Wound Care Certification Exam Wound Care Certification Practice 3 — Questions and Answers
Question 1: A patient receiving negative pressure wound therapy (NPWT) develops sudden bright red blood in the drainage tubing. The FIRST action the wound care clinician should take is:
- Decrease the negative pressure setting
- Irrigate the wound with saline
- Discontinue NPWT and apply direct pressure (Correct answer)
- Notify the physician and continue monitoring
Correct answer: Discontinue NPWT and apply direct pressure
Sudden bright red blood signals active hemorrhage; NPWT must be stopped immediately and direct pressure applied to control bleeding before any other action.
Question 2: Which statement BEST describes the role of matrix metalloproteinases (MMPs) in chronic wounds?
- MMPs are elevated and cause excessive degradation of the extracellular matrix, impairing healing (Correct answer)
- MMPs are absent in chronic wounds, preventing collagen remodeling
- MMPs promote angiogenesis as their primary function
- MMPs are responsible for epithelialization across the wound surface
Correct answer: MMPs are elevated and cause excessive degradation of the extracellular matrix, impairing healing
Chronic wounds have elevated MMP levels that degrade growth factors, collagen, and fibronectin, creating a proteolytic environment that impedes healing.
Question 3: For a venous leg ulcer, the MINIMUM ankle-brachial index (ABI) generally required before applying full compression (40 mmHg) is:
- 0.4
- 0.6
- 0.8 (Correct answer)
- 1.0
Correct answer: 0.8
An ABI of 0.8 or above is the accepted threshold for safe application of full therapeutic compression therapy for venous ulcers.
Question 4: A wound with 100% black eschar on the heel of an immobile patient should initially be treated by:
- Immediate sharp debridement at bedside
- Applying moisture to soften and remove the eschar
- Leaving it intact and monitoring for signs of infection (Correct answer)
- Applying an enzymatic debrider immediately
Correct answer: Leaving it intact and monitoring for signs of infection
Stable, dry, non-infected heel eschar should be left intact per NPUAP/EPUAP guidelines, as it serves as the body's natural cover over an ischemic area.
Question 5: Which wound bed preparation concept is captured by the acronym TIME?
- Tissue, Infection/Inflammation, Moisture, Edge (Correct answer)
- Temperature, Inflammation, Moisture, Exudate
- Tissue, Ischemia, Maceration, Epithelialization
- Texture, Infection, Moisture, Evaluation
Correct answer: Tissue, Infection/Inflammation, Moisture, Edge
TIME stands for Tissue (non-viable), Infection/Inflammation, Moisture imbalance, and Edge (non-advancing or undermined), guiding wound bed preparation.
Question 6: Hyperbaric oxygen therapy (HBOT) is MOST indicated for which wound type?
- Stage 2 pressure injury in a healthy patient
- Diabetic foot ulcer with compromised tissue perfusion unresponsive to standard care (Correct answer)
- Venous leg ulcer with adequate ABI
- Superficial partial-thickness burn
Correct answer: Diabetic foot ulcer with compromised tissue perfusion unresponsive to standard care
HBOT is evidence-supported for Wagner Grade 3+ diabetic foot ulcers with hypoxic tissue that fails to respond to standard wound care.
Question 7: When assessing wound depth using a cotton-tipped applicator, the clinician identifies that the probe contacts bone. This finding most likely indicates:
- Stage 3 pressure injury
- Unstageable pressure injury
- Suspected osteomyelitis requiring further evaluation (Correct answer)
- Deep tissue pressure injury
Correct answer: Suspected osteomyelitis requiring further evaluation
A positive probe-to-bone test is highly predictive of osteomyelitis and should prompt further workup including imaging and possible bone biopsy.
Wound Care Certification Exam Wound Care Certification Practice 3
A patient receiving negative pressure wound therapy (NPWT) develops sudden bright red blood in the drainage tubing.
The FIRST action the wound care clinician should take is: