WCC Exam Questions and Answers for Wound Healing 2024, Exams of Nursing

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WCC Exam Questions and Answers 2024 fibroblast Correct Answer is The cell responsible for building new granulation tissue keratinocytes Correct Answer is Cells involved in epithelialization macrophages and polymorphonuclear neutrophils Correct Answer is Cells which can kill bacteria lightly fill the wound base with gauze to prevent premature epithelialization Correct Answer is To assist with managing a wound that is hypogranular: high levels of MMPs and low levels of TIMPs Correct Answer is Chronic wounds contain insufficient collagen tensile strength Correct Answer is Surgical wound dehiscence is most often due to: secondary wound closure Correct Answer is A severely contaminated wound should be allowed to close by: Integrins Correct Answer is cell surface receptors that allow cells to reversibly bind to the extracellular matrix to achieve cell migration 80% Correct Answer is The maximum strength that a scar tissue can attain after the occurrence of remodeling is: six months to two years. Correct Answer is The maturation and remodeling phase of wound healing typically lasts for: fibroblasts Correct Answer is Cells that can be found in the dermis are: epidermis Correct Answer is The stratum corneum can be found in the: epidermis, dermis, and subcutaneous tissue Correct Answer is A full-thickness wound involves the following tissue layers: partial-thickness Correct Answer is A stage 2 pressure injury can also be described as a ________ lesion. False Correct Answer is A callus is caused by a build-up of cells within the stratum basale. histamine Correct Answer is Mast cells produce the following substance: Nonviable joint capsule Correct Answer is When examining a patient's wound, you notice gray-black, dry, leathery-appearing, irregular fibrous tissue. What do you suspect this structure is? Muscle Correct Answer is When examining a patient's wound, you notice regularly arranged red tissue. What do you suspect this structure is? adipose tissue and fascia Correct Answer is The subcutaneous tissue consists of: faster Correct Answer is Partial-thickness wounds heal ___ than full-thickness wounds warm Correct Answer is Wounds should heal faster if both the patient and the patient's wound are kept ___. faster Correct Answer is Surgical wounds heal ___ than traumatic wounds True Correct Answer is Change in wound surface area can be used to predict wound healing. slowly Correct Answer is Covering a wound with a dressing facilitates wound healing because a dry wound progresses through the phases of inflammation more ___ than a moist wound. barriers Correct Answer is Serial debridement facilitates wound healing by removing ___ to healing False Correct Answer is Wound debridement is vital to wound healing and should be completed despite a patient's pain complaint. Available as sponges, impregnated woven gauzes, film dressings, absorptive products, island dressings, nylon fabric, non-adherent barriers or a combination of materials Antimicrobial dressings Correct Answer is Aquacel, prisma, dermablue, opticell AG, urgotul Collagens Correct Answer is Wound dressings that are gels, pads, particles, pastes, powders, sheets or solutions derived from bovine, equine, porcine or avian sources. Some interact with wound exudate to form a gel. Indicated for partial- and full-thickness pressure ulcers, venous ulcers, donor sites, surgical wounds, vascular ulcers, diabetic ulcers, second-degree burns, abrasions and traumatic wounds Composites Correct Answer is Dressings that combine physically distinct components into a single product to provide multiple functions such as a bacterial barrier, absorption and adhesion. Usually, they are composed of multiple layers and incorporate a semi- or non- adherent pad that covers the wound. May also include an adhesive border of non- woven fabric tape or transparent film. Contact Layers Correct Answer is Dressings that are thin, non-adherent sheets placed on an open wound bed to protect tissue from direct contact with other agents or dressings applied to the wound. They conform to the shape of the wound and are porous to allow exudate to pass through for absorption by an overlying, secondary dressing. Indicated for partial- and full-thickness wounds, infected wounds, donor sites and split-thickness skin grafts Foam Dressings Correct Answer is Dressings that are sheets and other shapes of foamed polymer solutions (most commonly polyurethane) with small, open cells capable of holding fluids. They may be impregnated or layered in combination with other materials. Indicated for partial- and full-thickness wounds. Some dressings are indicated for pressure injury prevention when used as part of a broader pressure injury prevention protocol. Gauzes & Non-Wovens Correct Answer is dry woven or non-woven sponges and wraps with varying degrees of absorbency, based on design. Fabric composition may include cotton, polyester or rayon. Available sterile or non-sterile in bulk and with or without an adhesive border. They are used for cleansing, packing and covering a variety of wounds. Medical Grade Honey Correct Answer is useful for acute and chronic wounds. The dressings help to prepare the wound bed and promote an optimal healing environment. Multiple mechanisms of action include reducing edema, lowering wound pH and debriding slough and eschar. Multiple versions of the dressing are available to handle differing levels of exudates. Indicated for partial- and full-thickness wounds including pressure ulcers, leg ulcers (arterial, venous and diabetic ulcers), burns, donor sites and surgical wounds. Hydrocolloids Correct Answer is wafers, powders or pastes composed of gelatin, pectin or carboxymethylcellulose. Absorption capability depends on thickness and composition. Wafers are self-adhering and available with or without an adhesive border and in a wide variety of shapes and sizes. Useful on areas that require contouring, such as heels and sacral ulcers. Powders and pastes require a secondary dressing. Indicated for partial- and full-thickness wounds with or without necrotic tissue. Hydrogels: Amorphous Correct Answer is formulations of water, polymers and other ingredients with no shape, designed to donate moisture to a dry wound and to maintain a moist healing environment. The high moisture content serves to rehydrate wound tissue. Indicated for partial- and full-thickness wounds, wounds with necrosis, minor burns and radiation tissue damage. Hydrogels: Impregnated Correct Answer is gauzes and non-woven sponges, ropes and strips saturated with an amorphous hydrogel. The high moisture content serves to rehydrate wound tissue. Indicated for partial- and full-thickness wounds, wounds with necrosis and deep wounds with tunneling or sinus tracts. Hydrogels: Sheets Correct Answer is three-dimensional networks of cross-linked hydrophilic polymers that are insoluble in water and interact with aqueous solutions by swelling. They are highly conformable and permeable and can absorb varying amounts of drainage, depending on their composition. Indicated for partial- and full-thickness wounds, wounds with necrosis, minor burns and radiation tissue damage. Impregnated Dressings Correct Answer is gauzes and non-woven sponges, ropes and strips saturated with a solution, an emulsion, oil or some other agent or compound. Agents most commonly used include saline, oil, zinc salts, petrolatum, xeroform and scarlet red. Silicone Gel Sheets Correct Answer is soft wound covers composed of cross-linked polymers reinforced with or bonded to mesh or fabric. Indicated to prevent or improve the appearance of old and new hypertrophic and keloid scars. Hypertrophic scars occur from poorly designed surgical wound closure, too much tension applied to a surgical wound closure, a wound infection or partial- and full-thickness burns. Keloid scars result from an inherited metabolic alteration in collagen. Transparent Films Correct Answer is polymer membranes of varying thickness coated on one side with an adhesive. They are impermeable to liquid, water and bacteria but permeable to moisture vapor and atmospheric gases. Transparency allows visualization of the wound. Indicated for partial-thickness wounds with little or no exudate, wounds with necrosis and as both a primary or secondary dressing. Also used to cover IV sites, donor sites, lacerations, abrasions and second-degree burns. Wound Fillers Correct Answer is beads, creams, foams, gels, ointments, pads, pastes, pillows, powders, strands or other formulations that are non-adherent. They may include a time- released antimicrobial. Fillers function to maintain a moist environment and manage exudate. Indicated for partial- and full- thickness wounds, infected wounds, draining wounds and deep wounds that require packing. 312 Correct Answer is Order the following dressings from least absorptive to most absorptive 1. semipermeable foam 2. alginate 3. Semipermeable film occlusive Correct Answer is An ___ dressing is impermeable to water, vapor, and bacteria. lower Correct Answer is Moisture-retentive dressings are associated with a ___ rate of infection than gauze dressings water, bacteria Correct Answer is Hydrocolloid dressings are impermeable to ___ and ___ protect Correct Answer is Skin sealants ___ the periwound from maceration and adhesives pressurized Correct Answer is Wound irrigation can be delivered with ___ saline canisters limb Correct Answer is Whirlpools increase ___ volume granulation Correct Answer is Pulsed lavage with suction promotes ___ tissue formation cell, collagen Correct Answer is Electrical stimulation is believed to increase ___ proliferation and ___ synthesis toe pressures Correct Answer is Values greater than 30 mm Hg are consistent with wound healing An amorphous hydrogel, gauze pad, gauze roll Correct Answer is Which of the following dressings would be most appropriate for a patient with a typical arterial insufficiency ulcer High toe box Correct Answer is Temporary footwear for patients with arterial insufficiency ulcers should: most, frequently Correct Answer is Venous insufficiency ulcers are the ___ common type of leg ulcer and ___ recur venous HTN Correct Answer is Venous insufficiency ulcers are ultimately caused by Irregular, glossy, mild to moderate Correct Answer is Shape, wound bed, pain characteristics of venous ulcer dermatitis Correct Answer is Patients with chronic venous insufficiency often have inflammation of the skin associated with itching and redness also known as True Correct Answer is It is common for patients with chronic venous insufficiency to have allergic reactions or sensitization. Semipermeable foam Correct Answer is Given the following dressing choices, which would be the most appropriate for a typical patient with a venous insufficiency ulcer? acute infection Correct Answer is contraindication to the use of compression therapy for patients with venous insufficiency? walk regularly Correct Answer is When using compression therapy for venous insufficiency ulcer management, the patient should be instructed to: Shear, impaired mobility, and excessive moisture Correct Answer is risk factors for pressure injuries stage II Correct Answer is A pressure injury that presents as a shallow crater or blister should be described as a ________ pressure injury. partial thickness Correct Answer is A stage 3 pressure injury would be classified as impaired integumentary integrity associated with __-__ skin involvement ischium, posterior heel, lateral malleolus Correct Answer is Pressure injuries are most commonly seen in these locations osteomyelitis Correct Answer is When assessing your patient's sacral pressure injury, you are able to probe to bone but cannot visualize the bone. This patient is at risk for ___. hydrocolloid Correct Answer is Your patient presents with a stage 3 pressure injury over his right greater trochanter without evidence of infection. Which of the following dressings would be most appropriate? odor control Correct Answer is Charcoal-containing wound dressings may be beneficial for patients with pressure injuries because charcoal dressings can assist in ___ reactive Correct Answer is support surfaces should be used for patients who can attain a variety of positions without bearing weight on an existing pressure injury. Sharp Correct Answer is Which of the following methods of debridement would be most appropriate for your patient with a full-thickness eschar-covered pressure injury with signs of infection? Stage III/IV Correct Answer is Undermining and tunneling may be found in these types of pressure injuries: 2 Correct Answer is Type ___ diabetes is the most common form of diabetes in the United States. amputation Correct Answer is About half of patients with a diabetic foot ulcer who have an ___ will eventually have a contralateral amputation. Native Americans Correct Answer is Hispanic/Latino Americans and ___ ___ are more likely to develop diabetes than non-Hispanic Whites. Callus rim, foot deformities, minimal Correct Answer is typical characteristics of a neuropathic ulceration? edges, appearance of foot, drainage Autonomic neuropathy Correct Answer is Your patient with diabetes presents with dry, cracked skin. What is the most likely cause of this? Charcot Correct Answer is Your patient with diabetes presents with a rocker-bottom foot. This is most likely due to fractures and/or dislocations causing a ___ deformity. increase Correct Answer is A localized ___ in plantar foot skin temperature is a hallmark of future ulceration or a current deep space infection. Wagner Grade I and II Correct Answer is Total contact casts are appropriate for the following neuropathic ulcers: radiological testing for OM Correct Answer is Patients with neuropathic ulcerations that contain exposed bone would most benefit from: Insoles Correct Answer is High plantar foot pressures increase the risk of neuropathic ulceration. Plantar foot pressures can be reduced by providing full contact ___ Blood flow Correct Answer is Autonomic neuropathy increases ___ ___ to the bones of the foot in patients with diabetes predisposes them to fracture due to osteopenia Contact time Correct Answer is The severity of a thermal burn is dependent upon: low voltage current Correct Answer is Most electrical burns are the result of: outpatient Correct Answer is Provided the patient has adequate pain control, in what setting are patients with minor burns generally treated? cellular, perfusion Correct Answer is Lymph from which of the following body regions empties into the right lymphatic duct? angiomotoricity Correct Answer is Sympathetic stimulation can increase lymph ___. Lipedemia Correct Answer is You are evaluating a patient with bilateral lower extremity swelling. The patient reports her swelling began around puberty. She has no history of surgery or radiation. She reports her legs are tender to touch. On examination, while the patient does appear to have swelling in both legs, the dorsa of both feet appear normal. The patient is most likely to have: Seroma Correct Answer is You are working with a patient four days after a left mastectomy. You notice a localized accumulation of fluid in the patient's left axilla. You alert the surgeon and notify of a: xerosis Correct Answer is condition of dryness Xerosis, pruritus Correct Answer is What are two of the most common problems associated with aging skin? Primary lesions Correct Answer is Vesicles, pustules, and bullae are considered ___ ___ asymmetrical Correct Answer is Most early melanomas are ___ Basal cell carcinoma Correct Answer is Which form of skin cancer presents primarily on the face, head, and neck? malignant melanoma (MM) Correct Answer is Most serious form of skin cancer; often characterized by black or dark brown patches on the skin that may appear uneven in texture, jagged, or raised. squamous cell carcinoma (SCC) Correct Answer is skin cancer that begins in the epidermis but may grow into deeper tissue; does not generally metastasize to other areas of the body Kaposi's sarcoma Correct Answer is Which type of lesion appears red, pink, or tan in color and becomes purple-brown with a green hemosiderin halo over time? reaction to silver sulfadiazine Correct Answer is A patient is being treated in an outpatient wound center for an infected plantar diabetic foot ulcer. Treatment includes debridement as needed, silver sulfadiazine, dry dressings, and off-loading with a post-op shoe. On the second day of treatment, the patient reports a rash and severe pruritus around the wound and along the dorsum of the foot. The most likely cause of the patient's symptoms is: Whirlpool Correct Answer is Which of the following interventions for cellulitis is generally discouraged, as it may exacerbate the condition? fungal infections Correct Answer is When examining a patient's foot, you should assess the interdigital spaces for signs of tinea pedis and educate the patient regarding appropriate foot care to care for the following: intertriginous dermatitis Correct Answer is A patient has skin damage from perspiration and friction under his abdominal pannus and the culture comes back as Candida. The best way to classify this skin damage is as: Psoriasis Correct Answer is Which disease is characterized by round, circumscribed, erythematous, dry, scaling plaques of various sizes that are covered by silvery, white scales? first-degree burns Correct Answer is Which types of dressings are not covered under the Medicare/Medicaid surgical dressings benefits? randomized controlled clinical trial Correct Answer is A study in which the participants are assigned by chance to separate groups that compare different treatments is called a Cohort studies Correct Answer is take a group of people who have a specific condition or receive a particular treatment over time and compare them with another group that has not been affected by the condition or treatment being studied Quantitative research Correct Answer is Research based on something that can be accurately and precisely measured. Meta-analysis Correct Answer is thoroughly examine a number of valid studies on a topic and combine the results using accepted statistical methodology as if they were from one large study ischemic ulcer Correct Answer is develops within hours of events such as hemorrhage, multisystem trauma, severe burns, heart failure, or sepsis zinc Correct Answer is In wound healing zinc is needed for stratum basale Correct Answer is deepest layer of epidermis Stratum lucidum Correct Answer is a layer of the epidermis found only in the thick skin of the fingers, palms, and soles Stratum germinativum Correct Answer is also known as the basal cell layer, the deepest live layer of the epidermis that produces new epidermal skin cells and is responsible for growth stratum spinosum Correct Answer is a layer of the epidermis that provides strength and flexibility to the skin Basement membrane zone Correct Answer is The epidermis is anchored to the dermis by the Elastin Correct Answer is responsible for skin recoil Thermoregulation`` Correct Answer is Which function of the skin involves sweating, vasoconstriction, and vasodilation? Protection Correct Answer is Which function of the skin is involved in preventing excessive fluid loss Platelets Correct Answer is Which cells play a major role in hemostasis? Inflammatory Correct Answer is In which phase of wound healing do the macrophages destroy bacteria and cleanse the wound site of cellular debris? fever Correct Answer is systemic sign of infection? wound biopsy Correct Answer is The gold standard for identifying wound infection is a: Biofilms Correct Answer is communities of microorganisms that attach to the wound surface encasing themselves in a matrix or glycocalyx Artherosclerosis Correct Answer is The most common cause of arterial ulcers is: Albumin Correct Answer is Which laboratory test has a half-life of 18-20 days, making it sensitive to long-term protein deficiencies? 7 days Correct Answer is Multilayer compression bandaging systems usually provide sustained graduated compression for at least: arterial insufficiency Correct Answer is Arterial ulcers are caused by a decrease in blood supply, also known as Punched out Correct Answer is Ischemic ulcers typically have a ___ ___ appearance BMI Correct Answer is A nutritional assessment should include: contrast angiography Correct Answer is The best test to evaluate lower extremity arterial occlusive disease when considering arterial reconstruction is which of the following? calcified Correct Answer is Diabetic patients often have ___ arteries resulting in artificially higher ABI's and no palpable pulses Contamination Correct Answer is Which term accurately describes the existence of the least harmful levels of bacteria within a wound? 3 Correct Answer is In the Meggit-Wagner classification system, which grade would be used for a diabetic foot ulcer with osteomyelitis? Low Correct Answer is ___ frequency debrides over time. matrix metalloproteinases (MMPs) Correct Answer is A family of zinc-containing enzymes that act in the extracellular space to digest various extracellular proteins and proteoglycans Vitamin C Correct Answer is The most important vitamin required for adequate collagen synthesis during tissue repair is: exceeds Correct Answer is Lymphedema can occur when the volume of lymph ___ the transport capacity Painful Correct Answer is Partial-thickness burns are usually ___ foam dressing Correct Answer is A patient presents with a chronic erythematous traumatic wound on the anterior lower leg. Current care includes use of mupirocin (Bactroban) cream and a four-layer compression wrap. Hypergranulation tissue is present in the wound bed. Which of the following modifications should be made to the treatment program? amorphous hydrogel Correct Answer is -best for: dry wounds, arterial wounds; will add moisture to wound Silver nitrate Correct Answer is Treats hyper granulation of wound edges ABI (Ankle-brachial index) Correct Answer is MOST significant assessment parameter in a patient with a lower extremity ischemic ulcer? Surgically Correct Answer is Eschar is found in full-thickness thermal injuries and must be removed ___ Perfusion Correct Answer is MOST significant factor in healing an ischemic ulcer? Hydrocolloid Correct Answer is The MOST appropriate dressing for a shallow wound that is clean and granulating with minimal exudate is: partial thickness, min to mod exudate Correct Answer is Wound indications for hydrocolloids Mod to heavy exudate Correct Answer is Drainage for Alginate Dressings Partial-thickness skin loss Correct Answer is A 70-year-old woman with a recent left hip fracture has developed a stage II pressure ulcer on her right heel. What BEST describes her ulcer? inflammatory Correct Answer is Leukocytosis plays a key role during which of the following phases of wound healing? (3-7 days) Neutrophils Correct Answer is Primary cells responsible for cleansing the wound of microorganisms Hemostasis Correct Answer is One sequence of events occurring during the inflammatory phase. Clotting factors are released when injury occurs, results of platelet aggregation and vasocontriction proliferative Correct Answer is Granulation occurs in this phase as a result of fibroblasts stimulating the ongoing production of collagen and granulation tissues (4-24 days) remodeling Correct Answer is Phase aka maturation that lasts up to 1+ years. Collagen fibers organize and reorganize, increasing tensile strength. Fibroblasts are the key cells organizing this process neuropathy Correct Answer is Over-the-counter orthotics have the potential to cause pressure and ulcerations in a patient with ___ Elevate Correct Answer is Non pharm intervention for venous insufficiency arterial Correct Answer is Prior to application of a compression wrap, ___ disease needs to be ruled out. venous HTN Correct Answer is defined as soft, moist, avascular tissue which may be white, yellow, tan, or green, may be loose or firmly adherent Alginate Correct Answer is If hemostatic dressings are needed in the treatment of fungating wounds, what product is MOST appropriate? Coagulation Correct Answer is Enzyme debriding agents should be used with caution in patients with ___ disorders. Proliferative phase Correct Answer is 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? Calcium alginate Correct Answer is A patient has a large full-thickness, heavily exudating pressure ulcer with a 3 cm tunnel. What is the BEST dressing? composite Correct Answer is In wounds with depth, primary wound-filler material is required to fill the dead space before covering the wound with a ___ dressing. Inadequate pressure reduction Correct Answer is 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. What is the MOST LIKELY explanation for the recurrence of the ulcer? Ischial Correct Answer is ___ ulcers occur secondary to prolonged sitting without adequate pressure reduction and frequent changes in position. Petrolatum-impregnated gauze. Correct Answer is A female patient with metastatic breast cancer is admitted with a fungating mass measuring 12 cm by 10 cm in the left breast. To assist with palliative care and pain management, the nurse should recommend applying: bioburden Correct Answer is Silver-impregnated foam is appropriate in managing wound exudate and decreasing ___ Pyoderma gangrenosum Correct Answer is A patient with history of Crohn's disease has a painful full-thickness ulcer on his right lower leg. The ulcer has a violaceous ring and punctate appearance. What is the MOST LIKELY condition? Pyoderma gangrenosum Correct Answer is This causes rapidly progressive painful ulcer with a purulent base and violaceous borders. More than 50% of patients have associated systemic disease (eg IBD, Crohn's). Tx: local or systemic CORTICOSTEROIDs Arterial Correct Answer is ___ ulcers are more commonly found on the foot with well-defined borders and a faint halo of erythema. Venous Correct Answer is ___ ulcers present with irregular borders and maceration, crusting, and scaling of surrounding skin. Calciphylaxis Correct Answer is These lesions may have some of the same characteristics as pyoderma gangrenosum, but is associated with end-stage renal disease. hypoxia Correct Answer is A patient complains of unrelenting burning pain four hours after the application of a chemical debriding agent. The pain may lead wound to ___, impairing healing and increasing rate of infection Prealbumin Correct Answer is levels are often the most current indicator of nutritional status. The normal value is 15-25 mg/dL. 300 Correct Answer is Transferring normal value ___ mg/dL 2,000 Correct Answer is TLC normal value ___ cells per mm3 gel fusion Correct Answer is A neonate has developed a non-erythemic eschar on the occiput. Which should be the INITIAL intervention? intact peripheral pulses Correct Answer is Which of the following assessment parameters is critical in distinguishing calciphylaxis from other forms of peripheral vascular disease ischemia Correct Answer is Non palpable pulses is critical indicator for limb ___. Also including ABI >0.4 and rest pain damage to cellular components Correct Answer is An adult received irradiation therapy to the sacral area eight years ago and has now developed a sacral pressure ulcer. The factor that MOST LIKELYputs this patient at risk is: 8 Correct Answer is Irradiation-induced ulcers appear approximately ___ years after therapy. arterial insufficiency Correct Answer is Use of compression therapy to treat a venous ulcer is CONTRAINDICATED in a patient with: reduces Correct Answer is Compression therapy decreases edema and ___ exudate fibrinolytic Correct Answer is Compression therapy increases fibrinolytic activity. When fluid collects over the lesion Correct Answer is How often should a transparent film dressing covering a dermal ulcer be changed? Hypertonic saline gauze Correct Answer is MOST appropriate dressing for a deep, heavily exudating, stage-III trochanteric pressure plaques, papules, and pustules Correct Answer is Fungal infections are typically characterized by: Vitamin A Correct Answer is The effects of corticosteroids on wound healing can be partially counteracted by the administration of: