Wound Care Certification Exam Wound Care Certification Lower Extremity Wound Management 2 — Questions and Answers
Question 1: Which compression system is considered the gold standard for venous leg ulcer treatment?
- Short-stretch bandage applied alone
- Four-layer compression bandage system (Charing Cross regimen) (Correct answer)
- Class I elastic stockings providing 15–20 mmHg
- Intermittent pneumatic compression device only
Correct answer: Four-layer compression bandage system (Charing Cross regimen)
The four-layer compression bandage system delivers sustained 40 mmHg compression at the ankle and has the strongest evidence base for venous leg ulcer healing.
Question 2: Compression therapy is CONTRAINDICATED in which clinical scenario?
- ABI of 0.85 with a venous leg ulcer and moderate edema
- ABI of 0.45 with a venous leg ulcer and significant edema (Correct answer)
- Bilateral leg edema from chronic venous insufficiency
- Periwound skin maceration from excessive wound exudate
Correct answer: ABI of 0.45 with a venous leg ulcer and significant edema
Compression is contraindicated when ABI is below 0.5–0.6 because the arterial perfusion pressure is too compromised; added external pressure would critically worsen ischemia.
Question 3: What is the primary therapeutic mechanism of compression therapy in venous leg ulcer management?
- Reduction of wound bioburden and infection risk
- Counteracting venous hypertension by promoting venous return and reducing edema (Correct answer)
- Stimulating granulation tissue and angiogenesis
- Preventing wound contamination from external pathogens
Correct answer: Counteracting venous hypertension by promoting venous return and reducing edema
Compression therapy directly addresses the underlying pathophysiology by countering venous hypertension, improving venous return, and reducing edema that impairs wound healing.
Question 4: Which wound characteristic best differentiates a diabetic neuropathic ulcer from an arterial ulcer?
- Pale wound bed with minimal exudate and necrotic base
- Located on the plantar surface at bony pressure points with surrounding callus (Correct answer)
- Severe pain that worsens with limb elevation
- Associated with absent pedal pulses and dependent rubor
Correct answer: Located on the plantar surface at bony pressure points with surrounding callus
Neuropathic diabetic ulcers characteristically occur on plantar pressure points and are surrounded by callus from undetected repetitive trauma due to loss of protective sensation.
Question 5: The Semmes-Weinstein 5.07 (10-gram) monofilament test is used to assess which clinical finding in diabetic patients?
- Adequacy of arterial perfusion in the lower extremity
- Presence or absence of protective sensation (Correct answer)
- Competence of venous valves in the lower leg
- Wound depth and presence of undermining or tunneling
Correct answer: Presence or absence of protective sensation
The 5.07 monofilament test detects loss of protective sensation (LOPS); inability to feel the 10-gram filament identifies patients at high risk for neuropathic ulcers.
Question 6: Which dressing strategy is most appropriate for a venous leg ulcer with moderate exudate?
- Dry gauze dressing changed daily with compression over it
- Absorbent foam dressing under compression bandaging (Correct answer)
- Hydrocolloid dressing applied without compression
- Calcium alginate dressing applied without compression
Correct answer: Absorbent foam dressing under compression bandaging
Foam dressings effectively manage moderate exudate, are compatible with compression bandaging, and together the combination addresses both wound moisture balance and venous hypertension.
Question 7: Regular callus debridement around a diabetic neuropathic ulcer is performed primarily to:
- Reduce infection risk by eliminating bacterial reservoirs
- Redistribute pressure, stimulate wound edge healing, and remove healing barriers (Correct answer)
- Eliminate the patient's need for offloading footwear
- Remove all periwound tissue for better wound visualization
Correct answer: Redistribute pressure, stimulate wound edge healing, and remove healing barriers
Callus debridement redistributes concentrated plantar pressure, converts the chronic wound edge to an acute state to enable epithelial migration, and removes physical barriers to healing.
Wound Care Certification Exam Wound Care Certification Lower Extremity Wound Management 2
Which compression system is considered the gold standard for venous leg ulcer treatment?