CWCN COMPREHENSIVE EXAM 2026 QUESTIONS AND
SOLUTIONS RATED A+
✔✔During a routine dressing change, the nurse observes the wound bed to be covered
with fragile, moist, red granulation tissue, which has grown above skin level. The current
dressing orders are for hydrocolloid dressing, changed every 3 days. Which of the
following dressings is MOST appropriate for the nurse to recommend at this time?
A. Polyurethane foam
B. Moist gauze
C. Transparent film
D. Hydrogel sheet - ✔✔A. Polyurethane foam (Helps w/ absorption)
Rationale: Overgrowth of gran tissue means that the wound is overly moist
✔✔Which of the following Ankle-Brachial Index (ABI) values indicates the best potential
for lower extremity wound healing?
A. 0.4
B. 0.7
C. 0.9
D. 1.5 - ✔✔C. 0.9
✔✔A 73-year-old woman, 5 ft 2 inches tall, weighing 113 kg (body mass index 46), with
respiratory failure and sepsis, is admitted to the intensive care unit. She is intubated and
sedated. Which of the following is one of the MOST common pressure ulcer
development locations for this patient?
A. Buttocks
B. Ischial tuberosities
C. Trochanters
D. Occiput - ✔✔A. Buttocks
✔✔Assessment of the periwound skin of a leg ulcer in a patient with rheumatoid arthritis
reveals palpable, nonblanchable purpura with petechiae, nodules, and vesicles. The
wound is very painful. The wound pathology is most likely related to:
A. Vasculitis
B. Infection
C. Pressure
D. Calciphylaxis - ✔✔A. Vasculitis
✔✔The gold standard for wound culture is as follows:
A. Tissue biopsy
B. Swab culture
C. Aspiration culture
D. Gram stain - ✔✔A. Tissue biopsy (the removal of piece of tissue w/ Scalpel or punch
biopsy)
,✔✔Which of the following is an appropriate dressing to minimize pain related to
fungating tumors? A. Sodium-impregnated gauze
B. Charcoal foam dressing
C. Nonadherent dressing
D. Wound drainage pouch - ✔✔C. Nonadherent dressing
✔✔What is the most reliable indicator of the existence of acute pain when performing
wound care? A. Family's report of patient's pain
B. Patient's self-report of pain
C. Observational Pain Intensity Scale
D. Patient's history of analgesic use - ✔✔B. Patient's self-report of pain
✔✔A 54-year-old male patient recently had revascularization surgery of the right lower
extremity. He now has an erythematous nodule with swelling on his right inner thigh,
chills and fever, subcutaneous crepitus, and exquisite pain at the nodule site. These
findings are most consistent with:
A. Pyoderma gangrenosum
B. Necrotizing fasciitis
C. Epidermolysis bullosa
D. Cellulitis - ✔✔B. Necrotizing fasciitis
✔✔A patient undergoing radiation therapy for breast cancer is experiencing dry
desquamation. An appropriate recommendation for management would be as follows:
A. Moisturizers such as hydrophilic lotions and creams
B. Silver-based wound gel with foam dressing
C. Petrolatum-based products applied twice daily
D. Alpha-hydroxy acid-based cream applied twice daily - ✔✔A. Moisturizers such as
hydrophilic lotions and creams
Heavy Metals (such as silver) & Petrolatum-based products CONTRAINDICATED with
Radiation Therapy
✔✔When using Dakin's solution (0.025%), what length of time is recommended for
treatment?
A. 24 hours
b. 48 hours
c. 15 days
d. 10 days - ✔✔D. 10 days (the cleansing agent is generally discouraged, but short-
term use if no more than 10 days)
✔✔An elderly woman is admitted to the critical care unit with pneumonia. She has an
unstageable pressure ulcer on her coccyx. The periwound has red-hot erythema and
the drainage has a foul odor. The best recommendation for debriding this wound is
A. chemical debridement
,B. wet to dry debridement
C. surgical sharp debridement
D. whirlpool debridement - ✔✔C. surgical sharp debridement
✔✔A WOC nurse is providing teaching to a diabetic patient. Which is the most
important aspect to emphasize?
A. Insulin administration
B. Foot care
C. Blood sugar regulation
D. Skin care - ✔✔B. Foot Care← limb preservation is a Primary concern of WOC nurse
✔✔Interventions helpful in reducing pain for the patient by using a negative-pressure
wound therapy wound unit include
A. the use of polyurethane instead of polyvinyl foam
b. discontinuation of the unit 30 minutes prior to removal
C. avoiding packing tunnels and undermining
D. the use of intermittent pressure throughout treatment - ✔✔b. discontinuation of the
unit 30 minutes prior to removal
✔✔A trauma patient is admitted to critical care with suspected air embolism.
Additionally, the patient has profound blood loss, a diabetic foot ulcer, and an acute
myocardial infarction. Which condition is the primary indication for hyperbaric oxygen
therapy?
A. Air embolism
B. Blood loss
C. Diabetic foot ulcer
D. Myocardial infarct - ✔✔A. Air embolism
primary indications for hyperbaric therapy include air/gas embolism, carbon monoxide
poisoning, and decompression sickness.
✔✔Which anatomical structure is most important to assess in the patient with lower
extremity arterial disease?
a. Knee.
b. Ankle.
c. Toe.
d. Calf. - ✔✔c. Toe.
✔✔The WOC nurse consults with a patient in the ICU. The patient is comatose and
intubated and has bilateral heel ulcers and 100% thick black leathery eschar. The
periwound has mild erythema and is nonboggy. What is the most important treatment to
recommend to the nurses?
a. Paint with povidone/iodine (Betadine) daily.
b. Silver sulfadiazine (Silvadene) and gauze.
, c. Chemical debrider and gauze.
d. Float heels off bed with pillow. - ✔✔d. Float heels off bed with pillow.
Remember: Treat pressure ulcers by Offloading the pressure
✔✔The WOC nurse visits a patient with venous stasis disease. In teaching regarding
long-term management, it is important to emphasize what information?
a. Elevation and compression of the lower extremities.
b. Elevation and nail care of the lower extremities.
c. Compression of the lower extremities and high fluid intake.
d. Compression of the lower extremities and high protein intake. - ✔✔a. Elevation and
compression of the lower extremities.
✔✔What advice would be helpful for the diabetic patient with a past history of
ulcerations on the feet?
a. Soak nightly in magnesium sulfate (Epsom salts).
b. Inspect feet daily.
c. Wear shoes with a tight toe box.
d. Wear shoes with a gel insole. - ✔✔b. Inspect feet daily. (wear shoes/socks for both
indoors and outdoors; never soak your feet; apply moisturizing lotion to the feet but
avoid in-between the toe spaces)
✔✔An arterial ulcer of the lower extremity can best be described as:
a. Painful lesion with well-defined edges, pale wound bed, and slough.
b. Irregular edges with thick creamy slough.
c. Painful lesion with dry edges and large amount of serous exudate.
d. Nonpainful lesion with eschar. - ✔✔a. Painful lesion with well-defined edges, pale
wound bed, and slough.
✔✔A patient comes to the wound clinic with brown skin discoloration on both lower
extremities. What is the likely cause?
a. Breakdown of hemoglobin in the tissues.
b. Contact dermatitis due to lotion.
c. Build up necrotic tissue.
d. Chronic erythema with edema. - ✔✔a. Breakdown of hemoglobin in the tissues.
✔✔A home health patient with a large chronic venous stasis ulcer complains that the
wound is draining more heavily and seems larger. Upon assessment, the WOC nurse
notes that the ulcer is 100% slough with bright red erythema and a foul odor. What
intervention would be appropriate?
a. Use an absorptive foam dressing.
b. Apply an antimicrobial dressing.
c. Cleanse the wound with an antiseptic.
d. Call the MD for an antibiotic order. - ✔✔d. Call the MD for an antibiotic order.
SOLUTIONS RATED A+
✔✔During a routine dressing change, the nurse observes the wound bed to be covered
with fragile, moist, red granulation tissue, which has grown above skin level. The current
dressing orders are for hydrocolloid dressing, changed every 3 days. Which of the
following dressings is MOST appropriate for the nurse to recommend at this time?
A. Polyurethane foam
B. Moist gauze
C. Transparent film
D. Hydrogel sheet - ✔✔A. Polyurethane foam (Helps w/ absorption)
Rationale: Overgrowth of gran tissue means that the wound is overly moist
✔✔Which of the following Ankle-Brachial Index (ABI) values indicates the best potential
for lower extremity wound healing?
A. 0.4
B. 0.7
C. 0.9
D. 1.5 - ✔✔C. 0.9
✔✔A 73-year-old woman, 5 ft 2 inches tall, weighing 113 kg (body mass index 46), with
respiratory failure and sepsis, is admitted to the intensive care unit. She is intubated and
sedated. Which of the following is one of the MOST common pressure ulcer
development locations for this patient?
A. Buttocks
B. Ischial tuberosities
C. Trochanters
D. Occiput - ✔✔A. Buttocks
✔✔Assessment of the periwound skin of a leg ulcer in a patient with rheumatoid arthritis
reveals palpable, nonblanchable purpura with petechiae, nodules, and vesicles. The
wound is very painful. The wound pathology is most likely related to:
A. Vasculitis
B. Infection
C. Pressure
D. Calciphylaxis - ✔✔A. Vasculitis
✔✔The gold standard for wound culture is as follows:
A. Tissue biopsy
B. Swab culture
C. Aspiration culture
D. Gram stain - ✔✔A. Tissue biopsy (the removal of piece of tissue w/ Scalpel or punch
biopsy)
,✔✔Which of the following is an appropriate dressing to minimize pain related to
fungating tumors? A. Sodium-impregnated gauze
B. Charcoal foam dressing
C. Nonadherent dressing
D. Wound drainage pouch - ✔✔C. Nonadherent dressing
✔✔What is the most reliable indicator of the existence of acute pain when performing
wound care? A. Family's report of patient's pain
B. Patient's self-report of pain
C. Observational Pain Intensity Scale
D. Patient's history of analgesic use - ✔✔B. Patient's self-report of pain
✔✔A 54-year-old male patient recently had revascularization surgery of the right lower
extremity. He now has an erythematous nodule with swelling on his right inner thigh,
chills and fever, subcutaneous crepitus, and exquisite pain at the nodule site. These
findings are most consistent with:
A. Pyoderma gangrenosum
B. Necrotizing fasciitis
C. Epidermolysis bullosa
D. Cellulitis - ✔✔B. Necrotizing fasciitis
✔✔A patient undergoing radiation therapy for breast cancer is experiencing dry
desquamation. An appropriate recommendation for management would be as follows:
A. Moisturizers such as hydrophilic lotions and creams
B. Silver-based wound gel with foam dressing
C. Petrolatum-based products applied twice daily
D. Alpha-hydroxy acid-based cream applied twice daily - ✔✔A. Moisturizers such as
hydrophilic lotions and creams
Heavy Metals (such as silver) & Petrolatum-based products CONTRAINDICATED with
Radiation Therapy
✔✔When using Dakin's solution (0.025%), what length of time is recommended for
treatment?
A. 24 hours
b. 48 hours
c. 15 days
d. 10 days - ✔✔D. 10 days (the cleansing agent is generally discouraged, but short-
term use if no more than 10 days)
✔✔An elderly woman is admitted to the critical care unit with pneumonia. She has an
unstageable pressure ulcer on her coccyx. The periwound has red-hot erythema and
the drainage has a foul odor. The best recommendation for debriding this wound is
A. chemical debridement
,B. wet to dry debridement
C. surgical sharp debridement
D. whirlpool debridement - ✔✔C. surgical sharp debridement
✔✔A WOC nurse is providing teaching to a diabetic patient. Which is the most
important aspect to emphasize?
A. Insulin administration
B. Foot care
C. Blood sugar regulation
D. Skin care - ✔✔B. Foot Care← limb preservation is a Primary concern of WOC nurse
✔✔Interventions helpful in reducing pain for the patient by using a negative-pressure
wound therapy wound unit include
A. the use of polyurethane instead of polyvinyl foam
b. discontinuation of the unit 30 minutes prior to removal
C. avoiding packing tunnels and undermining
D. the use of intermittent pressure throughout treatment - ✔✔b. discontinuation of the
unit 30 minutes prior to removal
✔✔A trauma patient is admitted to critical care with suspected air embolism.
Additionally, the patient has profound blood loss, a diabetic foot ulcer, and an acute
myocardial infarction. Which condition is the primary indication for hyperbaric oxygen
therapy?
A. Air embolism
B. Blood loss
C. Diabetic foot ulcer
D. Myocardial infarct - ✔✔A. Air embolism
primary indications for hyperbaric therapy include air/gas embolism, carbon monoxide
poisoning, and decompression sickness.
✔✔Which anatomical structure is most important to assess in the patient with lower
extremity arterial disease?
a. Knee.
b. Ankle.
c. Toe.
d. Calf. - ✔✔c. Toe.
✔✔The WOC nurse consults with a patient in the ICU. The patient is comatose and
intubated and has bilateral heel ulcers and 100% thick black leathery eschar. The
periwound has mild erythema and is nonboggy. What is the most important treatment to
recommend to the nurses?
a. Paint with povidone/iodine (Betadine) daily.
b. Silver sulfadiazine (Silvadene) and gauze.
, c. Chemical debrider and gauze.
d. Float heels off bed with pillow. - ✔✔d. Float heels off bed with pillow.
Remember: Treat pressure ulcers by Offloading the pressure
✔✔The WOC nurse visits a patient with venous stasis disease. In teaching regarding
long-term management, it is important to emphasize what information?
a. Elevation and compression of the lower extremities.
b. Elevation and nail care of the lower extremities.
c. Compression of the lower extremities and high fluid intake.
d. Compression of the lower extremities and high protein intake. - ✔✔a. Elevation and
compression of the lower extremities.
✔✔What advice would be helpful for the diabetic patient with a past history of
ulcerations on the feet?
a. Soak nightly in magnesium sulfate (Epsom salts).
b. Inspect feet daily.
c. Wear shoes with a tight toe box.
d. Wear shoes with a gel insole. - ✔✔b. Inspect feet daily. (wear shoes/socks for both
indoors and outdoors; never soak your feet; apply moisturizing lotion to the feet but
avoid in-between the toe spaces)
✔✔An arterial ulcer of the lower extremity can best be described as:
a. Painful lesion with well-defined edges, pale wound bed, and slough.
b. Irregular edges with thick creamy slough.
c. Painful lesion with dry edges and large amount of serous exudate.
d. Nonpainful lesion with eschar. - ✔✔a. Painful lesion with well-defined edges, pale
wound bed, and slough.
✔✔A patient comes to the wound clinic with brown skin discoloration on both lower
extremities. What is the likely cause?
a. Breakdown of hemoglobin in the tissues.
b. Contact dermatitis due to lotion.
c. Build up necrotic tissue.
d. Chronic erythema with edema. - ✔✔a. Breakdown of hemoglobin in the tissues.
✔✔A home health patient with a large chronic venous stasis ulcer complains that the
wound is draining more heavily and seems larger. Upon assessment, the WOC nurse
notes that the ulcer is 100% slough with bright red erythema and a foul odor. What
intervention would be appropriate?
a. Use an absorptive foam dressing.
b. Apply an antimicrobial dressing.
c. Cleanse the wound with an antiseptic.
d. Call the MD for an antibiotic order. - ✔✔d. Call the MD for an antibiotic order.
