WOUND CERTIFICATION EXAM
QUESTIONS AND ANSWERS 2026
VERIFIED.
What are 6 risk factor components of Braden Scale for pressure ulcer? - ANS sensory
perception, moisture, mobility, activity, nutrition, and shear/friction
What is the name of the organization that developed the pressure ulcer staging? -
ANS NPUAP (national pressure ulcer advisory panel)
pathological effect of excessive pressure on soft tissue can be attributed by 3 factors? what are
they? - ANS tissue tolerance, duration of pressure, and intensity of pressure
what are the extrinsic factors that impact pressure ulcers? - ANS increase in moisture, friction
and shearing
how does friction play a role in shearing which eventually leads to pressure ulcer? -
ANS friction 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? - ANS nutritional debilitation, advanced age,
low BP, stress, smoking, elevated body temperature
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 20
,Aging skin undergoes what elements affecting risk for pressure ulcer? - ANS dermoepidermal
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? - ANS when 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? - ANS deep
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? - ANS purple 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? - ANS Intact 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? - ANS partial-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? - ANS full-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
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 20
, Describe stage IV pressure ulcer? - ANS full-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? - ANS full-thickness wound where base of the ulcer is covered by
slough and/or eschar, obscuring depth
When should eschars not be removed? - ANS when 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? -
ANS immersion and envelopement
Define immersion? - ANS depth of penetration or skining into surgace allowing pressure to be
spread out over surrounding area rather than directly over boney prominence
Define envelopement? - ANS is the ability of support surface to conform to irregularities
without causing substantial increase in pressure
what is bottoming out? - ANS this occurs when depth of penetration or sinking is excessive,
allowing increased pressure to concentrate over boney prominences
what factors contribute to bottoming out? - ANS weight, disproportion of weight and size
such as amputation, tendency to keep HOB >30 degrees, inappropriate support surface settings
When should you consider reactive support surface with features and components such as low
air loss, alternating pressure, viscous or air fluids? - ANS for patients who cannot effectively
position off their wound, have PUs in multiple turning surfaces, or have PUs that fail to improve
despite optimal comprehensive management
When should active support surface be considered? - ANS when effective positioning is
determined by an MD to be medically contraindicated
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 20
QUESTIONS AND ANSWERS 2026
VERIFIED.
What are 6 risk factor components of Braden Scale for pressure ulcer? - ANS sensory
perception, moisture, mobility, activity, nutrition, and shear/friction
What is the name of the organization that developed the pressure ulcer staging? -
ANS NPUAP (national pressure ulcer advisory panel)
pathological effect of excessive pressure on soft tissue can be attributed by 3 factors? what are
they? - ANS tissue tolerance, duration of pressure, and intensity of pressure
what are the extrinsic factors that impact pressure ulcers? - ANS increase in moisture, friction
and shearing
how does friction play a role in shearing which eventually leads to pressure ulcer? -
ANS friction 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? - ANS nutritional debilitation, advanced age,
low BP, stress, smoking, elevated body temperature
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 20
,Aging skin undergoes what elements affecting risk for pressure ulcer? - ANS dermoepidermal
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? - ANS when 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? - ANS deep
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? - ANS purple 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? - ANS Intact 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? - ANS partial-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? - ANS full-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
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 20
, Describe stage IV pressure ulcer? - ANS full-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? - ANS full-thickness wound where base of the ulcer is covered by
slough and/or eschar, obscuring depth
When should eschars not be removed? - ANS when 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? -
ANS immersion and envelopement
Define immersion? - ANS depth of penetration or skining into surgace allowing pressure to be
spread out over surrounding area rather than directly over boney prominence
Define envelopement? - ANS is the ability of support surface to conform to irregularities
without causing substantial increase in pressure
what is bottoming out? - ANS this occurs when depth of penetration or sinking is excessive,
allowing increased pressure to concentrate over boney prominences
what factors contribute to bottoming out? - ANS weight, disproportion of weight and size
such as amputation, tendency to keep HOB >30 degrees, inappropriate support surface settings
When should you consider reactive support surface with features and components such as low
air loss, alternating pressure, viscous or air fluids? - ANS for patients who cannot effectively
position off their wound, have PUs in multiple turning surfaces, or have PUs that fail to improve
despite optimal comprehensive management
When should active support surface be considered? - ANS when effective positioning is
determined by an MD to be medically contraindicated
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 20
