NPTE-PT Integumentary System and Wounds 3 — Questions and Answers
Question 1: A PT assesses a wound and notes tunneling at the 3 o'clock position extending 2 cm. How should this finding be documented according to standard wound assessment convention?
- Tunneling is present at 3 o'clock, 2 cm deep, measured with the patient supine, head = 12 o'clock (Correct answer)
- Undermining is present anteriorly extending 2 cm
- Tunneling 2 cm at the lateral border
- A sinus tract is located at the proximal aspect of the wound
Correct answer: Tunneling is present at 3 o'clock, 2 cm deep, measured with the patient supine, head = 12 o'clock
Standard wound documentation uses a clock-face orientation with the patient's head at 12 o'clock, and tunneling depth is recorded in centimeters.
Question 2: Which skin change is an early sign of deep tissue pressure injury (DTI)?
- Partial-thickness skin loss with serous exudate
- Purple or maroon intact skin that may be painful or boggy (Correct answer)
- Full-thickness wound with black eschar
- White, waxy slough with surrounding erythema
Correct answer: Purple or maroon intact skin that may be painful or boggy
Deep tissue pressure injury presents as an area of persistent purple or maroon discoloration of intact skin, indicating underlying soft tissue damage.
Question 3: A patient receiving radiation therapy develops radiodermatitis with moist desquamation. Which intervention is contraindicated?
- Gentle cleansing with saline
- Application of a non-adherent dressing
- Wet-to-dry gauze dressings (Correct answer)
- Maintaining a moist wound environment
Correct answer: Wet-to-dry gauze dressings
Wet-to-dry dressings are contraindicated in moist desquamation because removal causes trauma and further tissue damage to already fragile irradiated skin.
Question 4: Which ABCDE criterion for melanoma assessment refers to a lesion having two or more distinct colors?
- Asymmetry
- Border
- Color (Correct answer)
- Diameter
Correct answer: Color
The 'C' in the ABCDE melanoma screening criteria stands for Color variation, which includes multiple shades of brown, black, red, or white within a single lesion.
Question 5: A wound swab culture returns positive for Pseudomonas aeruginosa. Which clinical sign is most associated with this organism?
- Sulfur-yellow granules in the wound
- Blue-green exudate with a fruity odor (Correct answer)
- Black eschar with surrounding crepitus
- White, cottony surface growth
Correct answer: Blue-green exudate with a fruity odor
Pseudomonas aeruginosa characteristically produces blue-green (pyocyanin) pigmented exudate with a fruity or grape-like odor.
Question 6: Which phase of wound healing is characterized by formation of granulation tissue and angiogenesis?
- Hemostasis
- Inflammation
- Proliferation (Correct answer)
- Remodeling
Correct answer: Proliferation
The proliferative phase involves fibroblast migration, collagen synthesis, angiogenesis, and formation of granulation tissue to fill the wound defect.
Question 7: A patient with a venous leg ulcer has a resting ABI of 0.55. Which treatment is contraindicated?
- Elevation of the extremity
- High-compression bandaging (40 mmHg) (Correct answer)
- Moist wound dressings
- Gentle exercise program
Correct answer: High-compression bandaging (40 mmHg)
An ABI below 0.8 indicates significant arterial insufficiency; high-compression bandaging is contraindicated because it further reduces arterial blood flow.
NPTE-PT Integumentary System and Wounds 3
A PT assesses a wound and notes tunneling at the 3 o'clock position extending 2 cm.
How should this finding be documented according to standard wound assessment convention?