OSCE OSCE Wound Care and Dressings 4 — Questions and Answers
Question 1: A patient has a wound with a sinus tract measuring 3 cm deep. How should this area be packed?
- Loosely fill the sinus tract without overpacking (Correct answer)
- Leave the sinus tract open and unpacked
- Pack tightly to obliterate all dead space
- Apply a foam dressing over the surface only
Correct answer: Loosely fill the sinus tract without overpacking
Sinus tracts should be loosely packed to absorb exudate and allow drainage without putting pressure on the tract walls that could impair healing.
Question 2: Which patient population is at HIGHEST risk for developing a pressure injury within 24 hours of admission?
- Ambulatory patient with mild hypertension
- Elderly patient with hip fracture on bed rest (Correct answer)
- Young adult post-appendectomy ambulating Day 1
- Patient with controlled type 2 diabetes, BMI 22
Correct answer: Elderly patient with hip fracture on bed rest
Elderly patients with hip fractures are immobile, often have reduced tissue perfusion, and poor skin integrity, placing them at very high risk for pressure injuries.
Question 3: In the OSCE, you are asked to perform a Braden Scale assessment. Which subscale specifically evaluates the patient's ability to change and control body position?
- Sensory perception
- Mobility (Correct answer)
- Activity
- Friction and shear
Correct answer: Mobility
The Mobility subscale of the Braden Scale assesses the patient's ability to change and control body position independently.
Question 4: A wound culture is ordered. Which technique for wound culture collection provides the most accurate results?
- Surface swab of wound exudate
- Tissue biopsy or quantitative wound swab after irrigation (Correct answer)
- Swab of the wound edge before cleansing
- Culture of removed dressing material
Correct answer: Tissue biopsy or quantitative wound swab after irrigation
Tissue biopsy or a quantitative Levine technique swab after irrigation provides the most accurate representation of true wound bioburden.
Question 5: A patient has a wound with undermining noted at the 9 o'clock position extending 2 cm. How would you document this finding?
- Undermining present, depth unknown
- Undermining 2 cm at 9 o'clock position (Correct answer)
- Tunneling 2 cm toward the left side
- Sinus tract at lateral wound margin
Correct answer: Undermining 2 cm at 9 o'clock position
Undermining is documented by its depth and clock position (e.g., 2 cm at 9 o'clock), distinguishing it from tunneling which has a narrow opening.
Question 6: Silver-containing dressings are indicated for which wound condition?
- Clean surgical wounds healing by primary intention
- Critically colonized or locally infected wounds (Correct answer)
- Wounds with no exudate in the proliferative phase
- Dry necrotic wounds requiring rehydration
Correct answer: Critically colonized or locally infected wounds
Silver dressings provide broad-spectrum antimicrobial activity and are indicated for critically colonized or locally infected wounds to reduce bioburden.
Question 7: During wound assessment, you note that wound edges are rolled inward (epibole). What does this finding indicate?
- The wound is ready for closure
- Epithelial cells have stopped migrating and the wound is stalled (Correct answer)
- Excessive granulation tissue is forming
- Normal progression in the proliferative phase
Correct answer: Epithelial cells have stopped migrating and the wound is stalled
Epibole (rolled or closed wound edges) indicates that epithelial cells have stopped migrating across the wound bed, signaling a stalled chronic wound.
OSCE OSCE Wound Care and Dressings 4
A patient has a wound with a sinus tract measuring 3 cm deep.
How should this area be packed?