS 2026/2027

EMORY WOUND EXAM #1 COMPREHENSIVE REVIEW: SKIN ANATOMY, PRESSURE INJURIES, WOUND HEALING & MANAGEMENT 200+ PRACTICE QUESTIONS WITH DETAILED EXPLANATIONS 1. Which structure of the skin provides the body with photoprotective properties by absorbing harmful UV light? A. Langerhans cells B. Stratum lucidum C. Melanin D. Odland bodies Correct Answer: C. Melanin Explanation: Melanin is the pigment produced by melanocytes that absorbs harmful UV radiation, protecting the skin from DNA damage. Langerhans cells provide immune function, Odland bodies (lamellar bodies) release lipids for barrier function, and stratum lucidum is a clear layer found only in thick skin. ________________________________________ 2. A WCN is assessing a patient whose wounds were caused by external factors. Which of the following is an example of this type of injury? A. Venous Leg Ulcer B. Eczema C. Malignant Wound D. Pressure Injury Correct Answer: D. Pressure Injury Explanation: Pressure injuries result from mechanical factors including friction, shear, pressure, and moisture—all external forces. Venous leg ulcers, eczema, and malignant wounds have underlying internal or systemic etiologies rather than purely external mechanical causes. ________________________________________ 3. What is the best descriptor of tissue damage caused by shear strain? A. Edema caused by impaired lymphatic function resulting from unrelieved pressure B. SQ tissue damaged by distortion of blood vessels C. Superficial skin loss caused by separation of epidermal and dermal layers D. Tissue compression caused by sustained pressure Correct Answer: B. SQ tissue damaged by distortion of blood vessels Explanation: Shear strain disrupts blood vessels from deeper structures, causing deep tissue injury (DTI) as occurs with pressure injuries. This distortion of vasculature compromises blood flow to subcutaneous tissues, leading to ischemic damage that may not be visible on the skin surface initially. ________________________________________ 4. Which type of wounds develop at the muscle-bone interface? A. Friction wounds B. Wounds caused by intertriginous dermatitis C. Incontinence wounds D. Pressure injuries Correct Answer: D. Pressure injuries Explanation: Pressure injuries typically begin at the muscle-bone interface where tissue compression is greatest, particularly over bony prominences. The damage progresses outward toward the skin surface, which is why pressure injuries are often full-thickness wounds by the time they become visible. ________________________________________ 5. What is the initial effect of sustained pressure on a body part? A. Tissue necrosis B. Tissue deformation C. Tissue loss D. Tissue remodeling Correct Answer: B. Tissue deformation Explanation: Sustained pressure initially causes tissue deformation as soft tissues are compressed between bone and an external surface. This deformation leads to microvascular occlusion, ischemia, and ultimately necrosis if pressure is not relieved. Tissue remodeling and loss are later consequences. ________________________________________ 6. What is the driving force for the collection of data regarding facility-acquired PIs? A. Minimizing staff workload B. Patient satisfaction C. Quality indicators D. Infection control Correct Answer: C. Quality indicators Explanation: Benchmarking of facility-acquired pressure injury rates reflects quality of care and identifies opportunities for improvement. This data is used for quality reporting, regulatory compliance, and performance improvement initiatives rather than primarily for patient satisfaction, infection control, or workload management. ________________________________________ 7. A WCN documents a wound as being of mixed etiology. What is the nurse describing? A. Patient positioning affected the development of the wound B. The wound is limited to the superficial skin and tissue layers C. Features of both superficial and deeper injury are manifested D. Patient history reveals exposure to only one mechanical stressor Correct Answer: C. Features of both superficial and deeper injury are manifested Explanation: Mixed etiology wounds show characteristics of both superficial skin loss (such as from friction or moisture) and evidence of deeper tissue damage (such as from pressure or shear). This often occurs when multiple mechanical stressors affect the same anatomical location. ________________________________________ 8. Which assessment parameter is of greatest value to differential assessment of wounds? A. Type of eschar involved B. Indicators of pressure vs indicators of maceration or friction C. Wound size D. Indicators of infected vs noninfected wounds Correct Answer: B. Indicators of pressure vs indicators of maceration or friction Explanation: Determining the source of injury is the most critical parameter in differential wound assessment. Differentiating between pressure-related damage, maceration, friction injuries, and other etiologies guides appropriate treatment selection and prevention strategies. ________________________________________ 9. Which condition might the WCN observe as an indicator of pressure injury? A. Edema B. Purple discoloration C. Maceration of surrounding tissue D. Excessive granulation tissue Correct Answer: B. Purple discoloration Explanation: Purple or maroon discoloration indicates deep tissue injury caused by ischemia from sustained pressure. This non-blanchable discoloration represents damage to underlying soft tissues and is a key indicator of pressure injury, particularly deep tissue pressure injuries (DTPI). ________________________________________ 10. Which of the following statements accurately describes how the skin functions as a barrier between the internal and external environments? A. Merkel receptors embedded in the eECM contribute to the mechanical rigidity and frictional resistance protection of the skin B. Protection against pathogenic invasion is supported by an acidic pH of the skin C. The skin lipids bind water, normally maintaining skin water content at 20% or higher D. When the barrier function of the skin is compromised, transepidermal water loss (TEWL) decreases Correct Answer: B. Protection against pathogenic invasion is supported by an acidic pH of the skin Explanation: The skin's acidic pH (acid mantle) inhibits pathogenic bacterial growth and supports the skin's immune barrier function. TEWL actually increases when barrier function is compromised, not decreases. Skin lipids help maintain moisture but water content is typically 10-20% in the stratum corneum. ________________________________________ 11. The WCN assessing the skin of patients in a nursing home keeps in mind the structural changes that occur in aging skin. What is one of these changes? A. Decrease in collagen B. Rounding of dermal-epidermal junction C. Increase in melanocytes D. Increase in Mast Cells Correct Answer: A. Decrease in collagen