NMC OSCE Wound Care & Tissue Viability 3

Question 1

A pressure ulcer shows full thickness skin and tissue loss with exposed bone, tendon, and muscle visible in the wound base. According to the EPUAP classification, what category is this?

Accepted Answer

Category 4

Answer

Category 2

Answer

Category 3

Answer

Unstageable

Question 2

What is the standard clinical method for documenting wound dimensions at the bedside?

Accepted Answer

Measure length x width x depth in centimetres using a sterile probe

Answer

Estimate size visually and document approximate size

Answer

Trace the wound outline onto acetate film only

Answer

Photograph the wound and rely solely on visual comparison

Question 3

What is the PRIMARY benefit of maintaining a moist wound environment during the healing process?

Accepted Answer

It promotes cell migration and prevents tissue dehydration

Answer

It eliminates the risk of wound infection entirely

Answer

It removes the need for regular dressing changes

Answer

It significantly reduces wound pain during all activities

Question 4

Which type of wound dressing is CONTRAINDICATED in a clinically infected wound?

Accepted Answer

Occlusive hydrocolloid dressings

Answer

Alginate dressings

Answer

Foam dressings

Answer

Antimicrobial silver dressings

Question 5

A patient has a Category 3 pressure ulcer over the sacrum. What is the MOST important nursing intervention to prevent further deterioration?

Accepted Answer

Implementing a regular repositioning schedule at least every 2 hours

Answer

Applying an antimicrobial dressing immediately

Answer

Increasing the patient's daily oral fluid intake

Answer

Elevating the sacral area above the level of the heart

Question 6

Which wound characteristic indicates that a wound is healing appropriately and progressing as expected?

Accepted Answer

Reduction in wound size with pink/red granulation tissue developing

Answer

Increasing wound dimensions with areas of bright red bleeding tissue

Answer

Increasing yellow slough across the majority of the wound bed

Answer

Spreading erythema beyond the wound margins with increased warmth

Question 7

A nurse is preparing to perform a wound dressing change. What should be the FIRST action taken before beginning the procedure?

Accepted Answer

Explain the procedure to the patient and obtain their consent

Answer

Gather all required equipment and dressings at the bedside

Answer

Perform hand hygiene and don appropriate personal protective equipment

Answer

Remove the existing dressing to assess the current wound condition