wound certification exam 2026 Questions
and Answers
what are 6 risk factor components of Braden Scale for pressure ulcer? - Correct
answer-sensory perception, moisture, mobility, activity, nutrition, and shear/friction
What is the name of the organization that developed the pressure ulcer staging? -
Correct answer-NPUAP (national pressure ulcer advisory panel)
pathological effect of excessive pressure on soft tissue can be attributed by 3
factors? what are they? - Correct answer-tissue tolerance, duration of pressure, and
intensity of pressure
what are the extrinsic factors that impact pressure ulcers? - Correct answer-
increase in moisture, friction and shearing
how does friction play a role in shearing which eventually leads to pressure ulcer?
- Correct answer-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
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,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? - Correct answer-nutritional
debilitation, advanced age, low BP, stress, smoking, elevated body temperature
Aging skin undergoes what elements affecting risk for pressure ulcer? - Correct
answer-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? - Correct answer-
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? -
Correct answer-deep tissue injury or PU is likely to occur sooner sitting down
because tissue offloading over boney prominences is higher
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,Describe what you will see in deep tissue injury? - Correct answer-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? - Correct answer-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? - Correct answer-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? - Correct answer-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? - Correct answer-full-thickness wound with
exposed bone,tendon, and muscle; slough or eschar may be seen in some parts of
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, the wound bed. you will often see tunneling and undermining. Osteomyelitis may
be dxed at this stage, since bone is palpable
Describe unstageble ulcers? - Correct answer-full-thickness wound where base of
the ulcer is covered by slough and/or eschar, obscuring depth
When should eschars not be removed? - Correct answer-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? -
Correct answer-immersion and envelopement
Define immersion? - Correct answer-depth of penetration or skining into surgace
allowing pressure to be spread out over surrounding area rather than directly over
boney prominence
Define envelopement? - Correct answer-is the ability of support surface to conform
to irregularities without causing substantial increase in pressure
what is bottoming out? - Correct answer-this occurs when depth of penetration or
sinking is excessive, allowing increased pressure to concentrate over boney
prominences
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and Answers
what are 6 risk factor components of Braden Scale for pressure ulcer? - Correct
answer-sensory perception, moisture, mobility, activity, nutrition, and shear/friction
What is the name of the organization that developed the pressure ulcer staging? -
Correct answer-NPUAP (national pressure ulcer advisory panel)
pathological effect of excessive pressure on soft tissue can be attributed by 3
factors? what are they? - Correct answer-tissue tolerance, duration of pressure, and
intensity of pressure
what are the extrinsic factors that impact pressure ulcers? - Correct answer-
increase in moisture, friction and shearing
how does friction play a role in shearing which eventually leads to pressure ulcer?
- Correct answer-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
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,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? - Correct answer-nutritional
debilitation, advanced age, low BP, stress, smoking, elevated body temperature
Aging skin undergoes what elements affecting risk for pressure ulcer? - Correct
answer-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? - Correct answer-
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? -
Correct answer-deep tissue injury or PU is likely to occur sooner sitting down
because tissue offloading over boney prominences is higher
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,Describe what you will see in deep tissue injury? - Correct answer-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? - Correct answer-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? - Correct answer-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? - Correct answer-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? - Correct answer-full-thickness wound with
exposed bone,tendon, and muscle; slough or eschar may be seen in some parts of
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, the wound bed. you will often see tunneling and undermining. Osteomyelitis may
be dxed at this stage, since bone is palpable
Describe unstageble ulcers? - Correct answer-full-thickness wound where base of
the ulcer is covered by slough and/or eschar, obscuring depth
When should eschars not be removed? - Correct answer-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? -
Correct answer-immersion and envelopement
Define immersion? - Correct answer-depth of penetration or skining into surgace
allowing pressure to be spread out over surrounding area rather than directly over
boney prominence
Define envelopement? - Correct answer-is the ability of support surface to conform
to irregularities without causing substantial increase in pressure
what is bottoming out? - Correct answer-this occurs when depth of penetration or
sinking is excessive, allowing increased pressure to concentrate over boney
prominences
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
