WOCNCB Certified Wound Ostomy Continence Nurse Practice Test

CWOCN test Format | Course Contents | Course Outline | test Syllabus | test Objectives

Exam Code: CWOCN
Exam Name: WOCNCB Certified Wound Ostomy Continence Nurse
Format: 175 multiple-choice questions
Questions: 150 scored, 25 unscored pretest questions.
Duration: 3 hours
Exam Type: Computer-based testing

- Assess Comprehensive Factors Affecting Wounds
- Psychosocial factors affecting care (e.g., patient and caregiver ability to learn and perform care, economic implications, education, mental status, family dynamics, cultural beliefs)
- Factors affecting wound healing (e.g., nutrition, comorbidities, medications, age, pain, mobility)
- Identifying need for diagnostic studies (e.g., biopsy, blood values, imaging, vascular, toe-brachial index [TBI], anklebrachial index [ABI], duplex scanning)
- Obtain patient health history through interviews, established medical records, and questionnaires to determine the patient’s current health and risk status.
- Interview processes
- Basic diagnostic test results (e.g., lab values, imaging studies, vascular studies, wound cultures)
- Performing initial assessment (e.g., history and presentation, comorbidities, cultural diversity, age, medications, psychological issues)
- Interpreting nutritional status (e.g., lab values, diet history, BMI, appearance)
- Interpreting pain using verbal and nonverbal tools

- Perform focused assessments to determine current skin status and wound etiology (pressure, venous, arterial, neuropathic, other)
- Dermatological etiology (e.g., contact dermatitis, fungal infection, herpetic lesions)
- Wound etiology (e.g., pressure, LEAD, LEVD, neuropathic, trauma, surgical, atypical, burns)
- Skin and wound classification systems (e.g., pressure injury stages, medical adhesive-related skin injury [MARSI], moistureassociated skin damage [MASD], skin tears, Wagner)
- Periwound characteristics (e.g., induration, temperature, fluctuance, denudation, maceration, cellulitis)
- Wound characteristics (e.g., tissue type, dimensions, location, exudate, odor, wound edges, color, epibole)
- Phases of wound healing (e.g., hemostasis, inflammation, proliferation, maturation)
- Characteristics of healing wounds (e.g., granulation, decreased dimensions, resurfacing)
- Characteristics of non-healing wounds (e.g., infection, biofilm, closed edge)
- Indications and side effects of medications affecting wound healing
- Utilizing risk assessment tools (e.g., Braden Scale, Braden Q Scale, Norton Plus Scale)
- Lower extremity assessment (e.g., quality of pulses, capillary refill, appearance of skin, elevational pallor, hair and nails, edema, protective sensation, proprioception)
- Identifying the need for wound culture and choosing the most appropriate method

- Recommend and/or provide appropriate interventions to promote optimal wound management.
- Principles of wound care (e.g., filling of dead space, moisture balance, periwound skin protection)
- Wound bed preparation (e.g., debridement, infection management, moisture management, wound edge optimization)
- Determining interventions to manage wounds (e.g., adjunctive modalities, offloading, support surfaces, protective footwear, tight glucose control, total contact casting)
- Types, indications, and contraindications of debridement (e.g., biologic, autolytic, chemical, mechanical, surgical, conservative sharp, excisional)
- Recommending appropriate pain management modalities
- Obtain wound cultures (e.g., aspirate, Levine, punch biopsy)
- Recommending and/or performing appropriate studies (e.g., biopsy, laboratory, radiography, toe-brachial index (TBI), anklebrachial index (ABI), transcutaneous oxygen pressure (TcPO2), duplex scanning)

- Implement prevention measures to promote optimal skin health and prevent injury.
- Preventive measures based on risk assessment (e.g., moisture management, pressure redistribution, offloading, friction and shear management, nutrition)
- Types of support surfaces
- Implementing interventions based on risk assessment (e.g., moisture management, pressure redistribution, nutrition, cognition, mobility, offloading)
- Utilizing appropriate skin care products
- Preventing complications of wound healing (e.g., infection, maceration, inappropriate product use)
- Selecting support surfaces

- Recommend and/or perform wound bed preparation.
- Recommending appropriate wound cleansing regimen
- Wound bed preparation (e.g., infection management, moisture management, wound edge optimization)

- Recommend and/or perform debridement to promote wound healing
- Types of debridement (e.g., biologic, autolytic, chemical, mechanical, surgical, conservative sharp, excisional)
- Identifying indications and contraindications for debridement
- Identifying wounds that require chemical cauterization
- Selecting appropriate debridement modalities

- Knowledge and application of topical therapies to promote wound healing.
- Topical therapies (e.g., absorbent dressing, antimicrobials, hydrating dressing)
- Recommending appropriate topical treatment to maintain periwound integrity
- Selecting and applying topical therapies for moist wound healing (e.g., containment of drainage, eliminate dead space, reduce bioburden, control odor)

- Knowledge and application of advanced/adjunctive therapies to promote wound healing
- Types, indications, and contraindications for compression therapy
- Types of advanced modalities for treatment (e.g., bioengineered tissue, negative pressure wound therapy, hyperbaric oxygen therapy)
- Types of adjunctive modalities (e.g., hydrotherapy, hyperbaric oxygen therapy, pulsed lavage, mist therapy, maggot therapy)
- Recommending compression therapy to manage edema (e.g., dynamic and static compression therapy)
- Applying compression therapy (e.g., dynamic and static compression therapy)
- Recommending and/or performing advanced wound therapies (e.g., bioengineered tissue, negative pressure wound therapy, hyperbaric oxygen therapy)
- Recommending and/or performing adjunctive modalities (e.g., hydrotherapy, hyperbaric oxygen therapy, pulsed lavage, mist therapy, maggot therapy)
- Recommending and/or performing total contact casting

- Develop a patient-centered plan of care by using health history and assessments to establish skin and wound management goals.
- Principles of patient-centered care (e.g., psychosocial issues, access to care, cultural beliefs)
- Identifying and supporting patient and caregiver goals (e.g., preventive, palliative, maintenance, curative)
- Setting patient-focused goals (e.g., preventive, palliative, maintenance, curative)
- Evaluate the patient-centered plan of care by using periodic assessments to promote optimal skin and wound management.
- Evaluating the effectiveness of the current treatment plan
- Interpreting patient responses to intervention
- Modifying interventions based on revised patient needs and goals

- Educate patients and caregivers by using the individualized skin and wound care plan to prevent complications, maintain optimal skin and wound health, and encourage patient autonomy.
- Education based on health literacy and goals of patient/caregiver
- Factors affecting wound management (e.g., infection control, nutrition, moisture management, repositioning, tobacco cessation, glycemic control, compliance)
- Available resources (e.g., support and advocacy, supply access, post-acute care)
- Educating the patient and family on the procedures, rationale, and significance of diagnostic test results
- Educating the patient and caregivers on wound care procedures and skin care
- Educating patient and caregivers regarding modifiable risk factors (e.g., tobacco cessation, exercise, safety awareness, diet, offloading)
- Educating on factors affecting wound management (e.g., infection control, nutrition, moisture management, repositioning, tobacco cessation, glycemic control, compliance)
- Recommending non-invasive and invasive interventions (e.g., pharmacological, walking program, surgical)

- Educate other health care professionals on skin and wound care management and prevent complications.
- Factors affecting wound management (e.g., infection control, nutrition, moisture management, repositioning, tobacco cessation, glycemic control, compliance, trauma avoidance)
- Educating health care clinicians and providers on skin and wound care principles, procedures, and treatment goals
- Educating on factors affecting wound management (e.g., infection control, nutrition, moisture management, repositioning, tobacco cessation, glycemic control, compliance, trauma avoidance)

- Multidisciplinary care collaboration and referrals to support patient-centered care.
- Available resources (e.g., support and advocacy, supply access, post-acute care)
- Referrals for other services (e.g., rehabilitation, nutrition, diabetic education, social services, mental health)
- Referral for appropriate studies (e.g., biopsy, laboratory, radiography, toe-brachial index (TBI), ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), duplex scanning)
- Facilitate appropriate consultations (e.g., surgery, infectious disease, dermatology, podiatry)
- Provide handoff communication

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Question: 1
Which of the following is an indication for surgical debridement?
1. Dry, eschar-covered wound
2. Stable, well-vascularized wound bed
3. Minimal necrotic tissue present
wer: D
anation: Suspected osteomyelitis is an indication for surgical debride ical debridement is often necessary when there is deep-seated infectio as osteomyelitis or deep tissue infection, where removal of infected ti quired for effective treatment. A dry, eschar-covered wound may bene other forms of debridement, such as autolytic or enzymatic, to promo kdown of the eschar. A stable, well-vascularized wound bed with mini otic tissue may not require surgical debridement.
stion: 2
ch of the following interventions is most appropriate for managing a opathic foot ulcer in a patient with diabetes?
ffloading with total contact casting yperbaric oxygen therapy
Suspected osteomyelitis Ans
Expl ment.
Surg n,
such ssue
is re fit
from te the
brea mal
necr
Que
Whi neur
1. O
2. H
3. Callus reduction
4. Chemical cauterization Answer: A
Explanation: Offloading with total contact casting is the most appropriate intervention for managing a neuropathic foot ulcer in a patient with diabetes.
stion: 3
ch of the following is an indication for debridement? ealthy granulation tissue
ecrotic tissue with no signs of infection inimal exudate and intact epithelium
ound showing signs of early epithelialization wer: B
anation: Necrotic tissue with no signs of infection is an indication for dement. Debridement is the process of removing non-viable tissue fro nd to promote healing. Necrotic tissue can impair wound healing and s otential source of infection. Debridement helps create a clean wound wing for the growth of healthy granulation tissue. Healthy granulation e, minimal exudate with intact epithelium, and a wound showing sign
Total contact casting helps distribute weight evenly across the foot, reducing pressure on the ulcer and promoting healing. It also provides immobilization and protection to the foot, allowing for optimal wound healing. Hyperbaric oxygen therapy is commonly used for specific indications such as non-healing diabetic foot ulcers with evidence of ischemia or infection. Callus reduction is important for preventing the formation of new ulcers but may not directly address the management of an existing ulcer. Chemical cauterization is not typically used for neuropathic foot ulcers.
Que
Whi
1. H
2. N
3. M
4. W
Ans Expl
debri m a
wou erve
as a p bed,
allo
tissu s of
early epithelialization do not require debridement, as they indicate a progressing healing process.
Question: 4
Which of the following factors can affect wound healing?
1. Environmental temperature
2. Gender
3. Blood type
4. Medications Answer: D
rticosteroids and immunosuppressants, can impair the normal healing ess by suppressing the immune response or inhibiting collagen synthe factors, such as nutrition, comorbidities, age, and pain, can also infl nd healing. Environmental temperature, gender, and blood type do not
ect impact on the wound healing process.
stion: 5
ch of the following is a type of compression therapy? ynamic compression therapy
yperbaric compression therapy atic compression therapy hemical compression therapy
wer: C
anation: Static compression therapy is a type of compression therapy u
Explanation: Medications can affect wound healing. Certain medications, such as co
proc sis.
Other uence
wou have
a dir Que Whi
1. D
2. H
3. St
4. C
Ans
Expl sed
in wound care. Static compression involves the application of a constant, evenly distributed pressure to the affected area using bandages or compression garments. It helps Improve venous return, reduce edema, and promote wound healing. Dynamic compression therapy, hyperbaric compression therapy, and chemical compression therapy are not recognized types of compression therapy.
Which of the following is an example of a biologic debridement modality?
1. Autolytic debridement
2. Surgical debridement
3. Mechanical debridement
anation: Enzymatic debridement is an example of a biologic debridem ality. Enzymatic debridement involves the application of topical agent ain enzymes to selectively break down and remove necrotic tissue. lytic debridement relies on the body's own enzymes and moisture to b
necrotic tissue. Surgical debridement is a manual removal of necroti
e. Mechanical debridement involves the use of physical force or irriga move necrotic tissue.
stion: 6
ch of the following is a contraindication for compression therapy? enous insufficiency
rterial insufficiency ymphedema
iabetic foot ulcer
Enzymatic debridement Answer: D
Expl ent
mod s that
cont
Auto reak
down c
tissu tion
to re Que Whi
1. V
2. A
3. L
4. D
Answer: B
Explanation: Arterial insufficiency is a contraindication for compression therapy. Compression therapy involves applying external pressure to the affected area to Improve venous return and reduce edema. However, in arterial insufficiency, the blood flow to the affected area is already compromised. Applying compression in this situation can further impede arterial blood flow,
leading to tissue ischemia and potential complications. Venous insufficiency, lymphedema, and diabetic foot ulcers are conditions where compression therapy is commonly indicated to manage edema and promote wound healing.
Question: 7
Which of the following is a primary goal of wound bed preparation?
oisture balance eriwound skin protection ead space filling
ound edge optimization wer: D
anation: The primary goal of wound bed preparation is wound edge mization. Wound edge optimization involves creating an environment motes healing by removing non-viable tissue, controlling exudate, and
cting the periwound skin. It aims to establish a healthy wound edge t ort epithelialization and wound closure. While moisture balance, wound skin protection, and dead space filling are important aspects of nd care, wound edge optimization takes precedence in ensuring proper nd healing.
stion: 8
M
P
D
W
Ans Expl
opti that
pro
prote o
supp peri wou wou
Que
Which of the following is a characteristic of an ideal wound dressing for a highly exuding wound?
1. Non-adherent to the wound bed
2. Occlusive and impermeable to moisture
3. High absorbency capacity
4. Promotes autolytic debridement
Answer: C
of excessive exudate. Occlusive and impermeable dressings are typic for wounds with minimal exudate or as a barrier protection, but they m e suitable for highly exuding wounds. Promoting autolytic debrideme irable characteristic of a wound dressing, but it may not be the primar ern for a highly exuding wound.
stion: 9
ch of the following topical therapies is commonly used for infected nds?
ydrogel dressing
lver-impregnated dressing lginate dressing
ilicone foam dressing wer: B
Explanation: In the case of a highly exuding wound, an ideal wound dressing should have a high absorbency capacity. This allows the dressing to effectively manage the excess exudate and maintain a moist wound environment, which is conducive to wound healing. Non-adherence to the wound bed is beneficial to minimize trauma during dressing changes, but it may not directly address the issue ally
used ay
not b nt is
a des y
conc
Que
Whi wou
1. H
2. Si
3. A
4. S
Ans
Explanation: Silver-impregnated dressings are commonly used for infected wounds. Silver has antimicrobial properties and can help reduce bacterial load in the wound. It is effective against a broad spectrum of bacteria and can help prevent or manage wound infections. Hydrogel dressings are more appropriate for dry or minimally exuding wounds. Alginate dressings are absorbent and can help manage exudate, but they do not have the same antimicrobial properties as silver dressings. Silicone foam dressings are primarily used for moderate-to-
heavy exuding wounds and may not specifically target wound infection.
Question: 10
Which of the following factors is known to impair wound healing?
1. Adequate nutrition
bsence of comorbidities hronic use of corticosteroids
wer: D
anation: Chronic use of corticosteroids is known to impair wound hea costeroids can have immunosuppressive effects, leading to decreased mmation and delayed wound healing. Adequate nutrition, young age, nce of comorbidities are generally favorable for wound healing and mote optimal tissue repair.
stion: 11
ch of the following is an example of a topical therapy used in wound c otal contact casting
ffloading
yperbaric oxygen therapy
Young age
2. A
3. C
Ans
Expl ling.
Corti
infla and
abse pro
Que
Whi are?
1. T
2. O
3. H
4. Antimicrobial dressing Answer: D
Explanation: Antimicrobial dressing is an example of a topical therapy used in wound care. Antimicrobial dressings contain agents that help reduce bacterial colonization and infection in the wound bed. They provide a moist environment
conducive to wound healing while preventing bacterial growth. Total contact casting, offloading, and hyperbaric oxygen therapy are not topical therapies but rather interventions used in wound care for different purposes, such as pressure redistribution and enhancing oxygen supply.
Question: 12
debridement?
urgical debridement utolytic debridement echanical debridement nzymatic debridement
wer: C
anation: Mechanical debridement is considered a conservative sharp dement. It involves the use of tools or techniques such as wet-to-dry ings, wound irrigation, or scrubbing with a gauze pad to mechanicall ve necrotic tissue. Surgical debridement involves the use of a scalpel sharp instrument by a healthcare professional to surgically remove otic tissue. Autolytic debridement utilizes the body's own enzymes an ture to break down necrotic tissue over time. Enzymatic debridement ves the application of topical enzymes to the wound to selectively bre
necrotic tissue.
Which of the following debridement modalities is considered a conservative sharp
1. S
2. A
3. M
4. E
Ans Expl
debri
dress y
remo or
other
necr d
mois
invol ak
down
Question: 13
Which of the following is a contraindication for compression therapy in the management of venous leg ulcers?
1. Peripheral arterial disease
2. Lymphedema
3. Deep vein thrombosis
4. Cellulitis Answer: A
ying external pressure to the leg to Improve venous return and reduce ma. However, in the presence of peripheral arterial disease, the arterial lation may be compromised, and applying compression can further re lood flow, potentially causing ischemia and tissue damage. Lymphed vein thrombosis, and cellulitis are conditions that may require adjust
ecautions in the application of compression therapy, but they are not lute contraindications.
stion: 14
ch of the following is a characteristic of dynamic compression therapy involves the use of compression bandages
requires the patient to be in a supine position
is contraindicated in patients with peripheral arterial disease provides continuous and consistent pressure
wer: A
Explanation: Peripheral arterial disease is a contraindication for compression therapy in the management of venous leg ulcers. Compression therapy involves appl
ede
circu strict
the b ema,
deep ments
or pr abso
Que
Whi ?
1. It
2. It
3. It
4. It
Ans
Explanation: Dynamic compression therapy involves the use of compression bandages. It utilizes an intermittent or cyclical application of pressure to the limb, promoting venous return and reducing edema. The patient's position can vary depending on the treatment, and it is not limited to a supine position. Dynamic compression therapy is generally safe for patients with peripheral arterial disease, although caution should be exercised and the pressure levels
should be adjusted accordingly. Continuous and consistent pressure is a characteristic of staticcompression therapy, not dynamic compression therapy.
Question: 15
Which of the following interventions is used to manage pressure ulcers?
allus reduction rotective footwear hemical cauterization
wer: A
anation: Offloading is an intervention used to manage pressure ulcers. oading involves reducing or eliminating pressure on the affected area t mote healing and prevent further tissue damage. It can be achieved thro us methods, such as using specialized cushions, mattresses, or braces, sitioning the patient regularly. Callus reduction, protective footwear, a mical cauterization are not specific interventions for managing pressure
s.
stion: 16
When selecting an appropriate debridement modality, which of the followi rs should be considered?
Offloading
C
P
C
Ans Expl
Offl o
pro ugh
vario and
repo nd
che ulcer
Que
ng facto
1. Patient's age
2. Wound size
3. Nutritional status
4. Pain level Answer: B
Explanation: When selecting an appropriate debridement modality, wound size should be considered. Different debridement modalities have varying effectiveness and limitations based on the size and characteristics of the wound. Factors such as patient's age, nutritional status, and pain level may influence the overall management of the wound but may not be the primary determining factors in selecting a debridement modality.

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