Wound Care Certification Exam Wound Care Certification Practice 4 — Questions and Answers
Question 1: Which nutritional marker is MOST sensitive for identifying malnutrition that may impair wound healing?
- Serum albumin
- Total lymphocyte count
- Serum prealbumin (transthyretin) (Correct answer)
- Serum transferrin
Correct answer: Serum prealbumin (transthyretin)
Prealbumin has a short half-life of 2–3 days, making it a more sensitive and responsive marker of recent nutritional status compared to albumin.
Question 2: A patient has a pressure injury with a wound that cannot be staged because the base is obscured by slough. This is classified as:
- Stage 3
- Stage 4
- Deep tissue pressure injury
- Unstageable pressure injury (Correct answer)
Correct answer: Unstageable pressure injury
When slough or eschar obscures the wound base, the depth — and therefore the stage — cannot be determined, making it unstageable.
Question 3: Which intervention is MOST effective in reducing peak plantar pressure to prevent diabetic foot ulcer recurrence?
- Standard athletic footwear
- Total contact casting (TCC) (Correct answer)
- Removable cast walker
- Accommodative insoles alone
Correct answer: Total contact casting (TCC)
Total contact casting is the gold standard for offloading diabetic plantar neuropathic ulcers because it is non-removable and redistributes pressure optimally.
Question 4: Periwound erythema, warmth, induration, and pain extending more than 2 cm from the wound edge BEST describe:
- Normal inflammatory phase
- Wound colonization
- Cellulitis requiring systemic antibiotics (Correct answer)
- Wound critical colonization
Correct answer: Cellulitis requiring systemic antibiotics
These classic signs of spreading infection beyond the wound edge define cellulitis, which requires systemic antibiotic treatment.
Question 5: A patient with a spinal cord injury is at HIGH risk for pressure injuries primarily due to:
- Increased skin moisture from diaphoresis
- Loss of protective sensation and impaired mobility (Correct answer)
- Malnutrition from dysphagia
- Arterial insufficiency from autonomic dysreflexia
Correct answer: Loss of protective sensation and impaired mobility
Loss of sensory feedback means the patient cannot feel pain from sustained pressure, and impaired mobility prevents spontaneous repositioning.
Question 6: The BEST evidence-based repositioning schedule to prevent hospital-acquired pressure injuries in a high-risk patient is:
- Every 4 hours on a standard mattress
- Every 2 hours with documented position changes (Correct answer)
- Every 1 hour when using a pressure-redistribution mattress
- Repositioning only when patient requests it
Correct answer: Every 2 hours with documented position changes
Every-2-hour repositioning with documentation is the standard of care supported by NPUAP/EPUAP guidelines for high-risk patients.
Question 7: Which type of wound closure is MOST appropriate for a contaminated traumatic wound presenting 18 hours after injury?
- Primary intention (immediate closure)
- Secondary intention (allowing to heal open)
- Delayed primary closure (Correct answer)
- Tissue adhesive application
Correct answer: Delayed primary closure
Delayed primary closure (closing after 4–5 days of open observation) reduces infection risk in contaminated wounds presenting beyond the golden period.
Wound Care Certification Exam Wound Care Certification Practice 4
Which nutritional marker is MOST sensitive for identifying malnutrition that may impair wound healing?