2026 Certified Wound Care Nurse (CWCN
Certification Exam) by WOCNCB New
Latest Version with All 50
Questions, Correct Answers and
Rationales.
**Question 1**
A patient presents with a shallow, painful wound on the lateral
malleolus with well-defined borders, minimal exudate, and cool,
hairless surrounding skin. The dorsalis pedis pulse is absent. What is the
most likely etiology?
A. Venous insufficiency ulcer
B. **Arterial insufficiency ulcer**
C. Diabetic neuropathic ulcer
D. Pressure injury
**Rationale:** This describes a classic arterial ulcer. They are typically
located on the distal extremities (lateral malleolus, toes), are deep with
"punched out" borders, and have minimal drainage due to poor
perfusion. The absence of hair, cool skin, and diminished pulses are
hallmark signs of arterial disease .
**Question 2**
,During an assessment, you note a wound with irregular edges,
moderate exudate, and surrounding skin that is brown and hardened
(hemosiderin staining). This wound is most likely a:
A. Arterial ulcer
B. **Venous ulcer**
C. Stage 3 pressure injury
D. Moisture-associated skin damage
**Rationale:** Venous ulcers result from chronic venous hypertension.
Hemosiderin staining (brown discoloration) is caused by leakage of red
blood cells into the dermis and breakdown of hemoglobin. The location
is usually the "gaiter area" (medial malleolus) .
**Question 3**
A nurse is staging a pressure injury on the sacrum. The wound bed is
100% covered with tan, hard, dry tissue. The depth cannot be
determined. How should this be staged?
A. Stage 3 Pressure Injury
B. Stage 4 Pressure Injury
C. **Unstageable Pressure Injury**
D. Deep Tissue Pressure Injury
**Rationale:** If the wound bed is covered by slough or eschar, the
true depth cannot be assessed, making it "Unstageable" until the
devitalized tissue is removed. Stage 3 and 4 require visualization of the
,base. Deep tissue injury presents as intact skin with purple/maroon
discoloration .
**Question 4**
A patient who had abdominal surgery 5 days ago calls the nurse
reporting a "popping" sensation and feeling wetness. Upon assessment,
the wound edges have separated, and loops of intestine are visible.
What is the priority nursing action?
A. Apply a dry sterile dressing and call the physician.
B. **Cover the exposed viscera with sterile saline-soaked gauze and call
for emergency assistance.**
C. Place the patient in a high-Fowler's position and monitor vital signs.
D. Reapproximate the edges using sterile tape.
**Rationale:** This describes **evisceration** (organs protruding)
with dehiscence. The priority is to prevent organ desiccation and
infection by covering the exposed viscera with sterile, non-adherent,
saline-moistened gauze. The patient should be placed supine with
knees bent to reduce abdominal tension. Do not attempt to reinsert the
organs .
**Question 5**
What is the term for the rolled or curled-under wound edges that
prevent epithelial migration in a chronic wound?
A. Maceration
, B. Induration
C. **Epibole**
D. Undermining
**Rationale:** **Epibole** refers to thickened, rolled wound edges
that have stalled in healing. This often requires debridement to
"freshen" the edges and allow epithelial cells to migrate across the
wound bed .
---
### Domain 2: Wound Healing and Biology
**Question 6**
A patient is on long-term corticosteroid therapy. How does this impact
wound healing?
A. It accelerates the inflammatory phase.
B. It has no effect on tensile strength.
C. **It inhibits collagen synthesis and masks signs of infection.**
D. It increases angiogenesis.
**Rationale:** Corticosteroids stabilize lysosomal membranes, which
reduces the inflammatory response. While this can reduce scarring, it
Certification Exam) by WOCNCB New
Latest Version with All 50
Questions, Correct Answers and
Rationales.
**Question 1**
A patient presents with a shallow, painful wound on the lateral
malleolus with well-defined borders, minimal exudate, and cool,
hairless surrounding skin. The dorsalis pedis pulse is absent. What is the
most likely etiology?
A. Venous insufficiency ulcer
B. **Arterial insufficiency ulcer**
C. Diabetic neuropathic ulcer
D. Pressure injury
**Rationale:** This describes a classic arterial ulcer. They are typically
located on the distal extremities (lateral malleolus, toes), are deep with
"punched out" borders, and have minimal drainage due to poor
perfusion. The absence of hair, cool skin, and diminished pulses are
hallmark signs of arterial disease .
**Question 2**
,During an assessment, you note a wound with irregular edges,
moderate exudate, and surrounding skin that is brown and hardened
(hemosiderin staining). This wound is most likely a:
A. Arterial ulcer
B. **Venous ulcer**
C. Stage 3 pressure injury
D. Moisture-associated skin damage
**Rationale:** Venous ulcers result from chronic venous hypertension.
Hemosiderin staining (brown discoloration) is caused by leakage of red
blood cells into the dermis and breakdown of hemoglobin. The location
is usually the "gaiter area" (medial malleolus) .
**Question 3**
A nurse is staging a pressure injury on the sacrum. The wound bed is
100% covered with tan, hard, dry tissue. The depth cannot be
determined. How should this be staged?
A. Stage 3 Pressure Injury
B. Stage 4 Pressure Injury
C. **Unstageable Pressure Injury**
D. Deep Tissue Pressure Injury
**Rationale:** If the wound bed is covered by slough or eschar, the
true depth cannot be assessed, making it "Unstageable" until the
devitalized tissue is removed. Stage 3 and 4 require visualization of the
,base. Deep tissue injury presents as intact skin with purple/maroon
discoloration .
**Question 4**
A patient who had abdominal surgery 5 days ago calls the nurse
reporting a "popping" sensation and feeling wetness. Upon assessment,
the wound edges have separated, and loops of intestine are visible.
What is the priority nursing action?
A. Apply a dry sterile dressing and call the physician.
B. **Cover the exposed viscera with sterile saline-soaked gauze and call
for emergency assistance.**
C. Place the patient in a high-Fowler's position and monitor vital signs.
D. Reapproximate the edges using sterile tape.
**Rationale:** This describes **evisceration** (organs protruding)
with dehiscence. The priority is to prevent organ desiccation and
infection by covering the exposed viscera with sterile, non-adherent,
saline-moistened gauze. The patient should be placed supine with
knees bent to reduce abdominal tension. Do not attempt to reinsert the
organs .
**Question 5**
What is the term for the rolled or curled-under wound edges that
prevent epithelial migration in a chronic wound?
A. Maceration
, B. Induration
C. **Epibole**
D. Undermining
**Rationale:** **Epibole** refers to thickened, rolled wound edges
that have stalled in healing. This often requires debridement to
"freshen" the edges and allow epithelial cells to migrate across the
wound bed .
---
### Domain 2: Wound Healing and Biology
**Question 6**
A patient is on long-term corticosteroid therapy. How does this impact
wound healing?
A. It accelerates the inflammatory phase.
B. It has no effect on tensile strength.
C. **It inhibits collagen synthesis and masks signs of infection.**
D. It increases angiogenesis.
**Rationale:** Corticosteroids stabilize lysosomal membranes, which
reduces the inflammatory response. While this can reduce scarring, it
