NPTE-PT Integumentary System and Wounds 4 — Questions and Answers
Question 1: A PT is treating a patient with a full-thickness burn to the anterior trunk and both anterior lower extremities. Using the Rule of Nines, what percentage of total body surface area (TBSA) is burned?
- 27%
- 36% (Correct answer)
- 45%
- 54%
Correct answer: 36%
The anterior trunk = 18% and each anterior lower extremity = 9% (×2 = 18%), totaling 36% TBSA using the Rule of Nines.
Question 2: Which type of scar results from excessive collagen deposition that extends beyond the original wound boundaries?
- Hypertrophic scar
- Keloid scar (Correct answer)
- Atrophic scar
- Contracture
Correct answer: Keloid scar
Keloid scars grow beyond the original wound margins into surrounding healthy tissue, unlike hypertrophic scars which remain within wound boundaries.
Question 3: A patient presents with a wound that has edges that are raised, rolled under (epibole), and not advancing across the wound bed. This indicates:
- Active wound healing progressing normally
- Chronic wound with rolled edges requiring intervention (Correct answer)
- Superficial wound requiring no treatment
- Newly formed epithelium migrating correctly
Correct answer: Chronic wound with rolled edges requiring intervention
Epibole (rolled wound edges) indicates a stalled chronic wound where epithelial cells have rolled under the edge and must be disrupted to allow healing.
Question 4: Which is the primary indication for negative pressure wound therapy (NPWT/VAC)?
- Infected wound with active osteomyelitis
- Large, complex wound with significant exudate requiring granulation tissue formation (Correct answer)
- Dry eschar on a heel with intact blood supply
- Superficial abrasion with minimal drainage
Correct answer: Large, complex wound with significant exudate requiring granulation tissue formation
NPWT is indicated for complex, high-exudate wounds to promote granulation tissue formation, reduce edema, and manage wound fluid.
Question 5: A second-degree partial-thickness burn is characterized by which finding?
- Dry, white, or charred appearance with no pain
- Blistering, moist, and extremely painful wound (Correct answer)
- Intact epidermis with erythema and pain
- Leathery, insensate wound extending into subcutaneous tissue
Correct answer: Blistering, moist, and extremely painful wound
Partial-thickness (second-degree) burns involve the epidermis and superficial dermis, presenting as blistered, moist, and intensely painful wounds.
Question 6: Which intervention is MOST appropriate to prevent pressure injury formation in a patient with complete spinal cord injury at T6?
- Repositioning every 4 hours
- Performing weight shifts every 15-30 minutes while in the wheelchair (Correct answer)
- Using a standard hospital foam mattress
- Elevating the head of bed to 90 degrees for 6 hours daily
Correct answer: Performing weight shifts every 15-30 minutes while in the wheelchair
Patients with SCI must perform frequent pressure relief (weight shifts) every 15-30 minutes to redistribute ischial pressure during prolonged sitting.
Question 7: During wound irrigation, which pressure range is recommended to effectively remove bacteria and debris without damaging granulation tissue?
- 1-4 psi
- 4-15 psi (Correct answer)
- 16-25 psi
- 26-35 psi
Correct answer: 4-15 psi
The recommended wound irrigation pressure is 4-15 psi, which is sufficient to remove debris without traumatizing fragile granulation tissue.
NPTE-PT Integumentary System and Wounds 4
A PT is treating a patient with a full-thickness burn to the anterior trunk and both anterior lower extremities.
Using the Rule of Nines, what percentage of total body surface area (TBSA) is burned?