CWCN Practice Questions With Complete Solutions
The foot care nurse should describe the distal margin of superficial skin
extending over the base of the toenail as:
a. subungual
b. periungual
c. perionychium
d. eponychium Right Ans - d. eponychium
Which of the following is an example of mechanical debridement?
A. Using gauze moistened with 0.25% sodium hypochlorite solution and a
cover dressing
B. Applying saline moistened gauze to the wound bed and removing when dry
C. Cleansing with betadine and applying a thin layer of silver sulfadiazine
cream
D. Using saline to clean the wound and applying a thin film dressing Right
Ans - B. Applying saline moistened gauze to the wound bed and removing
when dry
A 58 year old gentleman presents to the outpatient wound clinic for a new
onset of scattered bullae to the upper arms, shoulder and a few areas on the
abdomen and trunk. The palmar surfaces of his hands are red. You note that
the intact skin is dry and has a "tight" texture. He has been seeing
dermatology for the past few years and states he is taking the tacrolimus
(Prograf®) as scheduled for the Graft vs. Host Disease (GVHD). Your plan of
wound care will include:
A. A hydrocolloid dressing
B. A referral to the Registered Dietician, RD
C. A non-adherent, absorptive dressing
D. Transparent film as the secondary dressing Right Ans - C. A non-
adherent, absorptive dressing
A patient with a right venous insufficiency leg ulcer returns to the clinic 2
weeks after initiating weekly compression therapy; the leg edema is markedly
reduced, but the patient continues to have a large amount of exudate. The
wound has enlarged, and there is increased periwound erythema extending 3
cm from the wound edge. What is the best wound care-management approach
at this point?
,A. Weekly sharp debridement
B. Apply silver nitrate
C. Increase the compression-dressing change frequency
D. Consider obtaining a wound culture Right Ans - D. Consider obtaining a
wound culture
Mr. Jones, 75, lives with his family at home. His BMI is 45. He has two stage IV
pressure ulcers; one on his left trochanter, and one on his sacrum. You are
developing the plan of care. You understand that, under Medicare guidelines,
your patient qualifies for a specialty surface. The best surface for Mr. Jones is:
A. A low air loss mattress replacement
B. A small-cell mattress overlay
C. An air-fluidized bed
D. A high-density foam mattress Right Ans - A. A low air loss mattress
replacement
You are assessing a patient's neuropathic swollen foot and notice that the 6
mm indentation of the left dorsal foot does not resolve after 1 minute. The
edema is graded at:
A. 4+
B. Weeping
C. 2+
D. 3+ Right Ans - D. 3+
A family member calls you to relay their concern that their mother's
abdominal incision has "popped open" and is draining a moderate amount of
clear yellow fluid. When you arrive at their home, you find that the central
area of the incision has opened without any evidence of tunneling,
undermining or evisceration. What is the most appropriate primary dressing?
A. Calcium alginate packing
B. Wet-to-dry gauze packing
C. Amorphous hydrogel
D. Enzymatic ointment Right Ans - A. Calcium alginate packing
A patient's chronic, nonhealing left neuropathic plantar ulcer appears stalled.
The patient has a history of a below-the-knee amputation (BKA) secondary to
osteomyelitis. You recommend the following adjunctive therapy in addition to
local wound care and offloading to prevent an additional major amputation:
A. Hyperbaric oxygen therapy (HBOT)
,B. Whirlpool treatments
c. A low-grade compression stocking
d. Total contact casting Right Ans - A. Hyperbaric oxygen therapy (HBOT)
A patient and her husband present to the clinic with a lateral lower leg ulcer.
The patient's Ankle Brachial Index (ABI) = 0.5. The spouse tells the clinician
that the wound has always healed in the past with an Unna Boot dressing on
the affected leg, changed weekly. You reply:
A. This will be an appropriate compression dressing to help the wound heal
B. The medicated zinc in the wrap is known to heal arterial ulcers
C. It is important to visualize the ulcer more than once a week
D. Zinc application to the periwound will help prevent infection Right Ans -
C. It is important to visualize the ulcer more than once a week
A 73-year-old patient presents with a weeping wound on the right leg gaiter
region with associated long-standing lower leg edema. The patient reports leg
pain that worsens during the day. In discussing treatment recommendations
with the patient, the CWCN provides education that:
A. Solo therapy with absorptive dressing is indicated.
B. Compression therapy assists with increased healing rates, improved
symptoms, and reduction of edema.
C. Limb elevation for extending periods throughout the day is the best method
for edema reduction
D. Pharmacotherapy with diuretics for fluid reduction is the best treatment
option for edema. Right Ans - B. Compression therapy assists with
increased healing rates, improved symptoms, and reduction of edema.
You suspect that a patient may have a wound infection. What is the best
technique to obtain a wound culture?
A. Flush the wound with sterile water followed by a 10-point swab covering
all the areas of the wound surface
B. Use a 19-gauge angiocatheter and a 10-cc syringe to aspirate purulent fluid
from the wound bed
C. Flush the wound with normal saline and swab 1 square cm of the viable
tissue with enough force to produce fluid
D. Clean the wound with providone iodine, then use a10-pt swab to cover all
the areas of the wound surface Right Ans - C. Flush the wound with normal
, saline and swab 1 square cm of the viable tissue with enough force to produce
fluid
A 73-year-old woman with irritable bowel hesitantly reports occasional bowel
leakage. Which of the following strategies can the Certified Continence Care
Nurse (CCCN) employ to help reduce her reluctance to share with her health
care team?
A. Suggest a referral to a psychologist.
B. Offer body-worn absorbent product information.
C. Communicate consistently and avoid blaming language.
D. Provide a handout of pelvic floor exercises. Right Ans - C. Offer body-
worn absorbent product information.
Comprehensive exam of a 50-year-old man with inflammatory bowel disease
reveals chronic diarrhea with occasional fecal incontinence. His International
Consultation on Incontinence Questionnaire-Bowel Symptoms (ICIQ-B)
indicates a poor quality-of-life related to fecal incontinence. Further interview
provides evidence that the patient's lifestyle may be contributing to his
incontinence. Which of the following information provided during the
interview would the continence nurse identify as a reversible risk factor for
this patient's fecal incontinence?
A. High fat diet
B. History of back injury
C. Use of body-worn absorbent products
D. Probiotics Right Ans - A. High Fat diet (known to increased GI motility &
Risk fo for fecal incontinence)
The APRN is consulted to evaluate a malodorous wound. What would be the
most appropriate treatment?
A. Fluconazole
B. Metronidazole
C. Miconazole
D. Minocycline Right Ans - B. Metronidazole ← Effective in controlling odor
by reducing the odor-producing anaerobic pathogens
- Wound odor← Often caused by Anaerobic pathogens in wound
- Odor← common w/ chronic wounds
The foot care nurse should describe the distal margin of superficial skin
extending over the base of the toenail as:
a. subungual
b. periungual
c. perionychium
d. eponychium Right Ans - d. eponychium
Which of the following is an example of mechanical debridement?
A. Using gauze moistened with 0.25% sodium hypochlorite solution and a
cover dressing
B. Applying saline moistened gauze to the wound bed and removing when dry
C. Cleansing with betadine and applying a thin layer of silver sulfadiazine
cream
D. Using saline to clean the wound and applying a thin film dressing Right
Ans - B. Applying saline moistened gauze to the wound bed and removing
when dry
A 58 year old gentleman presents to the outpatient wound clinic for a new
onset of scattered bullae to the upper arms, shoulder and a few areas on the
abdomen and trunk. The palmar surfaces of his hands are red. You note that
the intact skin is dry and has a "tight" texture. He has been seeing
dermatology for the past few years and states he is taking the tacrolimus
(Prograf®) as scheduled for the Graft vs. Host Disease (GVHD). Your plan of
wound care will include:
A. A hydrocolloid dressing
B. A referral to the Registered Dietician, RD
C. A non-adherent, absorptive dressing
D. Transparent film as the secondary dressing Right Ans - C. A non-
adherent, absorptive dressing
A patient with a right venous insufficiency leg ulcer returns to the clinic 2
weeks after initiating weekly compression therapy; the leg edema is markedly
reduced, but the patient continues to have a large amount of exudate. The
wound has enlarged, and there is increased periwound erythema extending 3
cm from the wound edge. What is the best wound care-management approach
at this point?
,A. Weekly sharp debridement
B. Apply silver nitrate
C. Increase the compression-dressing change frequency
D. Consider obtaining a wound culture Right Ans - D. Consider obtaining a
wound culture
Mr. Jones, 75, lives with his family at home. His BMI is 45. He has two stage IV
pressure ulcers; one on his left trochanter, and one on his sacrum. You are
developing the plan of care. You understand that, under Medicare guidelines,
your patient qualifies for a specialty surface. The best surface for Mr. Jones is:
A. A low air loss mattress replacement
B. A small-cell mattress overlay
C. An air-fluidized bed
D. A high-density foam mattress Right Ans - A. A low air loss mattress
replacement
You are assessing a patient's neuropathic swollen foot and notice that the 6
mm indentation of the left dorsal foot does not resolve after 1 minute. The
edema is graded at:
A. 4+
B. Weeping
C. 2+
D. 3+ Right Ans - D. 3+
A family member calls you to relay their concern that their mother's
abdominal incision has "popped open" and is draining a moderate amount of
clear yellow fluid. When you arrive at their home, you find that the central
area of the incision has opened without any evidence of tunneling,
undermining or evisceration. What is the most appropriate primary dressing?
A. Calcium alginate packing
B. Wet-to-dry gauze packing
C. Amorphous hydrogel
D. Enzymatic ointment Right Ans - A. Calcium alginate packing
A patient's chronic, nonhealing left neuropathic plantar ulcer appears stalled.
The patient has a history of a below-the-knee amputation (BKA) secondary to
osteomyelitis. You recommend the following adjunctive therapy in addition to
local wound care and offloading to prevent an additional major amputation:
A. Hyperbaric oxygen therapy (HBOT)
,B. Whirlpool treatments
c. A low-grade compression stocking
d. Total contact casting Right Ans - A. Hyperbaric oxygen therapy (HBOT)
A patient and her husband present to the clinic with a lateral lower leg ulcer.
The patient's Ankle Brachial Index (ABI) = 0.5. The spouse tells the clinician
that the wound has always healed in the past with an Unna Boot dressing on
the affected leg, changed weekly. You reply:
A. This will be an appropriate compression dressing to help the wound heal
B. The medicated zinc in the wrap is known to heal arterial ulcers
C. It is important to visualize the ulcer more than once a week
D. Zinc application to the periwound will help prevent infection Right Ans -
C. It is important to visualize the ulcer more than once a week
A 73-year-old patient presents with a weeping wound on the right leg gaiter
region with associated long-standing lower leg edema. The patient reports leg
pain that worsens during the day. In discussing treatment recommendations
with the patient, the CWCN provides education that:
A. Solo therapy with absorptive dressing is indicated.
B. Compression therapy assists with increased healing rates, improved
symptoms, and reduction of edema.
C. Limb elevation for extending periods throughout the day is the best method
for edema reduction
D. Pharmacotherapy with diuretics for fluid reduction is the best treatment
option for edema. Right Ans - B. Compression therapy assists with
increased healing rates, improved symptoms, and reduction of edema.
You suspect that a patient may have a wound infection. What is the best
technique to obtain a wound culture?
A. Flush the wound with sterile water followed by a 10-point swab covering
all the areas of the wound surface
B. Use a 19-gauge angiocatheter and a 10-cc syringe to aspirate purulent fluid
from the wound bed
C. Flush the wound with normal saline and swab 1 square cm of the viable
tissue with enough force to produce fluid
D. Clean the wound with providone iodine, then use a10-pt swab to cover all
the areas of the wound surface Right Ans - C. Flush the wound with normal
, saline and swab 1 square cm of the viable tissue with enough force to produce
fluid
A 73-year-old woman with irritable bowel hesitantly reports occasional bowel
leakage. Which of the following strategies can the Certified Continence Care
Nurse (CCCN) employ to help reduce her reluctance to share with her health
care team?
A. Suggest a referral to a psychologist.
B. Offer body-worn absorbent product information.
C. Communicate consistently and avoid blaming language.
D. Provide a handout of pelvic floor exercises. Right Ans - C. Offer body-
worn absorbent product information.
Comprehensive exam of a 50-year-old man with inflammatory bowel disease
reveals chronic diarrhea with occasional fecal incontinence. His International
Consultation on Incontinence Questionnaire-Bowel Symptoms (ICIQ-B)
indicates a poor quality-of-life related to fecal incontinence. Further interview
provides evidence that the patient's lifestyle may be contributing to his
incontinence. Which of the following information provided during the
interview would the continence nurse identify as a reversible risk factor for
this patient's fecal incontinence?
A. High fat diet
B. History of back injury
C. Use of body-worn absorbent products
D. Probiotics Right Ans - A. High Fat diet (known to increased GI motility &
Risk fo for fecal incontinence)
The APRN is consulted to evaluate a malodorous wound. What would be the
most appropriate treatment?
A. Fluconazole
B. Metronidazole
C. Miconazole
D. Minocycline Right Ans - B. Metronidazole ← Effective in controlling odor
by reducing the odor-producing anaerobic pathogens
- Wound odor← Often caused by Anaerobic pathogens in wound
- Odor← common w/ chronic wounds
