WOCNCB Certified Wound
Care Nurse (CWCN) Exam
Prep 2025/2026 | Based on
Wound Management Core
Curriculum 2nd Edition by
Laurie McNichol, Catherine
Ratliff, and Stephanie Yates |
Detailed Questions &
Rationales for First-Attempt
Success
,what are 6 risk factor components of Braden Scale for pressure ulcer? - CORRECT
ANSWERSsensory perception, moisture, mobility, activity, nutrition, and shear/friction
What is the name of the organization that developed the pressure ulcer staging? -
CORRECT ANSWERSNPUAP (national pressure ulcer advisory panel)
pathological effect of excessive pressure on soft tissue can be attributed by 3 factors?
what are they? - CORRECT ANSWERStissue tolerance, duration of pressure, and
intensity of pressure
what are the extrinsic factors that impact pressure ulcers? - CORRECT
ANSWERSincrease in moisture, friction and shearing
how does friction play a role in shearing which eventually leads to pressure ulcer? -
CORRECT ANSWERSfriction alone causes only superfical abrasion, but with gravity it
plays a synergistic effect leading to shearing. When gravity pushes down on the body
and resistance (friction) between the patient and surface is exerted, shearing occurs.
because skin does not freely move, primary effect of shearing occurs at the deeper
fascial level.
what are the intrisinc factors of pressur ulcers? - CORRECT ANSWERSnutritional
debilitation, advanced age, low BP, stress, smoking, elevated body temperature
Aging skin undergoes what elements affecting risk for pressure ulcer? - CORRECT
ANSWERSdermoepidermal junction flattens, less nutrient exchange occurs, less
resistance to shearing, changes in sensory perception, loss of dermal thickness,
increased vascular fragility; ability of soft tisuse to distribute mechanical load w/out
comprosing blood flow is impaired
What does nonblanching erythema indicate in the skin r/t PU? - CORRECT
ANSWERSwhen pressure is applied to the erythematic area skin becomes white
(blanched), but once relieved, erythema returns -indicating blood flow; however in
, nonblanching erythema, skin does not blanche-indicating impaired blood flow-
suggesting tissue destructon
why does sitting in a chair pose more of a risk in skin break down than lying? -
CORRECT ANSWERSdeep tissue injury or PU is likely to occur sooner sitting down
because tissue offloading over boney prominences is higher
Describe what you will see in deep tissue injury? - CORRECT ANSWERSpurple or
maroon localized area of discolored intact skin skinor blood filled blister; may be
preceded by painful, firm, mushy, or boggy; skin may be warmer to cooler in adjacent
tissue. In dark skin, thin blister or eschar over a dark wound bed may bee seen
Describe stage I pressure ulcer? - CORRECT ANSWERSIntact skin with nonblanchable
redness of localized area. Will not see blanching in dark skin, but changes in skin tissue
consistency (firm vs boggy when palpated), sensation (pain), and warmer or cooler
temperature may differ from surrounding area
Describe stage II pressure ulcer? - CORRECT ANSWERSpartial-thickness wound
where epidermis and tip of dermis is lost with red-pink wound bed w/out slough. may
also present as intact or open/ruptured serum -filled blister
Describe stage III pressure ulcer? - CORRECT ANSWERSfull-thickness wound where
both epidermis and dermis is lost and subcutaneous tissue may be visible, but deeper
structures such as muscle, bone, and tendon are not exposed; slough my be present
but it doesn't obscure depth and tunneling and undermining may be present
Describe stage IV pressure ulcer? - CORRECT ANSWERSfull-thickness wound with
exposed bone,tendon, and muscle; slough or eschar may be seen in some parts of the
wound bed. you will often see tunneling and undermining. Osteomyelitis may be dxed at
this stage, since bone is palpable
Describe unstageble ulcers? - CORRECT ANSWERSfull-thickness wound where base
of the ulcer is covered by slough and/or eschar, obscuring depth
When should eschars not be removed? - CORRECT ANSWERSwhen it's stable with
dry, adherent, and intact w/out erythema on the heel; this serves as the body's natural
cover and should not be removed.
Therapeutic function of pressure distribution is accomplised by what 2 factors? -
CORRECT ANSWERSimmersion and envelopement
Define immersion? - CORRECT ANSWERSdepth of penetration or skining into surgace
allowing pressure to be spread out over surrounding area rather than directly over
boney prominence
Care Nurse (CWCN) Exam
Prep 2025/2026 | Based on
Wound Management Core
Curriculum 2nd Edition by
Laurie McNichol, Catherine
Ratliff, and Stephanie Yates |
Detailed Questions &
Rationales for First-Attempt
Success
,what are 6 risk factor components of Braden Scale for pressure ulcer? - CORRECT
ANSWERSsensory perception, moisture, mobility, activity, nutrition, and shear/friction
What is the name of the organization that developed the pressure ulcer staging? -
CORRECT ANSWERSNPUAP (national pressure ulcer advisory panel)
pathological effect of excessive pressure on soft tissue can be attributed by 3 factors?
what are they? - CORRECT ANSWERStissue tolerance, duration of pressure, and
intensity of pressure
what are the extrinsic factors that impact pressure ulcers? - CORRECT
ANSWERSincrease in moisture, friction and shearing
how does friction play a role in shearing which eventually leads to pressure ulcer? -
CORRECT ANSWERSfriction alone causes only superfical abrasion, but with gravity it
plays a synergistic effect leading to shearing. When gravity pushes down on the body
and resistance (friction) between the patient and surface is exerted, shearing occurs.
because skin does not freely move, primary effect of shearing occurs at the deeper
fascial level.
what are the intrisinc factors of pressur ulcers? - CORRECT ANSWERSnutritional
debilitation, advanced age, low BP, stress, smoking, elevated body temperature
Aging skin undergoes what elements affecting risk for pressure ulcer? - CORRECT
ANSWERSdermoepidermal junction flattens, less nutrient exchange occurs, less
resistance to shearing, changes in sensory perception, loss of dermal thickness,
increased vascular fragility; ability of soft tisuse to distribute mechanical load w/out
comprosing blood flow is impaired
What does nonblanching erythema indicate in the skin r/t PU? - CORRECT
ANSWERSwhen pressure is applied to the erythematic area skin becomes white
(blanched), but once relieved, erythema returns -indicating blood flow; however in
, nonblanching erythema, skin does not blanche-indicating impaired blood flow-
suggesting tissue destructon
why does sitting in a chair pose more of a risk in skin break down than lying? -
CORRECT ANSWERSdeep tissue injury or PU is likely to occur sooner sitting down
because tissue offloading over boney prominences is higher
Describe what you will see in deep tissue injury? - CORRECT ANSWERSpurple or
maroon localized area of discolored intact skin skinor blood filled blister; may be
preceded by painful, firm, mushy, or boggy; skin may be warmer to cooler in adjacent
tissue. In dark skin, thin blister or eschar over a dark wound bed may bee seen
Describe stage I pressure ulcer? - CORRECT ANSWERSIntact skin with nonblanchable
redness of localized area. Will not see blanching in dark skin, but changes in skin tissue
consistency (firm vs boggy when palpated), sensation (pain), and warmer or cooler
temperature may differ from surrounding area
Describe stage II pressure ulcer? - CORRECT ANSWERSpartial-thickness wound
where epidermis and tip of dermis is lost with red-pink wound bed w/out slough. may
also present as intact or open/ruptured serum -filled blister
Describe stage III pressure ulcer? - CORRECT ANSWERSfull-thickness wound where
both epidermis and dermis is lost and subcutaneous tissue may be visible, but deeper
structures such as muscle, bone, and tendon are not exposed; slough my be present
but it doesn't obscure depth and tunneling and undermining may be present
Describe stage IV pressure ulcer? - CORRECT ANSWERSfull-thickness wound with
exposed bone,tendon, and muscle; slough or eschar may be seen in some parts of the
wound bed. you will often see tunneling and undermining. Osteomyelitis may be dxed at
this stage, since bone is palpable
Describe unstageble ulcers? - CORRECT ANSWERSfull-thickness wound where base
of the ulcer is covered by slough and/or eschar, obscuring depth
When should eschars not be removed? - CORRECT ANSWERSwhen it's stable with
dry, adherent, and intact w/out erythema on the heel; this serves as the body's natural
cover and should not be removed.
Therapeutic function of pressure distribution is accomplised by what 2 factors? -
CORRECT ANSWERSimmersion and envelopement
Define immersion? - CORRECT ANSWERSdepth of penetration or skining into surgace
allowing pressure to be spread out over surrounding area rather than directly over
boney prominence
