NAWCO-AWCC test Format | Course Contents | Course Outline | test Syllabus | test Objectives
- Analyze procedural concepts to obtain patient history:
- Review, investigate, and document the patient’s history
- current complaint and condition
- past medical
- surgical history
- medications
- allergies
- family history
- social history
- past wound history
- Evaluate patient’s physical, mental, and psychosocial status
- cognition
- overall skin condition
- circulatory
- respiratory
- neurological
- musculoskeletal
- urological
- gastrointestinal
- Read and interpret healing assessment tools and recommend clinical interventions as appropriate.
- Identify and reevaluate on an ongoing basis intrinsic factors and their potential impact on wound healing
- age
- bio-burden
- BMI
- co-morbidities
- allergies
- infection
- non-adherence
- nutrition/hydration
- mobility
- cultural beliefs
- blood flow
- tissue perfusion
- necrotic tissue
- cognitive impairment
- allergies and/or adverse reaction to treatment modalities
- Identify and reevaluate on an ongoing basis extrinsic factors and their potential impact on wound healing
- infection
- medications
- pressure
- mechanical insult
- exposure to moisture
- smoking
- stress
- radiation
- cytotoxic solutions
- bio-burden
- foreign body
- Identify circumstances indicating need for interdisciplinary consults.
- Identify and differentiate between wound types
- acute vs. chronic
- partial thickness vs. full thickness
- Identify and differentiate between wound classifications.
- Describe how wound etiology contributes to determining appropriate treatment.
- Describe and document wound assessment to include:
- location and size including presence of tunneling
- under-mining
- sinus tract(s)
- appearance of the wound bed:
- type of tissue
- color
- presence of underlying structures
- wound margins
- wound drainage:
- Type
- Amount
- Color
- Odor
- appearance of the periwound area.
- Read and interpret lab studies
- blood sugar
- prealbumin
- albumin
- complete blood count
- zinc level
- coagulation studies
- hemoglobin A1C
- transferrin
- indicate situations in which these tests and other adjunctive modalities should be recommended and/or addressed.
- Evaluate the patient’s current nutritional status
- intake pattern
- BMI
- physical constraints limiting the patient’s ability to receive nutrition
- inability to use utensils
- impaired or unable to swallow
- inability to chew solid food
- Considering wound type
- overall patient status
- cost
- identify the most appropriate type of dressing
- topical
- Wound treatment
- alginates
- antimicrobial
- collagen
- composites
- contact layers
- foams
- growth factors
- hydrocolloids
- hydrogels
- special absorptives
- transparent films
- wound fillers
- impregnated gauze
- silicon
- bioengineered tissues
- cadaver
- porcine
- autologous grafts
- Considering wound type
- overall patient status
- cost
- identify the most appropriate type of pressure redistribution strategy:
- mattresses
- low air loss
- air fluidized
- alternating air
- foam, gel
- powered
- non-powered
- reactive vs non reactive
- cushions
- air
- foam
- gel
- alternating (air))
- mattress overlays
- low air loss
- alternating air
- foam
- gel
- specialty beds
- bariatric
- air fluidized
- lateral rotation
- Considering wound type, overall patient status, and cost
- identify the most appropriate type of wound bed preparation
- selective debridement types
- autolysis
- enzymatic
- biosurgical
- nonselective debridement types
- mechanical
- sharp/surgical
- chemical
- bacterial balancing (cleansing))
- Considering wound type, overall patient status, and cost
- identify the most appropriate type of adjunctive therapy
- ultrasounds
- diathermy
- electrical stimulation
- monochromatic therapy
- magnet therapy
- negative pressure therapy
- radiant therapy
- acupuncture
- laser
- total contact casting
- edema management
- compression therapy
- support stockings
- bandages
- pumps
- massage
- hyperbaric
- topical growth factors
- surgical
- Considering wound type
- identify adjunctive modalities
- determine use
- length of use
- indications and contraindication of the modalities
- how the products/treatments can be used in conjunction with other treatments and modalities.
- Identify and differentiate between signs and symptoms of wound infection and different levels of wound contamination.
- Identify signs and symptoms of complications and differentiate among complications that can occur in a wound
- infection
- hemorrhage
- dehiscence
- evisceration
- fistula
- Identify and address educational needs of the patient, healthcare team members, and/or family/support network
- Identify and address critical elements of a discharge/transitional plan for patient and family.
- Identify appropriate billing strategies and supporting documentation to mitigate denials.
- Demonstrate an understanding of the ethical aspects of wound care
- HIPAA
- informed consent
- advance directives
- IRB
- clinical trials
- research
- dissemination of findings
- patient’s preferences
- cultural
- religious
- personal beliefs
- Provide documentation throughout the process that complies with legal and institutional requirements and expectations for clear, concise, legible, and consistent documentation.
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Nursing
NAWCO-AWCC
NAWCO Advanced Wound Care Certified
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Question: 1391
A clinician is evaluating a patient with compromised blood flow due to peripheral vascular disease. Which assessment parameter should be prioritized to determine the severity of the patients condition and its potential impact on wound healing?
1. Serum albumin levels
2. Capillary refill time
assessment scale
er: B
nation: Capillary refill time is a quick measure of blood flow and perfusion. Delayed capillar es poor blood circulation, which directly impacts wound healing capacity.
ion: 1392
a clinical trial on a novel wound care treatment, the researchers discover unexpected advers in a subset of participants. What is the most appropriate action for the researchers to take ing the dissemination of these findings?
it until the trial is completed to report the findings cuss the findings only with the participants affected blish the findings without consulting the IRB mediately inform the IRB and halt the trial
er: D
nation: Immediate reporting to the IRB is crucial to ensure participant safety and ethical stan
Body Mass Index (BMI)
3. Pain
Answ
Expla y refill
indicat
Quest
During e
effects regard
1. Wa
2. Dis
3. Pu
4. Im
Answ
Expla dards,
allowing for a reassessment of the trial's risk-benefit ratio.
Question: 1393
A nurse is educating a patient about the use of hydrocolloid dressings for their wound management. Which statement should the nurse include to ensure proper understanding of the dressing's function?
1. Hydrocolloids are used exclusively for dry wounds.
2. Hydrocolloids should be changed daily.
3. Hydrocolloids promote a moist environment that aids in healing.
4. Hydrocolloids do not allow for gas exchange.
Answer: C
ion: 1394
essing a wound, you observe a 3 cm x 5 cm ulcer with a yellow slough covering the wound b dges are well-defined, and there is a slight odor. What does the presence of yellow slough in ing the healing process?
ection or necrosis nulation tissue formation althy epithelial migration
wound environment
er: A
nation: Yellow slough often indicates necrotic tissue or infection, which can hinder the heali and must be addressed in the treatment plan.
ion: 1395
Explanation: Hydrocolloid dressings promote a moist environment, which is beneficial for wound healing, contradicting the notion that they are only for dry wounds.
Quest
In ass ed.
The e dicate
regard
1. Inf
2. Gra
3. He
4. Dry
Answ
Expla ng
process
Quest
A patient with a chronic venous ulcer has been treated with compression therapy for several weeks, but the wound has not progressed toward healing. What additional treatment should be considered to optimize the healing process?
1. Introduction of a topical antiseptic to prevent infection
2. Change to a hydrogel dressing to maintain moisture
3. Assessment of venous function and potential surgical intervention
4. Increase in the frequency of dressing changes
Answer: C
Explanation: Assessing venous function and considering surgical interventions, such as vein stripping or endovenous laser therapy, may be necessary when chronic venous ulcers do not respond to conservative management like compression therapy.
Question: 1396
election of appropriate pressure redistribution strategies for a patient with a complex medic and multiple comorbidities, how does the use of lateral rotation beds contribute to overall p
reducing the risk of aspiration nhancing mobility
roviding continuous pressure relief improving patient comfort
er: C
nation: Lateral rotation beds provide continuous pressure relief by periodically redistributing which is essential for patients with complex medical histories at high risk for pressure ulce
ion: 1397
operative patient develops a hematoma at the incision site. Which of the following sympto most likely indicate that this hematoma is evolving into a more serious complication?
calized swelling and bruising sistent pain at the site
In the s al
history atient
care?
1. By
2. By e
3. By p
4. By
Answ Expla
weight, rs.
Quest
A post- ms
would
1. Lo
2. Per
3. Fever and increased heart rate
4. Minimal drainage from the incision
Answer: C
Explanation: The combination of fever and increased heart rate suggests a potential systemic infection or complications arising from the hematoma, necessitating prompt assessment.
Question: 1398
During a wound care meeting, a discussion arises about the use of alginates in managing wounds with heavy exudate. What critical aspect of alginates makes them particularly effective in such scenarios?
1. They are non-adherent.
2. They absorb moisture and gel upon contact with exudate.
3. They provide a cooling effect.
er: B
nation: Alginates absorb moisture and form a gel when in contact with exudate, which is effe naging wounds with heavy drainage.
ion: 1399
ent from a different cultural background refuses a standard wound care treatment due to pers As a clinician, what is the best approach to respect the patient's preferences while ensuring
priate care?
vide alternative treatment options that align with their beliefs st on the treatment for the patient's well-being
cument the refusal and proceed with the standard care
er the patient to another clinician without further discussion
er: A
nation: Offering alternative treatment options shows respect for the patient's cultural beliefs a
They enhance granulation tissue formation.
Answ
Expla ctive
for ma
Quest
A pati onal
beliefs. appro
1. Pro
2. Insi
3. Do
4. Ref
Answ
Expla nd
preferences while still aiming to provide effective wound care.
Question: 1400
A patient with a long-standing ulcer has been prescribed several medications. Which aspect of the medication history is critical to explore to understand its effects on wound healing?
1. Dosage frequency
2. Duration of each medication
3. Side effects experienced
4. Drug interactions Answer: D
Explanation: Understanding potential drug interactions is vital as they can adversely affect wound healing or the effectiveness of prescribed treatments.
ion: 1401
enario where a patients religious beliefs oppose certain medical treatments for wound care, nician's best approach to ensure ethical practice?
ucate the patient on the importance of the treatment
laborate with the patient to find compatible treatment options miss the beliefs if they contradict medical advice
cument the beliefs and proceed with the recommended treatment
er: B
nation: Collaborating with the patient respects their religious beliefs while finding a treatmen ith both the patient's values and medical needs.
ion: 1402
ent with a accurate history of surgery has a blood sugar level of 140 mg/dL postoperatively. W ost appropriate action regarding their management?
Quest
In a sc what is
the cli
1. Ed
2. Col
3. Dis
4. Do
Answ
Expla t that
aligns w
Quest
A pati hat is
the m
1. Initiate insulin therapy
2. No action needed
3. Increase oral hypoglycemics
4. Monitor blood sugar levels only
Answer: A
Explanation: A blood sugar level of 140 mg/dL postoperatively may warrant insulin therapy to ensure
Question: 1403
Which aspect of patient education is crucial for promoting adherence to a wound care regimen, particularly in patients with chronic wounds?
importance of regular follow-ups
ar instructions on dressing changes and signs of infection role of family support in healing
er: C
nation: Clear instructions on dressing changes and recognizing signs of infection are essential ting adherence to the wound care regimen and preventing complications.
ion: 1404
of the following factors is likely to exacerbate the impact of smoking on wound healing in diabetic patients?
Poor glycemic control h protein diet
gular exercise equate hydration
er: A
The aesthetic benefits of healing
The
Cle
The Answ
Expla for
promo
Quest
Which
A.
1. Hig
2. Re
3. Ad
Answ
Explanation: Poor glycemic control in diabetic patients can exacerbate the negative effects of smoking on wound healing, further impairing vascular and immune responses.
Question: 1405
What is the primary advantage of utilizing negative pressure therapy in the treatment of complex wounds, especially in terms of tissue management?
1. Rapid closure of the wound
2. Enhanced patient comfort
3. Decreased need for dressing changes
4. Promotion of granulation tissue Answer: D
ion: 1406
onsidering adjunctive therapies for a patient with a non-healing pressure ulcer, which optio be least effective in addressing the underlying pathology?
gical intervention
ema management through pumps perbaric oxygen therapy
al contact casting er: D
nation: Total contact casting is primarily effective for diabetic foot ulcers with pressure point uitable for pressure ulcers where the primary issue is pressure relief rather than offloading.
ion: 1407
wound assessment, determining the presence of tunneling is crucial. What is the best appro or tunneling accurately?
Explanation: The primary advantage of negative pressure therapy is its ability to promote granulation tissue formation, which is essential for wound healing.
Quest
When c n
would
1. Sur
2. Ed
3. Hy
4. Tot Answ
Expla s and
is not s
Quest
During ach to
assess f
1. Using a cotton swab to explore the wound edges
2. Visual inspection alone
3. Relying on patient feedback regarding pain
4. Measuring the wound only in two dimensions
Answer: A
Explanation: Using a cotton swab to gently explore the wound edges allows for accurate detection of
Question: 1408
The application of alginate dressings in wound care presents unique advantages. However, what is a potential limitation of using alginates on dry, eschar-covered wounds?
ey can cause maceration of surrounding skin. ey can lead to wound desiccation.
ey may not adhere adequately to the wound bed. er: C
nation: Alginates are not suitable for dry, eschar-covered wounds as they may draw moisture he wound, leading to desiccation and hindered healing.
ion: 1409
year-old female with a stage II pressure ulcer reports a accurate decline in appetite and increase Which assessment would provide the most relevant information regarding her nutritional st
mprehensive metabolic panel ay food diary
Mini Nutritional Assessment (MNA) dy composition analysis
er: C
They promote excessive moisture loss.
Th
Th
Th
Answ
Expla away
from t
Quest
A 74- d
fatigue. atus?
1. Co
2. 3-d C.
D. Bo
Answ
Explanation: The Mini Nutritional Assessment is specifically designed to identify malnutrition risk in the elderly and would provide relevant insights.
Question: 1410
A patient with a sacral ulcer reports significant discomfort when sitting for long periods. Which extrinsic factor should the nurse address to promote healing and prevent further tissue damage?
1. Medication review
2. Patient education on repositioning
3. Dietary modifications
4. Increased fluid intake
Answer: B
ion: 1411
of the following factors should be closely monitored in patients with chronic wounds to ev tential impact of external moisture on healing?
type of wound dressing used wounds exudate characteristics patients dietary habits patients pain levels
er: B
nation: Monitoring the characteristics of wound exudate helps assess moisture levels and dete propriate management strategy to prevent complications such as maceration.
ion: 1412
Explanation: Educating the patient on the importance of regular repositioning is vital in preventing further pressure damage and promoting healing of the sacral ulcer.
Quest
Which aluate
the po
1. The
2. The
3. The
4. The
Answ
Expla rmine
the ap
Quest
What is a common clinical sign that indicates increased bio-burden in a wound?
1. Bright red granulation tissue
2. Healthy keratinocyte migration
3. Decreased wound size
4. Presence of purulent drainage Answer: D
Explanation: The presence of purulent drainage is a common clinical sign of increased bio-burden, indicating potential infection that could complicate healing.
Question: 1413
What role does ethical consideration play in the management of patients who have advanced directives regarding their wound care?
equires healthcare providers to respect and adhere to the patient's wishes as outlined in their ce directives
llows healthcare providers to override patient preferences if they believe its in the patient's
secondary to medical necessity and urgency of treatment only relevant in end-of-life care scenarios
er: A
nation: Ethical principles dictate that healthcare providers must honor advance directives and patients preferences regarding their care.
ion: 1414
a research study, a participant withdraws consent after experiencing discomfort with a wou ure. What is the researchers ethical obligation in this situation?
spect the participant's decision and discontinue their involvement empt to persuade the participant to continue
cument the discomfort but continue the study with the remaining participants port the participant's withdrawal to the funding agency
It r advan
It a best
interest
It is
It is
Answ Expla
respect
Quest
During nd care
proced
1. Re
2. Att
3. Do
4. Re
Answer: A
Explanation: Respecting the participant's decision to withdraw consent is a fundamental ethical obligation, ensuring their autonomy and comfort are prioritized.
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