NCWO Wound Care Management 2 — Questions and Answers
Question 1: Enzymatic debridement agents such as collagenase work by:
- Absorbing necrotic tissue with high exudate capacity
- Digesting collagen fibers anchoring necrotic tissue to the wound bed (Correct answer)
- Rehydrating eschar to allow mechanical removal
- Killing bacteria in the wound biofilm
Correct answer: Digesting collagen fibers anchoring necrotic tissue to the wound bed
Collagenase enzymatically cleaves the collagen strands that anchor devitalized tissue to the wound bed, selectively dissolving the necrotic material.
Question 2: When applying a silver-containing dressing to a wound, the nurse should be aware that:
- Silver dressings should be used continuously for months without reassessment
- Silver should be discontinued once signs of infection resolve to prevent resistance or toxicity (Correct answer)
- Silver dressings must be moistened with normal saline before every use
- Silver is safe and indicated for all wound types including clean healing wounds
Correct answer: Silver should be discontinued once signs of infection resolve to prevent resistance or toxicity
Silver dressings should be used for a defined treatment course (typically 2–4 weeks) and discontinued when infection signs resolve to avoid silver toxicity and unnecessary cost.
Question 3: The primary goal of compression therapy for venous leg ulcers is to:
- Prevent arterial occlusion in the lower extremity
- Counteract venous hypertension and promote venous return (Correct answer)
- Reduce wound bioburden and infection risk
- Immobilize the ankle to decrease shear forces
Correct answer: Counteract venous hypertension and promote venous return
Compression therapy applies sustained external pressure to overcome venous hypertension, improving venous return and reducing edema that impairs healing.
Question 4: A foam dressing is most appropriate for a wound with:
- Minimal to no exudate and a dry eschar
- Moderate to heavy exudate and a granulating wound bed (Correct answer)
- Exposed bone or tendon requiring a protective barrier
- A heavily infected wound requiring antimicrobial action
Correct answer: Moderate to heavy exudate and a granulating wound bed
Foam dressings have high absorptive capacity and are ideal for wounds producing moderate to heavy exudate while maintaining a moist healing environment.
Question 5: Hyperbaric oxygen therapy (HBOT) for wound healing works by:
- Directly killing anaerobic bacteria through oxidation
- Increasing dissolved oxygen in plasma to hypoxic tissues and stimulating angiogenesis (Correct answer)
- Reducing wound biofilm through pressure changes
- Enhancing antibiotic absorption in wound tissue
Correct answer: Increasing dissolved oxygen in plasma to hypoxic tissues and stimulating angiogenesis
HBOT raises dissolved plasma oxygen levels, delivering oxygen to ischemic tissues and stimulating angiogenesis, collagen synthesis, and antimicrobial leukocyte activity.
Question 6: Maggot debridement therapy (MDT) is most beneficial for wounds containing:
- Dry, hard eschar on a heel
- Soft, moist, necrotic slough with suspected biofilm (Correct answer)
- Exposed bone requiring osteomyelitis treatment
- Clean granulating tissue near closure
Correct answer: Soft, moist, necrotic slough with suspected biofilm
Medical-grade maggots debride soft necrotic tissue and slough while secreting antimicrobial compounds that disrupt bacterial biofilm.
NCWO Wound Care Management 2
Enzymatic debridement agents such as collagenase work by: