CWCN UPDATED 2026 EXAM SCRIPT QUESTIONS AND
SOLUTIONS RATED A+
✔✔Comprehensive exam of a 50-year-old man with inflammatory bowel disease
reveals chronic diarrhea with occasional fecal incontinence. His International
Consultation on Incontinence Questionnaire-Bowel Symptoms (ICIQ-B) indicates a poor
quality-of-life related to fecal incontinence. Further interview provides evidence that the
patient's lifestyle may be contributing to his incontinence. Which of the following
information provided during the interview would the continence nurse identify as a
reversible risk factor for this patient's fecal incontinence?
A. High fat diet
B. History of back injury
C. Use of body-worn absorbent products
D. Probiotics - ✔✔A. High Fat diet (known to increased GI motility & Risk fo for fecal
incontinence)
✔✔The APRN is consulted to evaluate a malodorous wound. What would be the most
appropriate treatment?
A. Fluconazole
B. Metronidazole
C. Miconazole
D. Minocycline - ✔✔B. Metronidazole ← Effective in controlling odor by reducing the
odor-producing anaerobic pathogens
- Wound odor← Often caused by Anaerobic pathogens in wound
- Odor← common w/ chronic wounds
- Effective in fungating wounds due to Gram negative activity
✔✔A newly diagnosed patient with diabetes with an A1C of 10.2 has a wound on the
lateral aspect of the foot with evidence of exposed tendon (Wagner grade 2). What
would be the most appropriate intervention for this patient?
A. Evaluate for hyperbaric oxygen therapy (HBOT)
B. Order a pulse volume recording study
C. Refer to a diabetic educator
D. Start enzymatic debridement - ✔✔C. Refer to a diabetic educator
✔✔You are concerned about the patient's complaints of itching to the skin around the
leg ulcer. You will contact the licensed independent practitioner (LIP) to apply this
substance to the intact periwound skin before the compression stocking:
A. Lidocaine Gel
B. Topical corticosteroid
C. Neomycin
D. Silver Sulfadiazine - ✔✔B. Topical corticosteroid
,(mild potency) can be applied to periwound over Short term to decrease inflammation
+itching
✔✔Scattered thin lesions of smooth white plaque are noted around a patient's dry
bilateral ankles and feet. You tell the patient that:
A. They are healed full-thickness ulcers, and we need to protect them
B. They are healed full-thickness ulcers, and we need to protect them
C. These skin changes are called atrophie blanche, and we need to protect them
D. You will need a physical therapy referral for lymphedema management - ✔✔C.
These skin changes are called atrophie blanche, and we need to protect them
✔✔A patient with darker skin tone has a lower extremity wound. After a saturated
dressing is removed, the periwound skin was assessed as gray in color and wrinkled in
appearance. What is the best treatment for this wound?
A. Zinc-based barrier to peri-wound, nonadhesive foam dressing
B. Liquid acrylate barrier film to peri-wound, adhesive foam dressing
C. Petrolatum ointment to peri-wound, adhesive foam dressing
D. Hydrogel to wound base, transparent adhesive dressing - ✔✔B. Liquid acrylate
barrier film to peri-wound, adhesive foam dressing
✔✔A man with a chronic lower leg venous insufficiency ulcer has had intermittent
improvement and worsening of the ulcer over 5 years. In the last month, the wound has
developed a pearly white, flat wound bed with raised, firm wound margins. The ulcer
has not improved despite several topical dressing changes geared to disrupt biofilm
production and promote healing. You are considering the use of growth factors in the
wound care plan. What should you do next?
A. Consult a licensed independent practitioner, LIP, and request a wound biopsy
B. Consult a vascular medicine physician and request an arterial blood flow study
C. Consult a physician to request a complete blood count
D. Interview the patient to assess any barriers to wound care dressing adherence -
✔✔A. Consult a licensed independent practitioner, LIP, and request a wound biopsy
Marjolin ulcers present as flat, indolent, pearly white lesions with indurated, elevated
margins. (Growth factor use is contraindicated in the presence of cancerous lesion)
✔✔A 10-year-old boy with sickle cell anemia is being seen for a non-healing ulcer
caused by a bicycle accident near his right lateral malleolus. The child is terrified of his
twice-daily dressing changes due to the pain. What is the best recommendation?
A. Premedicate him for pain 20 minutes prior to the dressing changes
B. Apply a calcium alginate as the primary dressing, a nonadherent foam as the
secondary, and secure with a flexible tube netting. Change every other day
C. Recommend that a contact cast be applied twice weekly
,D. Refer for hyperbaric oxygen therapy (HBOT) to improve perfusion - ✔✔B. Apply a
calcium alginate as the primary dressing, a nonadherent foam as the secondary, and
secure with a flexible tube netting. Change every other day
✔✔The following are characteristics of a typical venous leg ulcer except:
A. Irregular wound edges
B. Gaiter location
C. Macerated periwound skin
D. Purulent drainage - ✔✔D. Purulent drainage
✔✔A man with a chronic lower leg venous insufficiency ulcer has had intermittent
improvement and worsening of the ulcer over 5 years. In the last month, the wound has
developed a pearly white, flat wound bed with raised, firm wound margins. The ulcer
has not improved despite several topical dressing changes geared to disrupt biofilm
production and promote healing. You are considering the use of growth factors in the
wound care plan. What should you do next?
A. Consult a licensed independent practitioner, LIP, and request a wound biopsy
B. Consult a vascular medicine physician and request an arterial blood flow study
B. Consult a physician to request a complete blood count
D. Interview the patient to assess any barriers to wound care dressing adherence -
✔✔A. Consult a licensed independent practitioner, LIP, and request a wound biopsy
✔✔A 65-year-old patient is receiving follow-up care in the wound center for a mixed
etiology lower extremity wound from venous and arterial disease. Initially, the wound
measured 6 x 4 x 0.4 cm with moderate exudate and marked edema. The initial
dressing consisted of hydrofiber dressing in addition to modified compression given
arterial disease. The patient is now 3 weeks into care and, upon assessment, the
edema has significantly decreased. The wound now measures 2 x 0.5 x 0.1 cm with
minimal exudative. What dressing would be most appropriate?
A. Alginate dressing and no compression
B. Normal saline wet to moist with no compression
C. Collagen dressing with modified compression
D. Continue hydrofiber and modified compression - ✔✔C. Collagen dressing with
modified compression
✔✔Ms. Y., a 56-year-old woman with paraplegia following a motor vehicle accident 7
years ago, presents with a stage IV pressure ulcer. The wound bed is clean with a
shallow bed of granulation tissue; it has not progressed for several weeks. There is no
evidence of infection, and a proper support surface with correct transfer techniques is
being used. What is the best option at this time?
A. Application of becaplermin (Regranex®)
B. Hyperbaric oxygen therapy (HBOT)
C. Negative-pressure wound therapy (NPWT)
D. Myocutaneous flap - ✔✔D. Myocutaneous flap
, ✔✔You are educating a family member about pressure ulcer prevention interventions.
Which of the following interventions would not be appropriate?
A. Ask family members to come to the hospital to learn techniques of care before the
patient's discharge
B. Inform family members the repositioning can be delayed if the patient just got to
sleep
C. Inform family members that patients have the right to decline interventions
D. Provide educational material at the family member's appropriate reading level - ✔✔B.
Inform family members the repositioning can be delayed if the patient just got to sleep
✔✔How do you effectively manage a gastrostomy tube site with hypergranulation
tissue?
A. Gel gauze and dry outer dressing
B. Dakin's solution®-moistened gauze and foam dressing
C. Domboro's® soaks application
D. Silver nitrate stick application - ✔✔D. Silver nitrate stick application
✔✔You document that the Stage III pressure ulcer has a heavy exudate. After cleansing
the wound with normal saline, the most appropriate wound dressing is:
A. Lightly pack the wound with a calcium alginate and cover with a secondary dressing
B. Cover with a hydrocolloid
C. Apply a layer of hydrogel and cover with a secondary dressing.
D. Apply a layer of hydrogel, lightly pack with a calcium alginate and cover with a
secondary dressing - ✔✔A. Lightly pack the wound with a calcium alginate and cover
with a secondary dressing
✔✔What measure could be implemented to reduce pain in a pediatric patient receiving
negative pressure wound therapy (NPWT)?
A. Contact layer
B. Increase negative pressure setting
C. White foam dressing
D. Silver nitrate - ✔✔A. Contact layer
✔✔Which one of the following historical risk factors does not contribute to venous
insufficiency ulcerations:
a. Open venous leg ulcer > 6 months
b. Lower extremity deep vein thrombosis
c. Paroxysmal atrial fibrillation
D. Motor vehicle accident involving the lower legs - ✔✔c. Paroxysmal atrial fibrillation
✔✔Mr. Jones has a partial-thickness wound on his right arm. The major components of
partial-thickness repair include (in order):
SOLUTIONS RATED A+
✔✔Comprehensive exam of a 50-year-old man with inflammatory bowel disease
reveals chronic diarrhea with occasional fecal incontinence. His International
Consultation on Incontinence Questionnaire-Bowel Symptoms (ICIQ-B) indicates a poor
quality-of-life related to fecal incontinence. Further interview provides evidence that the
patient's lifestyle may be contributing to his incontinence. Which of the following
information provided during the interview would the continence nurse identify as a
reversible risk factor for this patient's fecal incontinence?
A. High fat diet
B. History of back injury
C. Use of body-worn absorbent products
D. Probiotics - ✔✔A. High Fat diet (known to increased GI motility & Risk fo for fecal
incontinence)
✔✔The APRN is consulted to evaluate a malodorous wound. What would be the most
appropriate treatment?
A. Fluconazole
B. Metronidazole
C. Miconazole
D. Minocycline - ✔✔B. Metronidazole ← Effective in controlling odor by reducing the
odor-producing anaerobic pathogens
- Wound odor← Often caused by Anaerobic pathogens in wound
- Odor← common w/ chronic wounds
- Effective in fungating wounds due to Gram negative activity
✔✔A newly diagnosed patient with diabetes with an A1C of 10.2 has a wound on the
lateral aspect of the foot with evidence of exposed tendon (Wagner grade 2). What
would be the most appropriate intervention for this patient?
A. Evaluate for hyperbaric oxygen therapy (HBOT)
B. Order a pulse volume recording study
C. Refer to a diabetic educator
D. Start enzymatic debridement - ✔✔C. Refer to a diabetic educator
✔✔You are concerned about the patient's complaints of itching to the skin around the
leg ulcer. You will contact the licensed independent practitioner (LIP) to apply this
substance to the intact periwound skin before the compression stocking:
A. Lidocaine Gel
B. Topical corticosteroid
C. Neomycin
D. Silver Sulfadiazine - ✔✔B. Topical corticosteroid
,(mild potency) can be applied to periwound over Short term to decrease inflammation
+itching
✔✔Scattered thin lesions of smooth white plaque are noted around a patient's dry
bilateral ankles and feet. You tell the patient that:
A. They are healed full-thickness ulcers, and we need to protect them
B. They are healed full-thickness ulcers, and we need to protect them
C. These skin changes are called atrophie blanche, and we need to protect them
D. You will need a physical therapy referral for lymphedema management - ✔✔C.
These skin changes are called atrophie blanche, and we need to protect them
✔✔A patient with darker skin tone has a lower extremity wound. After a saturated
dressing is removed, the periwound skin was assessed as gray in color and wrinkled in
appearance. What is the best treatment for this wound?
A. Zinc-based barrier to peri-wound, nonadhesive foam dressing
B. Liquid acrylate barrier film to peri-wound, adhesive foam dressing
C. Petrolatum ointment to peri-wound, adhesive foam dressing
D. Hydrogel to wound base, transparent adhesive dressing - ✔✔B. Liquid acrylate
barrier film to peri-wound, adhesive foam dressing
✔✔A man with a chronic lower leg venous insufficiency ulcer has had intermittent
improvement and worsening of the ulcer over 5 years. In the last month, the wound has
developed a pearly white, flat wound bed with raised, firm wound margins. The ulcer
has not improved despite several topical dressing changes geared to disrupt biofilm
production and promote healing. You are considering the use of growth factors in the
wound care plan. What should you do next?
A. Consult a licensed independent practitioner, LIP, and request a wound biopsy
B. Consult a vascular medicine physician and request an arterial blood flow study
C. Consult a physician to request a complete blood count
D. Interview the patient to assess any barriers to wound care dressing adherence -
✔✔A. Consult a licensed independent practitioner, LIP, and request a wound biopsy
Marjolin ulcers present as flat, indolent, pearly white lesions with indurated, elevated
margins. (Growth factor use is contraindicated in the presence of cancerous lesion)
✔✔A 10-year-old boy with sickle cell anemia is being seen for a non-healing ulcer
caused by a bicycle accident near his right lateral malleolus. The child is terrified of his
twice-daily dressing changes due to the pain. What is the best recommendation?
A. Premedicate him for pain 20 minutes prior to the dressing changes
B. Apply a calcium alginate as the primary dressing, a nonadherent foam as the
secondary, and secure with a flexible tube netting. Change every other day
C. Recommend that a contact cast be applied twice weekly
,D. Refer for hyperbaric oxygen therapy (HBOT) to improve perfusion - ✔✔B. Apply a
calcium alginate as the primary dressing, a nonadherent foam as the secondary, and
secure with a flexible tube netting. Change every other day
✔✔The following are characteristics of a typical venous leg ulcer except:
A. Irregular wound edges
B. Gaiter location
C. Macerated periwound skin
D. Purulent drainage - ✔✔D. Purulent drainage
✔✔A man with a chronic lower leg venous insufficiency ulcer has had intermittent
improvement and worsening of the ulcer over 5 years. In the last month, the wound has
developed a pearly white, flat wound bed with raised, firm wound margins. The ulcer
has not improved despite several topical dressing changes geared to disrupt biofilm
production and promote healing. You are considering the use of growth factors in the
wound care plan. What should you do next?
A. Consult a licensed independent practitioner, LIP, and request a wound biopsy
B. Consult a vascular medicine physician and request an arterial blood flow study
B. Consult a physician to request a complete blood count
D. Interview the patient to assess any barriers to wound care dressing adherence -
✔✔A. Consult a licensed independent practitioner, LIP, and request a wound biopsy
✔✔A 65-year-old patient is receiving follow-up care in the wound center for a mixed
etiology lower extremity wound from venous and arterial disease. Initially, the wound
measured 6 x 4 x 0.4 cm with moderate exudate and marked edema. The initial
dressing consisted of hydrofiber dressing in addition to modified compression given
arterial disease. The patient is now 3 weeks into care and, upon assessment, the
edema has significantly decreased. The wound now measures 2 x 0.5 x 0.1 cm with
minimal exudative. What dressing would be most appropriate?
A. Alginate dressing and no compression
B. Normal saline wet to moist with no compression
C. Collagen dressing with modified compression
D. Continue hydrofiber and modified compression - ✔✔C. Collagen dressing with
modified compression
✔✔Ms. Y., a 56-year-old woman with paraplegia following a motor vehicle accident 7
years ago, presents with a stage IV pressure ulcer. The wound bed is clean with a
shallow bed of granulation tissue; it has not progressed for several weeks. There is no
evidence of infection, and a proper support surface with correct transfer techniques is
being used. What is the best option at this time?
A. Application of becaplermin (Regranex®)
B. Hyperbaric oxygen therapy (HBOT)
C. Negative-pressure wound therapy (NPWT)
D. Myocutaneous flap - ✔✔D. Myocutaneous flap
, ✔✔You are educating a family member about pressure ulcer prevention interventions.
Which of the following interventions would not be appropriate?
A. Ask family members to come to the hospital to learn techniques of care before the
patient's discharge
B. Inform family members the repositioning can be delayed if the patient just got to
sleep
C. Inform family members that patients have the right to decline interventions
D. Provide educational material at the family member's appropriate reading level - ✔✔B.
Inform family members the repositioning can be delayed if the patient just got to sleep
✔✔How do you effectively manage a gastrostomy tube site with hypergranulation
tissue?
A. Gel gauze and dry outer dressing
B. Dakin's solution®-moistened gauze and foam dressing
C. Domboro's® soaks application
D. Silver nitrate stick application - ✔✔D. Silver nitrate stick application
✔✔You document that the Stage III pressure ulcer has a heavy exudate. After cleansing
the wound with normal saline, the most appropriate wound dressing is:
A. Lightly pack the wound with a calcium alginate and cover with a secondary dressing
B. Cover with a hydrocolloid
C. Apply a layer of hydrogel and cover with a secondary dressing.
D. Apply a layer of hydrogel, lightly pack with a calcium alginate and cover with a
secondary dressing - ✔✔A. Lightly pack the wound with a calcium alginate and cover
with a secondary dressing
✔✔What measure could be implemented to reduce pain in a pediatric patient receiving
negative pressure wound therapy (NPWT)?
A. Contact layer
B. Increase negative pressure setting
C. White foam dressing
D. Silver nitrate - ✔✔A. Contact layer
✔✔Which one of the following historical risk factors does not contribute to venous
insufficiency ulcerations:
a. Open venous leg ulcer > 6 months
b. Lower extremity deep vein thrombosis
c. Paroxysmal atrial fibrillation
D. Motor vehicle accident involving the lower legs - ✔✔c. Paroxysmal atrial fibrillation
✔✔Mr. Jones has a partial-thickness wound on his right arm. The major components of
partial-thickness repair include (in order):
