CWS Certified Wound Specialist MCQ 5 — Questions and Answers
Question 1: Which clinical feature BEST distinguishes a calciphylaxis wound from a standard venous leg ulcer?
- Stellate, livedo-reticularis pattern with extremely painful necrosis (Correct answer)
- Superficial ulceration with fibrinous base and moderate pain
- Copious serous exudate with surrounding hyperpigmentation
- Pale wound bed with absent periwound hair and cool skin
Correct answer: Stellate, livedo-reticularis pattern with extremely painful necrosis
Calciphylaxis presents with stellate, extremely painful ischemic necrosis arising from a livedo-reticularis pattern, most often in patients with renal failure.
Question 2: A patient undergoing radiation therapy develops moist desquamation. The MOST appropriate dressing is:
- Non-adherent silicone or soft foam dressing (Correct answer)
- Wet-to-dry gauze dressing
- Hydrocolloid dressing
- Dry gauze changed twice daily
Correct answer: Non-adherent silicone or soft foam dressing
Non-adherent silicone dressings protect fragile irradiated skin without trauma on removal and maintain a moist environment to support re-epithelialization.
Question 3: In biofilm management, the phrase 'disrupt and disperse' refers to:
- Physically removing biofilm via debridement followed by antimicrobial application (Correct answer)
- Applying surfactants to dissolve the polysaccharide matrix only
- Using systemic antibiotics to penetrate and kill biofilm bacteria
- Allowing autolysis to break down the biofilm before dressing
Correct answer: Physically removing biofilm via debridement followed by antimicrobial application
Biofilm management requires physical disruption through debridement to break the matrix, followed immediately by antimicrobial agents to address dispersed planktonic bacteria.
Question 4: Which factor is the STRONGEST independent predictor of impaired wound healing in a patient with a chronic wound?
- Hemoglobin A1c above 8% (Correct answer)
- Age over 65 years
- Body mass index above 30
- Use of low-dose aspirin
Correct answer: Hemoglobin A1c above 8%
Poorly controlled diabetes (HbA1c >8%) impairs neutrophil function, collagen synthesis, and angiogenesis, making it the strongest independent predictor of impaired healing.
Question 5: Pyoderma gangrenosum (PG) is characterized by which wound behavior that distinguishes it from infection?
- Pathergy — wound enlargement following minor trauma or debridement (Correct answer)
- Rapid healing response to systemic antibiotics
- Central eschar with surrounding cellulitis
- Granular wound bed with high exudate and foul odor
Correct answer: Pathergy — wound enlargement following minor trauma or debridement
Pathergy, where minor trauma causes the wound to worsen or enlarge, is a hallmark of pyoderma gangrenosum and distinguishes it from infectious wounds.
Question 6: The MOST effective nutritional supplement supported by evidence for pressure injury prevention and healing is:
- Arginine, zinc, and vitamin C combined (Correct answer)
- Vitamin D alone
- Omega-3 fatty acids only
- Iron supplementation regardless of serum levels
Correct answer: Arginine, zinc, and vitamin C combined
Combination supplements containing arginine (supports collagen and nitric oxide production), zinc (cofactor for cell proliferation), and vitamin C (collagen hydroxylation) have the strongest evidence.
Question 7: A wound demonstrates 20% reduction in area after 4 weeks of standard care. According to evidence-based benchmarks, this indicates:
- Inadequate progress — the 4-week benchmark is at least 40% reduction (Correct answer)
- Acceptable progress consistent with expected healing trajectory
- Excellent progress warranting continuation of current therapy
- Inconclusive data requiring another 4 weeks before reassessment
Correct answer: Inadequate progress — the 4-week benchmark is at least 40% reduction
Evidence-based wound healing benchmarks indicate that wounds failing to reduce in area by at least 40–50% over 4 weeks should trigger reassessment and treatment modification.
CWS Certified Wound Specialist MCQ 5
Which clinical feature BEST distinguishes a calciphylaxis wound from a standard venous leg ulcer?