Exam (elaborations)
WOUND CERTIFICATION EXAM 2024/2025 (ACTUAL QUESTIONS AND ANSWERS)
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WOUND CERTIFICATION EXAM2024/2025 (ACTUAL QUESTIONS
AND ANSWERS)
What are 6 risk factor components of braden scale for pressure ulcer?
Sensory percep9on, moisture, mobility, ac9vity, nutri9on, and shear/fric9on
What is the name of the organiza9on that developed the pressure ulcer
staging?
Npuap (na9onal pressure ulcer advisory panel)
Pathological effect of excessive pressure on soE 9ssue can be aFributed by 3
factors? What are they?
Tissue tolerance, dura9on of pressure, and intensity of pressure
What are the extrinsic factors that impact pressure ulcers?
Increase in moisture, fric9on and shearing
How does fric9on play a role in shearing which eventually leads to pressure
ulcer?
Fric9on alone causes only superfical abrasion, but with gravity it plays a
synergis9c effect leading to shearing. When gravity pushes down on the body
and resistance (fric9on) between the pa9ent and surface is exerted, shearing
occurs. Because skin does not freely move, primary effect of shearing occurs at
the deeper fascial level.
What are the intrisinc factors of pressur ulcers?
Nutri9onal debilita9on, advanced age, low bp, stress, smoking, elevated body
temperature
Aging skin undergoes what elements affec9ng risk for pressure ulcer?
,Dermoepidermal junc9on flaFens, less nutrient exchange occurs, less
resistance to shearing, changes in sensory percep9on, loss of dermal thickness,
increased vascular fragility; ability of soE 9suse to distribute mechanical load
w/out comprosing blood flow is impaired
What does nonblanching erythema indicate in the skin r/t pu?
When pressure is applied to the erythema9c area skin becomes white
(blanched), but once relieved, erythema returns -indica9ng blood flow;
however in nonblanching erythema, skin does not blanche-indica9ng impaired
blood flow-sugges9ng 9ssue destructon
Why does siVng in a chair pose more of a risk in skin break down than lying?
Deep 9ssue injury or pu is likely to occur sooner siVng down because 9ssue
offloading over boney prominences is higher
Describe what you will see in deep 9ssue injury?
Purple or maroon localized area of discolored intact skin skinor blood filled
blister; may be preceded by painful, firm, mushy, or boggy; skin may be warmer
to cooler in adjacent 9ssue. In dark skin, thin blister or eschar over a dark
wound bed may bee seen
Describe stage i pressure ulcer?
Intact skin with nonblanchable redness of localized area. Will not see blanching
in dark skin, but changes in skin 9ssue consistency (firm vs boggy when
palpated), sensa9on (pain), and warmer or cooler temperature may differ from
surrounding area
Describe stage ii pressure ulcer?
Par9al-thickness wound where epidermis and 9p of dermis is lost with red-pink
wound bed w/out slough. May also present as intact or open/ruptured serum -
filled blister
Describe stage iii pressure ulcer?
, Full-thickness wound where both epidermis and dermis is lost and
subcutaneous 9ssue may be visible, but deeper structures such as muscle,
bone, and tendon are not exposed; slough my be present but it doesn't
obscure depth and tunneling and undermining may be present
Describe stage iv pressure ulcer?
Full-thickness wound with exposed bone,tendon, and muscle; slough or eschar
may be seen in some parts of the wound bed. You will oEen see tunneling and
undermining. Osteomyeli9s may be dxed at this stage, since bone is palpable
Describe unstageble ulcers?
Full-thickness wound where base of the ulcer is covered by slough and/or
eschar, obscuring depth
When should eschars not be removed?
When it's stable with dry, adherent, and intact w/out erythema on the heel;
this serves as the body's natural cover and should not be removed.
Therapeu9c func9on of pressure distribu9on is accomplised by what 2 factors?
Immersion and envelopement
Define immersion?
Depth of penetra9on or skining into surgace allowing pressure to be spread out
over surrounding area rather than directly over boney prominence
Define envelopement?
Is the ability of support surface to conform to irregulari9es without causing
substan9al increase in pressure
What is boFoming out?
This occurs when depth of penetra9on or sinking is excessive, allowing
increased pressure to concentrate over boney prominences
What factors contribute to boFoming out?
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