WOCN Wound Exam Questions And Correct
Answers (Verified Answers) 2026
Goals of wound assessment - CORRECT ANSWER -1. Determine etiologic factors
2. Assess systemic factors/comorbidities
3. Assess wound to determine phase of healing
4. Determine goals of topical therapy
Why does hyperglycemia affect wound healing? - CORRECT ANSWER -Impairs leukocyte
function and negatively impacts collagen syntehesis, development of tensile strength, epithelial
resurfacing
What BG parameters should be maintained for wound healing? - CORRECT ANSWER -BG
<180 for leukocyte function; <140 for healing
A1C <7 for most, <8 if hx of severe hypoglycemia, advanced comorbidities, limited life
expectancy
Why is nutrition relevant to wound healing? - CORRECT ANSWER -Muscle or SubQ wasting
increases risk of pressure/shear damage
malnourished pt unable to synthesize and cross-link collagen normally
protein deficiency increases risk of infection
What effect do low zinc levels have on wound healing? - CORRECT ANSWER -compromise
collagen synthesis/crosslinking
What amino acids are essential for collagen synthesis?
What is the effect of stress on these amino acids? - CORRECT ANSWER -Glutamine and l-
arginine
Not adequately produced during times of physiologic stress
,What weight trend suggests nutritional deficiency? - CORRECT ANSWER -Unplanned weight
loss =>2.5% of usual weight in 30 days or =>10% within 180 days
BMI <18.5
What serum albumin level indicates malnutrition? - CORRECT ANSWER -<3.5 g/dl
What serum transferrin level indicates malnutrition? - CORRECT ANSWER -<100mg/dl
What serum prealbumin level indicates malnutrition? - CORRECT ANSWER -<19.5
What total lymphocyte count level indicates malnutrition? - CORRECT ANSWER -<1500
What are s/s of nutritional deficits? - CORRECT ANSWER -skin rashes, cracks in mucous
membranes, edema, muscle and subQ tissue wasting, nonhealing wounds, dry/pluckable hair, dry
flaky itchy skin
What is the suggested caloric intake? - CORRECT ANSWER -30-35 cal/kg body weight
What is the suggested protein intake? - CORRECT ANSWER -1.25-1.5 g/kg body weight
What is the suggested fluid intake? - CORRECT ANSWER -30ml per kg (unless fluid restriction
indicated)
How do you assess perfusion/oxygenation? - CORRECT ANSWER -capillary refill, pulses,
presence/absence of edema, TcpO2 levels (at least 40), color of wound bed (bright pink/red), ABI
for lower extremity ulcers, systolic bp/episodes of hypotension, vasopressor administration
,How do you assess for immunosuppression? - CORRECT ANSWER -Comorbidities/therapies
such as HIV, steroid tehrapy in doses >30mg/day for >30 days, and/or chemo resulting in
neutropenia; high dose NSAIDs
What comorbidities compromise wound healing? - CORRECT ANSWER -renal failure, liver
failure, multisystem trauma, smoking, advanced age
What are the layers of the skin - CORRECT ANSWER -Epidermis
Basement Membrane Zone
Dermis
Subcutaneous Tissue
Muscle/Fascia/Bone
What are the layers of the epidermis? - CORRECT ANSWER -Stratum corneum - keratinocytes
filled with keratin
Stratum lucidum - only in palms/soles, thick areas
Stratum granulosum - odland bodies secrete ceramides, lipophilic
Stratum spinosum - desmosomes (cell to cell junctions)
Stratum germinativum - dermal-epidermal junction
What is the Basement Membrane Zone? - CORRECT ANSWER -Dermal-epidermal junction
What are the components of the dermis? - CORRECT ANSWER -Papillary dermis: papillae
interlock with rete ridges, capillary loops, sensitive to point pressure
Reticular dermis: mostly type 1 collagen, vasculars, and lymphatics
What structures of the skin can regenerate? - CORRECT ANSWER -Epidermis and parts of the
dermis
, What structures of the skin heal by scar formation? - CORRECT ANSWER -Epidermal
appendages, Subcutaneous tissue/fascia/muscle
How is newborn skin different? - CORRECT ANSWER -No scars up to 2nd trimester
30% thinner skin
Faster epidermal turnover
How is premature infant skin different? - CORRECT ANSWER -Very thin, increased fluid loss,
functional stratum corneum at 30-32 weeks
What problems may arise with infant skin? - CORRECT ANSWER -increased permeability,
increased MARSI risk, extravasation, diaper dermatitis
How do you mitigate MARSI risk in infants/elderly? - CORRECT ANSWER -avoid tape or use
hydrocolloid base or silicone adhesive, no alcohol removers only mineral oil, petroleum, silicone
(preferred), and citrus)
How do you mitigate extravasation in an infant? - CORRECT ANSWER -Hyaluronidase
OR
phentolamine if vasoconstrictor
How do you mitigate diaper dermatitis? - CORRECT ANSWER -Higher pH
Use petroleum base for mild erythema and zinc oxide for denuded skin
sever denudation - carboxymethylcellulose/petrolatum/zinc oxide (Ilex)
What bathing considerations must you take for premature infants? - CORRECT ANSWER -<30
weeks bathe with water only for 2 weeks
Answers (Verified Answers) 2026
Goals of wound assessment - CORRECT ANSWER -1. Determine etiologic factors
2. Assess systemic factors/comorbidities
3. Assess wound to determine phase of healing
4. Determine goals of topical therapy
Why does hyperglycemia affect wound healing? - CORRECT ANSWER -Impairs leukocyte
function and negatively impacts collagen syntehesis, development of tensile strength, epithelial
resurfacing
What BG parameters should be maintained for wound healing? - CORRECT ANSWER -BG
<180 for leukocyte function; <140 for healing
A1C <7 for most, <8 if hx of severe hypoglycemia, advanced comorbidities, limited life
expectancy
Why is nutrition relevant to wound healing? - CORRECT ANSWER -Muscle or SubQ wasting
increases risk of pressure/shear damage
malnourished pt unable to synthesize and cross-link collagen normally
protein deficiency increases risk of infection
What effect do low zinc levels have on wound healing? - CORRECT ANSWER -compromise
collagen synthesis/crosslinking
What amino acids are essential for collagen synthesis?
What is the effect of stress on these amino acids? - CORRECT ANSWER -Glutamine and l-
arginine
Not adequately produced during times of physiologic stress
,What weight trend suggests nutritional deficiency? - CORRECT ANSWER -Unplanned weight
loss =>2.5% of usual weight in 30 days or =>10% within 180 days
BMI <18.5
What serum albumin level indicates malnutrition? - CORRECT ANSWER -<3.5 g/dl
What serum transferrin level indicates malnutrition? - CORRECT ANSWER -<100mg/dl
What serum prealbumin level indicates malnutrition? - CORRECT ANSWER -<19.5
What total lymphocyte count level indicates malnutrition? - CORRECT ANSWER -<1500
What are s/s of nutritional deficits? - CORRECT ANSWER -skin rashes, cracks in mucous
membranes, edema, muscle and subQ tissue wasting, nonhealing wounds, dry/pluckable hair, dry
flaky itchy skin
What is the suggested caloric intake? - CORRECT ANSWER -30-35 cal/kg body weight
What is the suggested protein intake? - CORRECT ANSWER -1.25-1.5 g/kg body weight
What is the suggested fluid intake? - CORRECT ANSWER -30ml per kg (unless fluid restriction
indicated)
How do you assess perfusion/oxygenation? - CORRECT ANSWER -capillary refill, pulses,
presence/absence of edema, TcpO2 levels (at least 40), color of wound bed (bright pink/red), ABI
for lower extremity ulcers, systolic bp/episodes of hypotension, vasopressor administration
,How do you assess for immunosuppression? - CORRECT ANSWER -Comorbidities/therapies
such as HIV, steroid tehrapy in doses >30mg/day for >30 days, and/or chemo resulting in
neutropenia; high dose NSAIDs
What comorbidities compromise wound healing? - CORRECT ANSWER -renal failure, liver
failure, multisystem trauma, smoking, advanced age
What are the layers of the skin - CORRECT ANSWER -Epidermis
Basement Membrane Zone
Dermis
Subcutaneous Tissue
Muscle/Fascia/Bone
What are the layers of the epidermis? - CORRECT ANSWER -Stratum corneum - keratinocytes
filled with keratin
Stratum lucidum - only in palms/soles, thick areas
Stratum granulosum - odland bodies secrete ceramides, lipophilic
Stratum spinosum - desmosomes (cell to cell junctions)
Stratum germinativum - dermal-epidermal junction
What is the Basement Membrane Zone? - CORRECT ANSWER -Dermal-epidermal junction
What are the components of the dermis? - CORRECT ANSWER -Papillary dermis: papillae
interlock with rete ridges, capillary loops, sensitive to point pressure
Reticular dermis: mostly type 1 collagen, vasculars, and lymphatics
What structures of the skin can regenerate? - CORRECT ANSWER -Epidermis and parts of the
dermis
, What structures of the skin heal by scar formation? - CORRECT ANSWER -Epidermal
appendages, Subcutaneous tissue/fascia/muscle
How is newborn skin different? - CORRECT ANSWER -No scars up to 2nd trimester
30% thinner skin
Faster epidermal turnover
How is premature infant skin different? - CORRECT ANSWER -Very thin, increased fluid loss,
functional stratum corneum at 30-32 weeks
What problems may arise with infant skin? - CORRECT ANSWER -increased permeability,
increased MARSI risk, extravasation, diaper dermatitis
How do you mitigate MARSI risk in infants/elderly? - CORRECT ANSWER -avoid tape or use
hydrocolloid base or silicone adhesive, no alcohol removers only mineral oil, petroleum, silicone
(preferred), and citrus)
How do you mitigate extravasation in an infant? - CORRECT ANSWER -Hyaluronidase
OR
phentolamine if vasoconstrictor
How do you mitigate diaper dermatitis? - CORRECT ANSWER -Higher pH
Use petroleum base for mild erythema and zinc oxide for denuded skin
sever denudation - carboxymethylcellulose/petrolatum/zinc oxide (Ilex)
What bathing considerations must you take for premature infants? - CORRECT ANSWER -<30
weeks bathe with water only for 2 weeks
