CWCN FINAL EXAM 2026 ACTUAL QUESTIONS AND
SOLUTIONS RATED A+
✔✔The best assessment of an African American patient for pressure- related skin
alterations is to:
a. Look for redness of the skin over bony prominences
b. Look for blanching erythema the over bony prominences
c. Palpate the skin over bony prominences for a firm versus boggy consistency
d. Look for dark red or deep purple skin alterations over bony prominences - ✔✔c.
Palpate the skin over bony prominences for a firm versus boggy consistency
✔✔A patient with type 2 diabetes mellitus returns for her monthly wound care outpatient
follow-up visit. Her neuropathic hallux ulcer is healing nicely. Unfortunately, she
complains of a new onset of hyperpigmentation on the neck and axillary skin folds. You
suspect the dermatopathology of:
a. Necrobiosis lipoidica
b. A systemic reaction to the topical hallux ulcer dressing
c. Intertrigenous irritation
d. Acanthosis nigricans - ✔✔d. Acanthosis nigricans
✔✔You understand that identifying Stage I pressure ulcers in darker skin tones:
A. Only requires an ability to detect redness and other color changes over bony
prominences
B. Requires the comparison of adjacent and opposite intact skin or any identified skin
alterations
C. Is the same as required for lighter skin tones
D. Is easier to identify than for lighter skin tones - ✔✔B. Requires the comparison of
adjacent and opposite intact skin or any identified skin alterations
✔✔A patient with known lower extremity arterial disease (LEAD) is concerned about the
risk of amputation. You recommend the following limb-preservation strategies:
A. Keep feet warm with the use of hot water bottles
B. Use chemical agents to remove corns
C. Wear warm socks during cold weather
D. Walk barefoot only indoors - ✔✔C. Wear warm socks during cold weather
✔✔You identify the following wound as a Stage II pressure ulcer.
A. A shallow open area over the left lateral malleolus
B. A bright red partial thickness wound under an abdominal fold
C. A red partial thickness wound under the right axilla
D. A partial thickness midline abdominal wound at the distal end of an incision - ✔✔A. A
shallow open area over the left lateral malleolus
Stage II PI (Partial Thickness)
,✔✔A paraplegic patient is admitted with a Stage IV sacral/coccyx pressure ulcer. You
note that the patient has a Foley catheter, and is frequently incontinent of liquid feces.
The priority intervention is to obtain:
A. Nutritional referral
B. Incontinent briefs
C. A fecal containment system
D. Foam cut-out device for pressure redistribution - ✔✔C. A fecal containment system
Briefs can trap fecal output against the skin. Briefs are usually not recommended for
long-term fecal incontinence management because of the risk of Incontinence
Associated Dermatitis (IAD). Consider utilizing a pouching system or bowel or fecal
containment system to protect the skin from fecal effluent
✔✔The wound treatment nurse will consider the following when educating a patient and
family about the relationship between nutrition and wound healing.
A. High blood glucose levels are helpful because it will prevent protein being used as an
energy source.
B. Patients who are trying to lose weight should adhere to a calorie-restricted diet.
C. Vitamins A and C are water-soluble vitamins that help with collagen formation.
D. Protein needs for a patient with a wound may increase to 1.25 to 1.5 g/kg per day. -
✔✔D. Protein needs for a patient with a wound may increase to 1.25 to 1.5 g/kg per
day.
✔✔Which patient behavior would indicate that teaching about self-care and venous
insufficiency is effective? The patient reports:
A. Donning compression stockings first thing in the morning.
B. elevating the legs when sitting first thing in the morning.
C. not wearing the compression wrap consistently because shoes often do not fit.
D. not taking the prescribed diuretic because of increased nocturia. - ✔✔A. Donning
compression stockings first thing in the morning.
When donning stockings, Important to apply when edema is minimal (Optimal time to
apply the stockings: In the morning before getting out of bed)
✔✔How would the WOC nurse document skin injury present on each buttock at the site
where the buttocks touch each other?
A. Intertriginous dermatitis (ITD)
B. Incontinence-associated dermatitis (IAD)
C. Moisture-related pressure injury
D. Stage 2 pressure injury - ✔✔A. Intertriginous dermatitis (ITD)- "Kissing injury"
✔✔The WOC nurse is completing an initial assessment on a patient with controlled type
2 diabetes mellitus (DM) and a chronic diabetic neuropathic foot ulcer. Which of the
,following factors has the lowest risk of impacting the development of a sustainable
wound care plan?
A. Cultural factors
B. Financial resources
C. Cognitive ability
D. Disease process - ✔✔D. Disease process
✔✔When reviewing a patient's medication list, which medication is LEAST LIKELY to
impact wound healing?
A. Warfarin
B. Levothyroxine
C. Infliximab
D. Meloxicam - ✔✔B. Levothyroxine (indicated for thyroid conditions, no known effect
on wound healing)
✔✔The advanced practice registered nurse would consider which of the following tests
as the BEST option to further evaluate a diabetic foot ulcer that has increased in depth
and bone is now probed?
A. Wound culture
B. Magnetic resonance imaging (MRI)
c. X-ray
d. Complete blood cell count - ✔✔B. Magnetic resonance imaging (MRI)
Endogenous osteomyelitis is caused by pathogens carried by blood from a site of
infection in another area of the body. On the other hand, exogenous osteomyelitis is
caused by an infection that enters the body via open fractures, surgical procedures, or
wounds and spreads from soft tissue into adjacent bone.
✔✔Which of the following are key management strategies in treating calciphylaxis?
A. Pain management, sharp debridement, and warfarin
B. Sharp debridement, corticosteroids, and calcium supplement
C. Corticosteroids and avoiding warfarin and trauma
D. Pain management, underlying disease management, and avoiding trauma - ✔✔D.
Pain management, underlying disease management, and avoiding trauma
✔✔When caring for a 30-year-old man with Stevens-Johnson syndrome, what topical
dressing should be considered?
a. Petrolatum contact layer dressing
b. An occlusive transparent dressing
c. Dry gauze with no contact layer
d. Hydrocolloid dressing - ✔✔a. Petrolatum contact layer dressing (Help AVOID trauma
to wound bed & limit discomfort w/ removal of dressings)
, Stevens-Johnson syndrome (characterized by extensive necrosis & detachment of
epidermis, causing large amounts of transcutaneous fluid loss)
✔✔A 30-year-old female cosmetologist presents with recent onset of reddened patches
and multiple painful, oozing vesicles over her hands. Affected area is localized to the
dorsum, fingertips, and interdigital web spaces of hands. Her nails are unaffected. What
should the wound care nurse look for when reviewing the patient's history and
assessment?
A. History of childhood chicken pox
B. History of psoriasis or eczema
C. Recent change in soap, creams, or shampoo
D. Recent change in medications - ✔✔B. History of psoriasis or eczema
Acute irritant contact dermatitis occurs when an irritant, chemical or physical agent,
disrupts the topmost layer of the epidermis, thus leading to loss of skin barrier.
✔✔The advanced practice registered nurse (APRN) is managing a patient who has a
painful lower extremity wound with a necrotic wound bed and raised violaceous edges.
A culture and sensitivity test was negative for infection, and a biopsy showed
nonspecific findings but included neutrophilic inflammation. The patient has also
reported abdominal pains and diarrhea lasting for the past 5 months along with a 20-lb
weight loss. Which of the following should the APRN consider next?
A. Order a fiber supplement.
B. Refer the patient to gastrointestinal services for a colonoscopy.
C. Start the patient on loperamide.
D. Start the patient on corticosteroids. - ✔✔B. Refer the patient to gastrointestinal
services for a colonoscopy.
✔✔A 62-year-old patient has a nonhealing ulceration of the upper right arm that started
as a "scrape." The patient was referred to the wound clinic when topical and systemic
antibiotics were not successful in healing the wound. Since the patient has begun
treatment at the wound clinic, optimal topical management has been utilized to maintain
a moist wound-healing environment with still no improvement in the wound. What is the
next step in the treatment of this wound?
A. Obtain a wound culture.
B. Obtain a radiograph of the right arm.
C. Obtain a biopsy sample of the wound.
D. Check the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). -
✔✔C. Obtain a biopsy sample of the wound.
(Wound presents in an Atypical manner w/ Unclear etiology, Squamous cell carcinoma
+ basal cell carcinoma- can present as chronic wounds)
BIOPSY<-- "Gold Standard" for diagnosis & sample should be taken @ proximal or
leading margin of wound encompassing 50% of wound margin & 50% of adjacent tissue
SOLUTIONS RATED A+
✔✔The best assessment of an African American patient for pressure- related skin
alterations is to:
a. Look for redness of the skin over bony prominences
b. Look for blanching erythema the over bony prominences
c. Palpate the skin over bony prominences for a firm versus boggy consistency
d. Look for dark red or deep purple skin alterations over bony prominences - ✔✔c.
Palpate the skin over bony prominences for a firm versus boggy consistency
✔✔A patient with type 2 diabetes mellitus returns for her monthly wound care outpatient
follow-up visit. Her neuropathic hallux ulcer is healing nicely. Unfortunately, she
complains of a new onset of hyperpigmentation on the neck and axillary skin folds. You
suspect the dermatopathology of:
a. Necrobiosis lipoidica
b. A systemic reaction to the topical hallux ulcer dressing
c. Intertrigenous irritation
d. Acanthosis nigricans - ✔✔d. Acanthosis nigricans
✔✔You understand that identifying Stage I pressure ulcers in darker skin tones:
A. Only requires an ability to detect redness and other color changes over bony
prominences
B. Requires the comparison of adjacent and opposite intact skin or any identified skin
alterations
C. Is the same as required for lighter skin tones
D. Is easier to identify than for lighter skin tones - ✔✔B. Requires the comparison of
adjacent and opposite intact skin or any identified skin alterations
✔✔A patient with known lower extremity arterial disease (LEAD) is concerned about the
risk of amputation. You recommend the following limb-preservation strategies:
A. Keep feet warm with the use of hot water bottles
B. Use chemical agents to remove corns
C. Wear warm socks during cold weather
D. Walk barefoot only indoors - ✔✔C. Wear warm socks during cold weather
✔✔You identify the following wound as a Stage II pressure ulcer.
A. A shallow open area over the left lateral malleolus
B. A bright red partial thickness wound under an abdominal fold
C. A red partial thickness wound under the right axilla
D. A partial thickness midline abdominal wound at the distal end of an incision - ✔✔A. A
shallow open area over the left lateral malleolus
Stage II PI (Partial Thickness)
,✔✔A paraplegic patient is admitted with a Stage IV sacral/coccyx pressure ulcer. You
note that the patient has a Foley catheter, and is frequently incontinent of liquid feces.
The priority intervention is to obtain:
A. Nutritional referral
B. Incontinent briefs
C. A fecal containment system
D. Foam cut-out device for pressure redistribution - ✔✔C. A fecal containment system
Briefs can trap fecal output against the skin. Briefs are usually not recommended for
long-term fecal incontinence management because of the risk of Incontinence
Associated Dermatitis (IAD). Consider utilizing a pouching system or bowel or fecal
containment system to protect the skin from fecal effluent
✔✔The wound treatment nurse will consider the following when educating a patient and
family about the relationship between nutrition and wound healing.
A. High blood glucose levels are helpful because it will prevent protein being used as an
energy source.
B. Patients who are trying to lose weight should adhere to a calorie-restricted diet.
C. Vitamins A and C are water-soluble vitamins that help with collagen formation.
D. Protein needs for a patient with a wound may increase to 1.25 to 1.5 g/kg per day. -
✔✔D. Protein needs for a patient with a wound may increase to 1.25 to 1.5 g/kg per
day.
✔✔Which patient behavior would indicate that teaching about self-care and venous
insufficiency is effective? The patient reports:
A. Donning compression stockings first thing in the morning.
B. elevating the legs when sitting first thing in the morning.
C. not wearing the compression wrap consistently because shoes often do not fit.
D. not taking the prescribed diuretic because of increased nocturia. - ✔✔A. Donning
compression stockings first thing in the morning.
When donning stockings, Important to apply when edema is minimal (Optimal time to
apply the stockings: In the morning before getting out of bed)
✔✔How would the WOC nurse document skin injury present on each buttock at the site
where the buttocks touch each other?
A. Intertriginous dermatitis (ITD)
B. Incontinence-associated dermatitis (IAD)
C. Moisture-related pressure injury
D. Stage 2 pressure injury - ✔✔A. Intertriginous dermatitis (ITD)- "Kissing injury"
✔✔The WOC nurse is completing an initial assessment on a patient with controlled type
2 diabetes mellitus (DM) and a chronic diabetic neuropathic foot ulcer. Which of the
,following factors has the lowest risk of impacting the development of a sustainable
wound care plan?
A. Cultural factors
B. Financial resources
C. Cognitive ability
D. Disease process - ✔✔D. Disease process
✔✔When reviewing a patient's medication list, which medication is LEAST LIKELY to
impact wound healing?
A. Warfarin
B. Levothyroxine
C. Infliximab
D. Meloxicam - ✔✔B. Levothyroxine (indicated for thyroid conditions, no known effect
on wound healing)
✔✔The advanced practice registered nurse would consider which of the following tests
as the BEST option to further evaluate a diabetic foot ulcer that has increased in depth
and bone is now probed?
A. Wound culture
B. Magnetic resonance imaging (MRI)
c. X-ray
d. Complete blood cell count - ✔✔B. Magnetic resonance imaging (MRI)
Endogenous osteomyelitis is caused by pathogens carried by blood from a site of
infection in another area of the body. On the other hand, exogenous osteomyelitis is
caused by an infection that enters the body via open fractures, surgical procedures, or
wounds and spreads from soft tissue into adjacent bone.
✔✔Which of the following are key management strategies in treating calciphylaxis?
A. Pain management, sharp debridement, and warfarin
B. Sharp debridement, corticosteroids, and calcium supplement
C. Corticosteroids and avoiding warfarin and trauma
D. Pain management, underlying disease management, and avoiding trauma - ✔✔D.
Pain management, underlying disease management, and avoiding trauma
✔✔When caring for a 30-year-old man with Stevens-Johnson syndrome, what topical
dressing should be considered?
a. Petrolatum contact layer dressing
b. An occlusive transparent dressing
c. Dry gauze with no contact layer
d. Hydrocolloid dressing - ✔✔a. Petrolatum contact layer dressing (Help AVOID trauma
to wound bed & limit discomfort w/ removal of dressings)
, Stevens-Johnson syndrome (characterized by extensive necrosis & detachment of
epidermis, causing large amounts of transcutaneous fluid loss)
✔✔A 30-year-old female cosmetologist presents with recent onset of reddened patches
and multiple painful, oozing vesicles over her hands. Affected area is localized to the
dorsum, fingertips, and interdigital web spaces of hands. Her nails are unaffected. What
should the wound care nurse look for when reviewing the patient's history and
assessment?
A. History of childhood chicken pox
B. History of psoriasis or eczema
C. Recent change in soap, creams, or shampoo
D. Recent change in medications - ✔✔B. History of psoriasis or eczema
Acute irritant contact dermatitis occurs when an irritant, chemical or physical agent,
disrupts the topmost layer of the epidermis, thus leading to loss of skin barrier.
✔✔The advanced practice registered nurse (APRN) is managing a patient who has a
painful lower extremity wound with a necrotic wound bed and raised violaceous edges.
A culture and sensitivity test was negative for infection, and a biopsy showed
nonspecific findings but included neutrophilic inflammation. The patient has also
reported abdominal pains and diarrhea lasting for the past 5 months along with a 20-lb
weight loss. Which of the following should the APRN consider next?
A. Order a fiber supplement.
B. Refer the patient to gastrointestinal services for a colonoscopy.
C. Start the patient on loperamide.
D. Start the patient on corticosteroids. - ✔✔B. Refer the patient to gastrointestinal
services for a colonoscopy.
✔✔A 62-year-old patient has a nonhealing ulceration of the upper right arm that started
as a "scrape." The patient was referred to the wound clinic when topical and systemic
antibiotics were not successful in healing the wound. Since the patient has begun
treatment at the wound clinic, optimal topical management has been utilized to maintain
a moist wound-healing environment with still no improvement in the wound. What is the
next step in the treatment of this wound?
A. Obtain a wound culture.
B. Obtain a radiograph of the right arm.
C. Obtain a biopsy sample of the wound.
D. Check the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). -
✔✔C. Obtain a biopsy sample of the wound.
(Wound presents in an Atypical manner w/ Unclear etiology, Squamous cell carcinoma
+ basal cell carcinoma- can present as chronic wounds)
BIOPSY<-- "Gold Standard" for diagnosis & sample should be taken @ proximal or
leading margin of wound encompassing 50% of wound margin & 50% of adjacent tissue
