CWS Certified Wound Specialist MCQ 4 — Questions and Answers
Question 1: Which criterion from the NERDS acronym specifically indicates superficial critical colonization rather than systemic infection?
- Non-healing despite optimal care (Correct answer)
- Fever above 38.5°C
- Erythema spreading beyond 2 cm
- Leukocytosis on CBC
Correct answer: Non-healing despite optimal care
NERDS (Non-healing, Exudate increase, Red friable tissue, Debris, Smell) identifies superficial critical colonization; systemic signs like fever belong to the STONEES tool.
Question 2: The Braden Scale score that places a patient at HIGH risk for pressure injury development is:
- 12 or below (Correct answer)
- 13–14
- 15–16
- 17–18
Correct answer: 12 or below
A Braden Scale score of 12 or below indicates high risk; scores 13–14 are moderate risk, and 15–18 are mild to no risk.
Question 3: A wound clinician recommends collagen dressings for a stalled chronic wound. The PRIMARY rationale is to:
- Bind matrix metalloproteinases that degrade growth factors (Correct answer)
- Provide a physical scaffold for bacterial biofilm disruption
- Donate oxygen to hypoxic wound tissue
- Stimulate keratinocyte migration via electrical signaling
Correct answer: Bind matrix metalloproteinases that degrade growth factors
Collagen dressings bind and inactivate excess MMPs in chronic wounds, protecting growth factors and allowing healing to progress.
Question 4: According to the National Pressure Injury Advisory Panel (NPIAP), a full-thickness wound with exposed bone that is covered with slough but the base cannot be visualized should be staged as:
- Unstageable (Correct answer)
- Stage 3
- Stage 4
- Deep tissue pressure injury
Correct answer: Unstageable
When wound depth cannot be determined due to slough or eschar covering the base, the wound is classified as unstageable until the bed is visible.
Question 5: Which topical agent is MOST appropriate for a wound with suspected Pseudomonas aeruginosa infection indicated by a blue-green exudate?
- Silver-containing antimicrobial dressing (Correct answer)
- Iodine-impregnated gauze
- Hydrocolloid dressing
- Collagen matrix dressing
Correct answer: Silver-containing antimicrobial dressing
Silver has broad-spectrum antimicrobial activity including against Pseudomonas and is appropriate for critically colonized or locally infected wounds.
Question 6: The 'probe to bone' test in a diabetic foot wound carries which predictive value for osteomyelitis?
- High positive predictive value in high-prevalence populations (Correct answer)
- Low sensitivity making it unreliable for screening
- High specificity but low sensitivity in all settings
- Equal sensitivity and specificity regardless of clinical context
Correct answer: High positive predictive value in high-prevalence populations
In high-prevalence diabetic foot populations, a positive probe-to-bone test has a positive predictive value of approximately 89%, making it a useful bedside tool.
Question 7: Lymphedema differs from venous edema in that lymphedema characteristically involves:
- Non-pitting edema in the dorsum of the foot and toes (Stemmer sign) (Correct answer)
- Pitting edema that resolves with overnight leg elevation
- Hemosiderin staining and lipodermatosclerosis
- Dependent edema improving with diuretics
Correct answer: Non-pitting edema in the dorsum of the foot and toes (Stemmer sign)
Lymphedema produces non-pitting edema that extends to the toes (positive Stemmer sign), whereas venous edema typically spares the foot dorsum and toes.
CWS Certified Wound Specialist MCQ 4
Which criterion from the NERDS acronym specifically indicates superficial critical colonization rather than systemic infection?