Wound care Certification
- 1.
A 75 year old female developed a dehisced wound following abdominal surgery for a bowel obstruction. She weighs 150 pounds and had chemotherapy and adbdominal radiation for colon cancer 5 years ago. Which of the following conditions best explains what placed her at risk for developing a wound dehiscience?
- A.
Blood glucose levels ranging form 90-150
- B.
Performing a surgical procedure in a previously irradiated area
- C.
A prealbumin level of 28
- D.
Her history of chemotherapy
Correct Answer
B. Performing a surgical procedure in a previously irradiated area -
- 2.
Patient undergoing myocutaneous flap closure of a pressure ulcer are best managed in the initial postoperative period on what type of support surface?
- A.
An alternating air mattress with frequent position changes
- B.
Any surface as long as they are turned every 2 hours
- C.
A water flotation device
- D.
An air fluidized bed with nonshear surface
Correct Answer
D. An air fluidized bed with nonshear surface -
- 3.
Which of the following causes massive tissue loss it most commonly associated with a severe drug reaction?
- A.
Toxic Epidermal Necrolysis (TEN)
- B.
Graft vs Host Disease (GVHD
- C.
Staphylococcal Scalded Skin Syndrome (SSSS)
- D.
Epidermolysis bullosa (EB)
Correct Answer
A. Toxic Epidermal Necrolysis (TEN) -
- 4.
Hyperbaric oxygen treatments are indicated for which of the following conditions?
- A.
Staphylococcal scaled skin syndrome (SSSS)
- B.
Recalcitrant chronic venous ulcer
- C.
Epidermolysis Bullosa
- D.
Radiation induced necrotic wounds
Correct Answer
D. Radiation induced necrotic wounds -
- 5.
When choosing topical therapy for the patient with massive tissue loss, two priority objectives are to:
- A.
Remove nonviable tissue and control exudate
- B.
Provide a moist environment and prevent shear
- C.
Manage exudate and eliminate deadspace
- D.
Control odor and minimize pain
Correct Answer
A. Remove nonviable tissue and control exudate -
- 6.
A 45 year old man has massive tissue loss over his chest and abdomen due to a thermal injury. During the early phases of care, the most commonly used topical management for this type of injury is?
- A.
0.5% silver nitrate
- B.
Foam dressing
- C.
Apligraf, skin substitue
- D.
1% silver Sulfadiazine
Correct Answer
D. 1% silver Sulfadiazine -
- 7.
Which of the following topical interventions would be most appropriate to manage a full thickness, clean thigh incision that is healing by secondary intent and has copious drainage?
- A.
Cadexomer iodine
- B.
Amorphous hydrogel
- C.
Hydrofiber
- D.
Hydrocolloid
Correct Answer
C. Hydrofiber -
- 8.
A patient has pyderma grangrenosum on their lower leg that measures 6cm x 5cm and shallow. The patient reports a 8 out of 10 pian level that is constant and 10 out 10 when dressings are changed. The ulcer is extremely exudative and has bands of black necrotic tissue and yellow slough mixed in with islands of granulation tissue. What recommendations can be made for topical therapy?
- A.
Apply skin substitute such as Apligraft
- B.
Culture the wound and then apply silvadene twice daily secured with rolled gauze.
- C.
Apply a sodium impregnated gauze and cover with nonadhesive foam dressing.
- D.
Apply a contact layer and then hydrogel impregnated gauze
Correct Answer
C. Apply a sodium impregnated gauze and cover with nonadhesive foam dressing. -
- 9.
Which of the following statements about a keloid is TRUE?
- A.
It develops as a result of excess moisture
- B.
It remains within the boundary of the original injury
- C.
The scar becomes firm and fibrous and extends beyond the original wound margin.
- D.
It will cause contractures
Correct Answer
C. The scar becomes firm and fibrous and extends beyond the original wound margin. -
- 10.
Which of the following statements about wound closure methods is true?
- A.
Musculocutaneous flaps differ from skin grafts in that they carry their own blood supply
- B.
Skin grafts are also known as primary closure
- C.
Skin grafts replace deep tissue layers such as subcutaneous tissue and muscle
- D.
Tissue flaps are used to provide superficial wound closure
Correct Answer
A. Musculocutaneous flaps differ from skin grafts in that they carry their own blood supply -
- 11.
A patient has a full-thickness, minimially exudative pressure ulcer extending to the muscle layer with extensive undermining. Which of the following would be the MOST appropriate topical dressing?
- A.
Hydrogel impregnated gauze
- B.
Composite dressing
- C.
Foam dressing
- D.
Calcium alginate
Correct Answer
A. Hydrogel impregnated gauze -
- 12.
What is the name of the surgical procedure in which a surgical incision is made through the muscle to relieve the edema formation beneath the muscle and fascia?
- A.
Esharotomy
- B.
Fasciotomy
- C.
Burn excision
- D.
Split thickness skin graft
Correct Answer
B. Fasciotomy -
- 13.
Negative pressure wound therapy is an appropriate option for which of the following wounds?
- A.
Stage 4 pressure ulcer with possible osteomyelitis
- B.
Coccyx pressure ulcer with 20% granulation tissue and 80% eschar
- C.
Dehisced abdominal incision with copious exudate and periwound erythema
- D.
Dehisced abdominal wound draining fecal material and a suspected entercutaneous fistula
Correct Answer
C. Dehisced abdominal incision with copious exudate and periwound erythema -
- 14.
In which of the following wounds would surgical intervention for debridment be considered urgent?
- A.
Calciphylaxis
- B.
Necrotizing fasciitis
- C.
Pyoderma granulosum
- D.
Epidermolysis bullosa
Correct Answer
B. Necrotizing fasciitis -
- 15.
The superficial burn with red, unbroken skin present is best managed with?
- A.
Oral nonsterodial anti-inflammatory medication and cooled hydrogel dressing to the burned area
- B.
Asprin, hydrocolloid dressing and moist cool pack to site
- C.
Debridement and sulfamylon cream
- D.
Oral narcatics and Vaseline to the burn site
Correct Answer
A. Oral nonsterodial anti-inflammatory medication and cooled hydrogel dressing to the burned area -
- 16.
A patient has an eschar covered ulcer on the heel due to prolonged pressure during a surgical procedure. The eschar is intact, there is no bogginess of the eschar and no periwound erythema. The patient has Type II diabetes and an ABI of 0.8 in that limb. Based on this information, which of the following treatments is most appropriate for this patient?
- A.
Cross hatch the eschar and cover with hydrogel wafer and change daily
- B.
Transparent dressing change every 3 days
- C.
Paint with betadine and cover with dry gauze; change every day
- D.
Apply enzymatic debriding agent, cover with a foam dressing and change daily.
Correct Answer
C. Paint with betadine and cover with dry gauze; change every day -
- 17.
Which of the following dressings is most appropriate to use in a pressure ulcer with a granulation tissue filled wound bed measuring 3cm x 5cm x 2.5cm with undermining that extends 4cm from 6 to 9 o'clock? The wound has become increasingly exudative in the past 3 weeks.
- A.
Dakin's wet to dry gauze
- B.
Chemical Debriding agent
- C.
Hydrogel impregnated gauze
- D.
Silver impregnated alginate rope
Correct Answer
D. Silver impregnated alginate rope -
- 18.
An esharotomy is indicated in which of the following situations?
- A.
A circumferential full thickness burn to the chest
- B.
Stage 4 pressure ulcer
- C.
Nonfluctuant eschar covered heel ulcer
- D.
Neuropathic ulcer on the 3rd metatarsal head
Correct Answer
A. A circumferential full thickness burn to the chest -
- 19.
A nurse in home care called you to give you and update on a patient with whom you consulted and ordered compression stockings and a foam dressing. She reports that the venous ulcer continues to have a large amount of exudate present and the wound size has not changed for 2 weeks. She also reports that the wound bed continues to have a red cobblestone appearance. Of the following, what would be the most appropriate intervention at this point?
- A.
Discontinue compression
- B.
Request and oral antibiotic
- C.
Refer to the surgeon for debridement of nonviable tissue
- D.
Determine if the patient has been able to comply with compression therapy
Correct Answer
D. Determine if the patient has been able to comply with compression therapy -
- 20.
A patient has been diagnosed with Staphylococcal Scaled Skin Syndrome. Which of the following signs were present as a key indicator of this condition?
- A.
Skin develops a sandpaper feel
- B.
Pustules and anhydrosis
- C.
Ulcerations extending into the dermis
- D.
Maculopapular rash
Correct Answer
A. Skin develops a sandpaper feel -
- 21.
The prolonged presence of wound drainage on the periwound skin predisposes the skin to ?
- A.
Maceration
- B.
Folliculitis
- C.
Excoriation
- D.
Anhydrosis
Correct Answer
A. Maceration -
- 22.
The transforming growth factor-beta (TGF-b) Regranex, is specifically indicated for which of the following wounds?
- A.
Eschar covered pressure ulcers
- B.
Diabetic plantar ulcers
- C.
Arterial ulcers with and ABI of
- D.
Chronic venous ulcers
Correct Answer
B. Diabetic plantar ulcers -
- 23.
Preoperative preparation for a patient with paraplegia who is scheduled for a myocutaneous flap closure of a stage IV sacral pressure ulcer includes which of the following interventions?
- A.
Hyperbaric oxygenation to enhance perfusion of the surgical site
- B.
Intravenous corticosteroids to reduce inflammation at the surgical site
- C.
Control of spasms to prevent tension of the incision
- D.
Intravenous antibiotic to reduce bioburden in the wound
Correct Answer
C. Control of spasms to prevent tension of the incision -
- 24.
What is the primary objective of a burn excision?
- A.
Reduce the risk of contractures
- B.
Reduce the risk of infection
- C.
Prevent compartment syndrome
- D.
Prevent wound dessication
Correct Answer
B. Reduce the risk of infection -
- 25.
The preoperative preparation for the surgical repair of an extensive wound should include which of the following interventions to reduce or control co-factors
- A.
Discontinue the use of corticosteroids temporarily
- B.
Maintain blood glucose of 180mg/dl or less
- C.
Daily prealbumin levels to monitor nutritional status
- D.
Administration of intravenous broad spectrum antibiotics
Correct Answer
B. Maintain blood glucose of 180mg/dl or less -
- 26.
A patient with paraplegia has developed a pressure ulcer over the ischial tuberosity. This is the second ulcer that has developed in this exact location within the past year. Which of the following is the MOST likely explanation for the recurrence of the ulcer?
- A.
Ineffective wound debridement
- B.
Insufficient protein intake
- C.
Insufficient oxygen to lower extremities
- D.
Inadequate pressure reduction
Correct Answer
D. Inadequate pressure reduction -
- 27.
Which of the following wound and dressing combinations promotes autolytic debridment?
- A.
A granular wound and alginate dressing
- B.
An infected wound and hydrocolloid dressing
- C.
A wound with dry eschar and alginate dressing
- D.
A wound with fibrin slough and hydrocolloid dressing
Correct Answer
D. A wound with fibrin slough and hydrocolloid dressing -
- 28.
A neonate has developed a non-erthemic eschar on the occiput. Which of the following should be the INITIAL intervention?
- A.
Provide a gel head cushion
- B.
Place the infant in the prone position
- C.
Apply a hydrocolloid dressing
- D.
Perform conservative sharp debridment
Correct Answer
A. Provide a gel head cushion -
- 29.
A 62 year old patient with acute myelocytic leukemia is undergoing chemotherapy. The right heel is covered with dry eschar. Which of the following is the most appropriate intervention?
- A.
Place patient on a specialty bed
- B.
Apply an enzymatic debriding agent
- C.
Use a positional device
- D.
Remove eschar with sharp debridement
Correct Answer
C. Use a positional device -
- 30.
In addition to topical wound care, which of the following is most important in treating nonhealing arterial ulcers?
- A.
Whirlpool therapy
- B.
Revascularization
- C.
Corrective footwear
- D.
Limb elevation
Correct Answer
B. Revascularization -
- 31.
A patient with diabetic neuropathy has an ulcer on the plantar surface of the foot. The patient has regularly returned to the clinic for wound care and blood glucose monitoring. After 15 weeks, the wound is healed. Which of the folllowing should the nurse include in the teaching plan?
- A.
Over the counter orthotics
- B.
Frequent foot elevation
- C.
Daily foot soaks
- D.
Daily inspection of feet
Correct Answer
D. Daily inspection of feet -
- 32.
Which of the following is the most significant assessment parameter in a patient with a lower extremity ischemic ulcer?
- A.
Patient compliance
- B.
Extent of necrosis
- C.
Ankle brachial index
- D.
Serum transferrin level
Correct Answer
C. Ankle brachial index -
- 33.
A patient seen in the outpatient wound clinic has a 5cm x 6cm shallow, chronic ulcerationon the lower right leg over the lateral malleolus. The ulcer has a ruddy granular bed and a moderate amount of serous drainage. Pitting edema is present in the ankle; pedal pulses are strong. The patient reports she is a single mother and cannot miss work as a pharmacist. A patient presents with chronic venous statis ulcers. Upon further assessment, the nurse notes dry, flaky skin with significant pruritis. Based on this information, the nurse should:
- A.
Culture the ulcer
- B.
Request a tissue biopsy
- C.
Use a moisturizer without lanolin
- D.
Use a moisture barrier ointment
Correct Answer
C. Use a moisturizer without lanolin -
- 34.
A home care patient has a partial thickness thermal injury on the left lower leg. The nurse's recommendaton for topical wound management should include:
- A.
A sterile technique for cleansing
- B.
Encouraging frequent tub baths
- C.
Showering with mild soap
- D.
Vigorous scrubbing to limit eschar formation
Correct Answer
C. Showering with mild soap -
- 35.
Which of the following dressings is most appropriate for a deep, heavily exudating stage III trochanteric pressure ulcer
- A.
Amorphous hydrogel
- B.
Hydrocolloid dressing
- C.
Hypertonic saline gauze
- D.
Hydrophilic foam sheet
Correct Answer
C. Hypertonic saline gauze -
- 36.
An insulin dependent diabetic patient is incontinent of bowel and bladder. The patient's home health nurse discovers that he has developed pustules with associated scaling and white cheesy exudate in his perineal area. A non-pharmacologic treatment plan would include:
- A.
Burrow's solution
- B.
Reduction of moisture and humidity
- C.
Topical antifungal cream
- D.
Barrier ointment
Correct Answer
B. Reduction of moisture and humidity -
- 37.
A patient has chronic venous insufficiency and dry venous dermatitis that will require the use of compression therpay. The best time to apply compression stockings is
- A.
In the morning
- B.
At bedtime
- C.
After whirlpool
- D.
After manual lymph drainage
Correct Answer
A. In the morning -
- 38.
Use of compression therapy to treat a venous ulcer is contraindicated in a patient with;
- A.
Heavy exudate
- B.
Fibrin Slough
- C.
Peripheral edema
- D.
Arterial insufficiency
Correct Answer
D. Arterial insufficiency -
- 39.
Which of the following has the most beneficial effect on the healing of venous leg ulcers
- A.
High protein diet
- B.
Reduction of edema
- C.
Non selective debridement
- D.
Increased calcium intake
Correct Answer
B. Reduction of edema -
- 40.
Which of the following dressing is most appropriate for a patient with a full thickness pressure ulcer with undermining?
- A.
Wet to dry gauze
- B.
Moist saline gauze
- C.
Hydrocolloid
- D.
Hydrogel sheets
Correct Answer
B. Moist saline gauze -
- 41.
The effects of corticosterioids on wound healing can be partially countacted by the administration of:
- A.
Zinc
- B.
Iron
- C.
Vitamin A
- D.
Vitamin C
Correct Answer
C. Vitamin A -
- 42.
A 58 year old patient who has had type I diabetes for over 20 years is admitted with bilateral, lower leg venous ulcerations. The admitting orders include the application of a multi layer compression wrap. The nurse should first?
- A.
Check the venous filling time
- B.
Check the capillary refill
- C.
Assess ankle brachial index
- D.
Assess toe brachial index
Correct Answer
C. Assess ankle brachial index -
- 43.
An adult received irradiation therapy to the sacral area eight years ago and now has developed a sacral pressure ulcer. The factor that most likely puts this patient at risk is?
- A.
Chronic diarrhea due to gastrointestinal tract damage
- B.
Decreased mobility due to chronic fatigue
- C.
Damage to cellular components
- D.
Aging which causes a change in the skin elasticity
Correct Answer
C. Damage to cellular components -
- 44.
If hemostatic dressings are needed in the treatment of fungating wounds, which of the following products is most appropriate?
- A.
Alginate Dressing
- B.
Transparent film dressing
- C.
Enzyme debriding agent
- D.
Gauze dressing
Correct Answer
A. Alginate Dressing -
- 45.
A patient with history of Crohn's disease has a painful full thickness ulcer on his right lower leg. The ulcer has a violacceous ring and punctate apperance. Which of the following is the mostly likely condition?
- A.
Pyoderma gangrenosum
- B.
Arterial ulcer
- C.
Venous ulcer
- D.
Calciphylaxis
Correct Answer
A. Pyoderma gangrenosum -
- 46.
A patient with a nonhealing pressure ulcer of the right lateral malleolus is seen in the wound clinic. At prior visits, the wound presented with erythema, undermining of wound edges, and exudate. Currently, the wound is contracted and pink with granulation tissue and reduced undermining. In which stage of healing is the wound in?
- A.
Proliferation
- B.
Remodeling
- C.
Inflammation
- D.
Hemostasis
Correct Answer
A. Proliferation -
- 47.
Which of the following is the most significant factor in healing an ischemic ulcer?
- A.
Topical therapy
- B.
Perfusion
- C.
Nutrition
- D.
Adequate debridement
Correct Answer
B. Perfusion -
- 48.
Fungal infections are typically characterized by:
- A.
Excoriation, macules, and bullae
- B.
Plaques, papules and pustules
- C.
Maceration, vesicles and wheals
- D.
Hyperplasia, pustules and erythema
Correct Answer
B. Plaques, papules and pustules -
- 49.
When conducting a preliminary assessment of a patient's nutritional status, which of the following indicates probable need for nutritional support?
- A.
Serum albumin of 3.5 g/Dl
- B.
Transferrin of 300 mg/Dl
- C.
Prealbumin of 10 mg/Dl
- D.
Total lymphocyte count of 2,000 cells per mm3
Correct Answer
C. Prealbumin of 10 mg/Dl -
- 50.
Leukocytosis plays a key role during which of the following phases of wound healing?
- A.
Inflammatory
- B.
Hemostasis
- C.
Proliferation
- D.
Remodeling
Correct Answer
A. Inflammatory -
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Feb 20, 2013Quiz Edited by
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Aug 01, 2012Quiz Created by
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