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Certified Foot Care Nurse Practice Test

WOCNCB-CFCN exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives

WOCNB WOCNCB-CFCN Certified Foot Care Nurse (CFCN)

Domain I: Assessment and Care Planning

Task 1: Obtain focused patient health history (e.g., current medications, co‐morbidities, health habits) through interviews, established medical records, and questionnaires in order to determine the patient’s current health and risk status.

- Medications
- Diseases affecting the lower extremities
(musculoskeletal, endocrine, neurological, vascular, integumentary, etc.)
- Health behaviors affecting lower extremities (smoking, diet, obesity, activity level, etc.)
- Active listening

Task 2: Perform focused lower extremity physical assessments in order to determine current physical (e.g., vascular, neurological, skin integrity, musculoskeletal) and mental status.

- Methods for mental health assessment
- Methods for pain assessment
- Pain types (neuropathic, musculoskeletal, ischemic, etc.)
- Anatomy and physiology of the lower extremities (foot, nails, bone structure, etc.)
- Functional disabilities (gait, mobility, balance, visual, cognitive)
- Factors reflecting vascular status (temperature, hair growth patterns, pulses, blanching, capillary refill, dependent rubor, pallor, edema)
- Indicators of compromised skin integrity (fissures, ulcers, corns, calluses, dermatitis)
- Physical/musculoskeletal function of the foot (range of motion, deformities, strength)
- Neurological status of the lower extremities (sensory, motor, autonomic)
- Palpating pulses (dorsalis pedis, posterior tibialis)
- Using a Doppler
- Determining ankle brachial index (ABI)
- Performing monofilament, vibratory, and proprioception tests

Task 3: Develop an initial patient‐centered plan of care using health history and physical assessment information to meet established foot care goals.

- Principles of patient‐centered care
- Normal and abnormal physical assessment results
- Appropriate interventions (education, treatments, referrals)
- Cultural and ethnic differences affecting foot health
- Interpreting patient assessment results
- Setting appropriate goals based on identified patient needs
- Planning interventions based on patient needs and goals

Task 4: Perform ongoing evaluation and modification of the patient‐centered plan.

- Principles of patient‐centered care
- Anticipated responses to current interventions
- Appropriate modifications based on responses to interventions
- Interpreting patient responses to interventions
- Modifying goals based on patient response
- Modifying interventions based on revised patient needs and goals

Domain II: Intervention and Treatment

Task 1: Perform skin care on feet and lower extremities using appropriate skin care products in order to promote optimal skin health and integrity.

- Integumentary system
- Skin cleansing principles
- Skin moisturizers (humectants, emollients)
- Barrier products (dimethicone, petrolatum, zinc‐based products, etc.)
- Topical medications
- Selecting and applying appropriate skin care products (cleansers, moisturizers, medications)

Task 2: Recommend treatment and/or provide care for dermatological conditions affecting the feet and lower extremities using appropriate skin care products in order to promote optimal skin health and integrity.

- Integumentary system
- Signs/symptoms of skin impairments/abnormalities (blisters, hyperkeratotic lesions, stasis dermatitis, fissures, verucca vulgaris, trauma, tinea pedis, paronychia, maceration, hemosiderosis, etc.)
- Skin cleansing principles
- Skin moisturizers (humectants, emollients)
- Barrier products (dimethicone, petrolatum, zinc‐based products, etc.)
- Topical medications
- Management of hyperkeratotic lesions
- Applying skin care products (cleansers, moisturizers, medications)

Task 3: Implement offloading interventions utilizing offloading products in order to promote optimal skin health and integrity and prevent further injury (e.g., ulceration, callous formation, deep tissue injury).

- Appropriate footwear (shoes, socks, hosiery, inserts)
- Offloading principles to reduce and/or redistribute pressure, friction, and/or sheer
- Offloading and padding products (orthotics, lamb’s wool, moleskin, felt padding, silicone products, etc.)
- Applying offloading and padding products
appropriately

Task 4: Perform nail care and debridement using appropriate instruments in order to promote comfort and optimize function.

- Nail anatomy
- Onychopathology (onychomycosis, onychocryptosis, paronychia, etc.)
- Personal protective equipment (PPE) guidelines
- Debridement techniques
- Instrument sterilization guidelines (cold sterilization, autoclave, etc.)
- Identifying free nail border (nail debris)
- Appropriately selecting and using equipment (rotary powered instrument, nippers, etc.) for nail care and debridement

Task 5: Identify lower extremity wounds (i.e., venous, arterial, neuropathic, traumatic, and pressure ulcers) and make wound care treatment recommendations and/or referrals that support the goals of care.

- Characteristics of wound types (venous, arterial, neuropathic, traumatic, pressure ulcers)
- National Pressure Ulcer Advisory Panel (NPUAP) pressure ulcer staging system
- Wagner grading system for diabetic foot ulcers 020503
- Principles of moist wound healing 020504
- Principles of basic wound care 020505
- Appropriate topical treatment to maintain periwound integrity
- Dressings for moist wound healing (containment of drainage, eliminate dead space, reduce bioburden, control odor, debridement, etc.)
- Compression therapy (indications and contraindications)
- Advanced wound therapy (electrical stimulation, bioengineered tissue, negative pressure wound therapy, hyperbaric oxygen therapy)
- Selecting and applying dressings
- Educating patients and caregivers regarding wound healing (infection, tobacco cessation, nutrition, optimal health choices, causative factors, etc.)

Domain III: Education and Referral

Task 1: Instruct patients and caregivers on foot care principles (e.g., hygiene, footwear, daily foot inspections) and disease, lifestyle, and/or age‐related processes to prevent complications, maintain optimal foot health, and encourage patient autonomy.

- Preventive skin care strategies
- Disease processes and conditions affecting feet and lower extremities (arterial disease, venous disease, neurological disease, diabetes, autoimmune, arthritis, trauma, etc.)
- Age‐related processes affecting feet and lower extremities
- Health habits affecting feet and lower extremities (activity level, exercise, obesity, diet, smoking, etc.)
- Assessing patient health literacy (learning style, readiness to learn, barriers to learning, current understanding, etc.)

Task 2: Collaborate with interdisciplinary healthcare professionals and make appropriate referrals to support patient‐centered goals of care.

- Available healthcare‐related resources
- Roles and responsibilities of specialized healthcare providers (vascular specialist/surgeon, endocrinologist, podiatrist, orthopedic surgeon, dermatologist, pedorthist/orthotist, pain management specialist, diabetic educator, wound care specialist, etc.)
- Health care delivery systems
- Communicating with members of the interdisciplinary team
- Navigating health care systems (identifying and accessing programs for specific lower extremity disease processes)

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Question: 1
Which of the following is a risk factor for the development of peripheral
arterial disease (PAD)?
A. Regular exercise
B. Low body mass index (BMI)
C. Smoking
D. Vegetarian diet
Answer: C
Explanation: Smoking is a significant risk factor for the development of
peripheral arterial disease (PAD). Smoking damages the blood vessels, leading
to narrowing and reduced blood flow to the extremities. Regular exercise is
generally beneficial for cardiovascular health and can help prevent PAD. Low
body mass index (BMI) and a vegetarian diet are not direct risk factors for
PAD.
Question: 2
Which of the following sensory tests is commonly used to assess the protective
sensation of the foot?
A. Monofilament testing
B. Doppler ultrasound
C. Vibration testing
D. Capillary refill test
Answer: A
Explanation: Monofilament testing is a sensory examination that assesses the
protective sensation of the foot. A monofilament, a thin nylon thread, is applied
to specific areas of the foot to determine if the patient can perceive the
pressure. This test is commonly used to detect loss of protective sensation,
which can be indicative of peripheral neuropathy. Doppler ultrasound is used to
evaluate blood flow, vibration testing assesses vibratory sensation, and the
capillary refill test assesses peripheral perfusion.
Question: 3
Which of the following conditions is commonly associated with
onychomycosis?
A. Ingrown toenails
B. Paronychia
C. Fungal nail infections
D. Cuticle infections
Answer: C
Explanation: Onychomycosis refers to a fungal infection of the nails,
commonly known as fungal nail infections. It often causes discoloration,
thickening, and brittleness of the nails. Ingrown toenails involve the nail
growing intothe surrounding skin, paronychia is an infection of the skin around
the nail, and cuticle infections specifically affect the cuticle area. While these
conditions can occur in various individuals, onychomycosis is specifically
associated with fungal nail infections.
Question: 4
Which of the following foot deformities is commonly associated with
peripheral neuropathy?
A. Hallux valgus
B. Hammer toes
C. Pes planus
D. Bunionette
Answer: B
Explanation: Peripheral neuropathy is a condition that affects the nerves in the
extremities, including the feet. Hammer toes, characterized by an abnormal
bending or curling of the toes, is a common foot deformity associated with
peripheral neuropathy. Hallux valgus refers to the deviation of the big toe
towards the other toes, while pes planus refers to flat feet. Bunionette is a
deformity of the small toe joint. While these deformities can occur in various
individuals, hammer toes are particularly prevalent in those with peripheral
neuropathy.
Question: 5
Which of the following is NOT typically assessed when evaluating toenails and
cuticles?
A. Nail color
B. Nail thickness
C. Nail length
D. Nail curvature
Answer: C
Explanation: When evaluating toenails and cuticles, various factors are
typically assessed. These factors include nail color, nail thickness, nail
curvature, and the presence of any abnormalities such as discoloration or
ingrown nails. Nail length, although important for general nail care, is not
typically assessed as part of the evaluation.
Question: 6
Which of the following techniques is used to assess foot circulation by
palpation?
A. Monofilament testing
B. Capillary refill test
C. Doppler ultrasound
D. Pulses assessment
Answer: D
Explanation: Palpation is a technique used to assess foot circulation by feeling
the pulses in specific areas of the foot. By evaluating the strength and regularity
of the pulses, healthcare professionals can gain insights into the blood flow to
the foot. Monofilament testing is used to assess sensory perception, not
circulation. Capillary refill test measures the time it takes for capillaries to refill
after being compressed, providing information about peripheral perfusion.
Doppler ultrasound is a separate technique that uses sound waves to evaluate
blood flow.
Question: 7
Which of the following health habits is associated with an increased risk of foot
complications?
A. Regular exercise
B. Proper hygiene
C. Smoking
D. Balanced nutrition
Answer: C
Explanation: Smoking is a health habit that is associated with an increased risk
of foot complications. Smoking has been shown to negatively impact
circulation, impair wound healing, and increase the risk of peripheral vascular
disease. These factors can contribute to the development of foot ulcers,
infections, and other complications. Regular exercise, proper hygiene, and
balanced nutrition are generally beneficial for foot health and overall well-
being.
Question: 8
Which of the following is an appropriate method for assessing foot circulation?
A. Palpation of pulses
B. Monofilament testing
C. Doppler ultrasound
D. Vibration testing
Answer: A
Explanation: Palpation of pulses is an appropriate method for assessing foot
circulation. By manually feeling the pulses in the foot, such as the dorsalis
pedis and posterior tibial pulses, the healthcare provider can evaluate the blood
flow and perfusion to the foot. Monofilament testing is used to assess sensation,
while Doppler ultrasound is used to evaluate blood flow by detecting and
measuring the Doppler shift. Vibration testing is also used to assess sensation.
However, when specifically assessing foot circulation, palpation of pulses is the
most appropriate method.
Question: 9
Which of the following is a common sign of compromised foot circulation?
A. Blanching of the skin
B. Excessive hair growth
C. Warmth of the feet
D. Callus formation
Answer: A
Explanation: Blanching of the skin refers to the temporary whitening or
paleness of the skin when pressure is applied and then released. It is a common
sign of compromised foot circulation, indicating decreased blood flow to the
area. Excessive hair growth is not directly associated with compromised
circulation. Warmth of the feet may indicate increased blood flow or
inflammation. Callus formation is a result of excessive pressure or friction on
the skin, not solely related to circulation.
Question: 10
Which of the following foot conditions is characterized by the presence of
fissures, ulcers, corns, calluses, and dermatitis?
A. Athlete's foot
B. Plantar fasciitis
C. Ingrown toenail
D. Foot eczema
Answer: D
Explanation: Foot eczemais a foot condition characterized by the presence of
fissures, ulcers, corns, calluses, and dermatitis. It refers to inflammation of the
skin on the feet, often caused by allergic reactions or irritants. Athlete's foot,
also known as tinea pedis, is a fungal infection characterized by itching,
redness, and scaling of the skin. Plantar fasciitis is a condition involving
inflammation of the plantar fascia, resulting in heel pain. Ingrown toenail is a
condition in which the edge of the toenail grows into the surrounding skin,
causing pain and inflammation.
Question: 11
Which of the following foot deformities is characterized by an abnormal inward
curvature of the foot arch?
A. Hallux valgus
B. Pes cavus
C. Hammer toes
D. Metatarsalgia
Answer: B
Explanation: Pes cavus, also known as high arches, is a foot deformity
characterized by an abnormally high arch that may cause the foot to curve
inward. Hallux valgus refers to the deviation of the big toe towards the other
toes. Hammer toes involve abnormal bending or curling of the toes.
Metatarsalgia is a condition characterized by pain and inflammation in the ball
of the foot. While these deformities can occur in various individuals, pes cavus
specifically involves an inward curvature of the foot arch.
Question: 12
Which of the following factors is NOT typically assessed when evaluating a
patient for functional disabilities related to gait?
A. Mobility
B. Balance
C. Visual acuity
D. Cognitive function
Answer: C
Explanation: When evaluating a patient for functional disabilities related to
gait, various factors are assessed. These factors include mobility, balance,
visual acuity, and cognitive function. Visual acuity, which refers to the
sharpness and clarity of vision, is not directly related to gait. While visual
impairment can impact overall mobility and balance, it is not specifically
assessed as part of gait evaluation. Therefore, option C, visual acuity, is the
factor that is NOT typically assessed when evaluating a patient for functional
disabilities related to gait.
Question: 13
Which of the following is NOT typically assessed when evaluating hair growth
on the legs and feet?
A. Hair density
B. Hair color
C. Hair length
D. Hair texture
Answer: B
Explanation: When evaluating hair growth on the legs and feet, various factors
are typically assessed. These factors include hair density, hair length, hair
texture, and the presence of any abnormalities such as reduced hair growth.
Hair color is not typically assessed as part of the evaluation. While changes in
hair color may occur due to various factors, they are not directly relevant to
assessing hair growth on the legs and feet.
Question: 14
Which of the following foot conditions is commonly associated with peripheral
arterial disease (PAD)?
A. Fissures
B. Ulcers
C. Corns
D. Dermatitis
Answer: B
Explanation: Peripheral arterial disease (PAD) refers to the narrowing or
blockage of arteries that supply blood to the extremities, including the feet.
This condition can lead to inadequate blood flow, resulting in the development
of ulcers on the feet. Fissures are deep cracks in the skin, corns are thickened
areas of skin, and dermatitis refers to skin inflammation. While these
conditions can occur in various individuals, foot ulcers are particularly
associated with PAD.
Question: 15
Which of the following tests is commonly used for assessing sensation in the
foot?
A. Monofilament testing
B. Doppler ultrasound
C. Palpation of pulses
D. Vibration testing
Answer: A
Explanation: Monofilament testing is commonly used for assessing sensation in
the foot. It involves applying a nylon monofilament to specific areas of the foot
to determine if the patient can feel the pressure. This test is particularly useful
for detecting loss of protective sensation, which is a risk factor for foot ulcers
and other complications in individuals with diabetes. Doppler ultrasound is
used to evaluate blood flow, palpation of pulses assesses circulation, and
vibration testing evaluates sensory perception. However, when specifically
assessing sensation in the foot, monofilament testing is the most commonly
used test.
Question: 16
When assessing the physical/musculoskeletal function of the foot, which of the
following would NOT be typically evaluated?
A. Range of motion
B. Deformities
C. Strength
D. Skin integrity
Answer: D
Explanation: When assessing the physical/musculoskeletal function of the foot,
various factors are typically evaluated. These include range of motion,
deformities, and strength. Skin integrity, although important, is not specifically
assessed when evaluating the physical/musculoskeletal function of the foot.
Skin integrity is typically assessed separately as part of the foot skin integrity
examination.
Question: 17
When assessing the legs and feet for temperature, which of the following
findings would be considered abnormal?
A. Warmth and even temperature distribution
B. Mild coolness in the toes
C. Symmetrical temperature between legs
D. Mild warmth in the ankle area
Answer: B
Explanation: When assessing the legs and feet for temperature, warmth and
even temperature distribution are considered normal findings. However, mild
coolness in the toes would be considered abnormal. It may indicate
compromised circulation or peripheral vascular disease, which can impair blood
flow to the extremities. Symmetrical temperature between the legs and mild
warmth in the ankle area are also normal findings.
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Certified Foot Care Nurse Practice Test

WOCNCB-CFCN exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives

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