2026 CERTIFIED WOUND CARE NURSE
(CWCN) CERTIFICATION EXAMINATION
Domain 1: Pressure Injury Staging & Assessment (Q1-15)
Q1. A patient presents with a wound over the sacrum that is shallow with a
pink/red wound bed. There is no slough or bruising. How should the nurse
document this pressure injury?
• A. Stage 1 Pressure Injury
• B. Stage 2 Pressure Injury
• C. Stage 3 Pressure Injury
• D. Deep Tissue Pressure Injury
Correct Answer: B. Stage 2 Pressure Injury
Rationale: A Stage 2 pressure injury presents as partial-thickness skin loss with
exposed dermis. The wound bed is viable, pink or red, and moist, without slough
or bruising. Stage 1 is intact skin with non-blanchable erythema. Stage 3 involves
full-thickness skin loss with visible subcutaneous fat. Deep Tissue Injury presents
as intact skin with non-blanchable deep red, maroon, or purple discoloration .
Q2. What are the 6 risk factor components of the Braden Scale for pressure
ulcer prediction?
, • A. Age, gender, nutrition, mobility, continence, skin condition
• B. Sensory perception, moisture, mobility, activity, nutrition, and
shear/friction
• C. Mental status, nutrition, incontinence, activity, mobility, infection
• D. Pain, temperature, edema, capillary refill, skin turgor, sensation
Correct Answer: B. Sensory perception, moisture, mobility, activity, nutrition,
and shear/friction
Rationale: The Braden Scale assesses six subscales: sensory perception (ability to
respond to pressure-related discomfort), moisture (degree of skin exposure to
moisture), activity (degree of physical activity), mobility (ability to change and
control body position), nutrition (usual food intake pattern), and friction/shear .
Q3. What does non-blanching erythema indicate regarding pressure ulcer
development?
• A. Normal blood flow response
• B. Impaired blood flow suggesting tissue destruction
• C. Superficial fungal infection
• D. Allergic contact dermatitis
Correct Answer: B. Impaired blood flow suggesting tissue destruction
Rationale: When pressure is applied to an erythematous area, normal skin
becomes white (blanches) as blood is temporarily displaced. In non-blanching
erythema, the skin does not blanche, indicating impaired blood flow and
suggesting tissue destruction has begun. This is the defining characteristic of a
Stage 1 pressure injury .
, Q4. The pathological effect of excessive pressure on soft tissue can be
attributed to which 3 factors?
• A. Infection, inflammation, and ischemia
• B. Tissue tolerance, duration of pressure, and intensity of pressure
• C. Moisture, friction, and bacterial load
• D. Age, nutrition, and medication use
Correct Answer: B. Tissue tolerance, duration of pressure, and intensity of
pressure
Rationale: The pathological effect of excessive pressure on soft tissue is
determined by three interrelated factors: tissue tolerance (the ability of tissue to
withstand pressure), duration of pressure (how long pressure is applied), and
intensity of pressure (the amount of pressure applied) .
Q5. Why does sitting in a chair pose more risk for skin breakdown than lying
down?
• A. Sitting increases body temperature
• B. Tissue offloading over bony prominences is higher when sitting
• C. Sitting decreases blood pressure
• D. Chair surfaces are harder than mattress surfaces
Correct Answer: B. Tissue offloading over bony prominences is higher when
sitting
Rationale: Deep tissue injury or pressure ulcers are likely to occur sooner when
sitting because tissue offloading over bony prominences is higher. The ischial
(CWCN) CERTIFICATION EXAMINATION
Domain 1: Pressure Injury Staging & Assessment (Q1-15)
Q1. A patient presents with a wound over the sacrum that is shallow with a
pink/red wound bed. There is no slough or bruising. How should the nurse
document this pressure injury?
• A. Stage 1 Pressure Injury
• B. Stage 2 Pressure Injury
• C. Stage 3 Pressure Injury
• D. Deep Tissue Pressure Injury
Correct Answer: B. Stage 2 Pressure Injury
Rationale: A Stage 2 pressure injury presents as partial-thickness skin loss with
exposed dermis. The wound bed is viable, pink or red, and moist, without slough
or bruising. Stage 1 is intact skin with non-blanchable erythema. Stage 3 involves
full-thickness skin loss with visible subcutaneous fat. Deep Tissue Injury presents
as intact skin with non-blanchable deep red, maroon, or purple discoloration .
Q2. What are the 6 risk factor components of the Braden Scale for pressure
ulcer prediction?
, • A. Age, gender, nutrition, mobility, continence, skin condition
• B. Sensory perception, moisture, mobility, activity, nutrition, and
shear/friction
• C. Mental status, nutrition, incontinence, activity, mobility, infection
• D. Pain, temperature, edema, capillary refill, skin turgor, sensation
Correct Answer: B. Sensory perception, moisture, mobility, activity, nutrition,
and shear/friction
Rationale: The Braden Scale assesses six subscales: sensory perception (ability to
respond to pressure-related discomfort), moisture (degree of skin exposure to
moisture), activity (degree of physical activity), mobility (ability to change and
control body position), nutrition (usual food intake pattern), and friction/shear .
Q3. What does non-blanching erythema indicate regarding pressure ulcer
development?
• A. Normal blood flow response
• B. Impaired blood flow suggesting tissue destruction
• C. Superficial fungal infection
• D. Allergic contact dermatitis
Correct Answer: B. Impaired blood flow suggesting tissue destruction
Rationale: When pressure is applied to an erythematous area, normal skin
becomes white (blanches) as blood is temporarily displaced. In non-blanching
erythema, the skin does not blanche, indicating impaired blood flow and
suggesting tissue destruction has begun. This is the defining characteristic of a
Stage 1 pressure injury .
, Q4. The pathological effect of excessive pressure on soft tissue can be
attributed to which 3 factors?
• A. Infection, inflammation, and ischemia
• B. Tissue tolerance, duration of pressure, and intensity of pressure
• C. Moisture, friction, and bacterial load
• D. Age, nutrition, and medication use
Correct Answer: B. Tissue tolerance, duration of pressure, and intensity of
pressure
Rationale: The pathological effect of excessive pressure on soft tissue is
determined by three interrelated factors: tissue tolerance (the ability of tissue to
withstand pressure), duration of pressure (how long pressure is applied), and
intensity of pressure (the amount of pressure applied) .
Q5. Why does sitting in a chair pose more risk for skin breakdown than lying
down?
• A. Sitting increases body temperature
• B. Tissue offloading over bony prominences is higher when sitting
• C. Sitting decreases blood pressure
• D. Chair surfaces are harder than mattress surfaces
Correct Answer: B. Tissue offloading over bony prominences is higher when
sitting
Rationale: Deep tissue injury or pressure ulcers are likely to occur sooner when
sitting because tissue offloading over bony prominences is higher. The ischial
