CWS Wound Care 3 — Questions and Answers
Question 1: Which clinical sign BEST differentiates critical colonization from biofilm-associated wound infection?
- Increased pain and friable granulation tissue (Correct answer)
- Purulent exudate and systemic fever
- Elevated white blood cell count
- Wound odor alone
Correct answer: Increased pain and friable granulation tissue
Critical colonization and biofilm often present with subtle signs like increased pain, friable or hypergranulation tissue, and stalled healing rather than classic systemic infection signs.
Question 2: A wound with undermining is BEST described as tissue destruction that extends:
- Straight down into the wound bed perpendicularly
- Under the wound edges in a closed pocket (Correct answer)
- Through the skin into adjacent body cavities
- Along fascial planes visible on imaging only
Correct answer: Under the wound edges in a closed pocket
Undermining refers to tissue destruction beneath intact skin at the wound margins, creating a closed pocket that requires probing to assess.
Question 3: Which topical agent is CONTRAINDICATED for long-term use in chronic wounds due to cytotoxicity to fibroblasts?
- Normal saline
- Povidone-iodine (Correct answer)
- Hydrogel
- Silver-impregnated dressing
Correct answer: Povidone-iodine
Povidone-iodine is cytotoxic to fibroblasts, keratinocytes, and leukocytes, impairing wound healing when used chronically.
Question 4: What is the Braden Scale used to assess?
- Wound depth and tissue involvement
- Pressure injury risk in hospitalized patients (Correct answer)
- Venous ulcer severity scoring
- Diabetic foot ulcer classification
Correct answer: Pressure injury risk in hospitalized patients
The Braden Scale assesses pressure injury risk using six subscales: sensory perception, moisture, activity, mobility, nutrition, and friction/shear.
Question 5: When using the Wagner grading system for diabetic foot ulcers, a grade 3 ulcer is characterized by:
- Superficial ulcer without subcutaneous involvement
- Deep ulcer to tendon or capsule
- Deep ulcer with abscess or osteomyelitis (Correct answer)
- Gangrene of partial foot
Correct answer: Deep ulcer with abscess or osteomyelitis
Wagner grade 3 denotes a deep ulcer complicated by abscess, osteomyelitis, or tendon/capsule involvement requiring aggressive treatment.
Question 6: Which phase of wound healing is characterized by collagen remodeling and scar maturation lasting up to 2 years?
- Hemostasis
- Inflammatory phase
- Proliferative phase
- Remodeling phase (Correct answer)
Correct answer: Remodeling phase
The remodeling (maturation) phase involves type III collagen replacement by type I collagen and scar tissue reorganization, occurring from weeks to up to 2 years post-injury.
Question 7: A wound measuring 6 cm × 4 cm last week now measures 4 cm × 3 cm. What percentage of wound area reduction occurred?
- 33%
- 40%
- 50% (Correct answer)
- 60%
Correct answer: 50%
Original area = 24 cm²; new area = 12 cm²; reduction = (24-12)/24 × 100 = 50% area reduction.
CWS Wound Care 3
Which clinical sign BEST differentiates critical colonization from biofilm-associated wound infection?