OSCE OSCE Wound Care and Dressings 5 — Questions and Answers
Question 1: A patient with a venous leg ulcer has an ankle-brachial pressure index (ABPI) of 0.6. What does this result indicate about wound management?
- Full compression therapy is safe to apply
- Compression therapy is contraindicated due to arterial insufficiency (Correct answer)
- Mild compression at 20 mmHg is indicated
- No further vascular assessment is needed
Correct answer: Compression therapy is contraindicated due to arterial insufficiency
An ABPI below 0.8 suggests significant arterial disease, making compression therapy contraindicated as it could further compromise arterial perfusion.
Question 2: When is hydrogel dressing MOST appropriately used?
- On a heavily exuding wound to absorb drainage
- On a dry, necrotic wound to rehydrate and soften eschar (Correct answer)
- On an infected wound as the primary treatment
- As a primary dressing on a fresh surgical incision
Correct answer: On a dry, necrotic wound to rehydrate and soften eschar
Hydrogels donate moisture to dry wounds and help rehydrate and soften necrotic tissue, facilitating autolytic debridement.
Question 3: Which action is MOST important before applying a new wound dressing in the OSCE?
- Select the most expensive available dressing
- Perform hand hygiene and don appropriate PPE (Correct answer)
- Apply the dressing quickly to minimize air exposure
- Review the previous nurse's documentation only
Correct answer: Perform hand hygiene and don appropriate PPE
Hand hygiene before and after wound care is the most critical step to prevent healthcare-associated infection.
Question 4: A postoperative patient develops a wound that is red, warm, and has purulent discharge on Day 5. The FIRST step in management is:
- Apply an antimicrobial dressing and reassess in 48 hours
- Notify the physician, obtain a wound culture, and document findings (Correct answer)
- Increase oral fluid intake to improve immune response
- Apply a hydrocolloid dressing to promote autolytic debridement
Correct answer: Notify the physician, obtain a wound culture, and document findings
Signs of wound infection require immediate physician notification, wound culture collection to identify the causative organism, and thorough documentation.
Question 5: Which nutritional deficiency MOST significantly impairs wound healing by reducing collagen synthesis?
- Vitamin D deficiency
- Vitamin C deficiency (Correct answer)
- Vitamin B12 deficiency
- Calcium deficiency
Correct answer: Vitamin C deficiency
Vitamin C (ascorbic acid) is essential for collagen cross-linking and synthesis; its deficiency leads to impaired wound healing and wound breakdown.
Question 6: In an OSCE station, a patient's wound is described as a 'full-thickness wound extending to and including muscle and bone.' This is classified as:
- Stage II pressure injury
- Stage III pressure injury
- Stage IV pressure injury (Correct answer)
- Unstageable pressure injury
Correct answer: Stage IV pressure injury
Stage IV pressure injuries involve full-thickness tissue loss with exposure of bone, tendon, or muscle.
Question 7: A patient with a leg wound asks why their clinician is using a moist wound healing approach rather than keeping the wound dry. The BEST response is:
- Moist environments kill all bacteria and prevent infection
- Moist wound healing speeds epithelialization, reduces pain, and supports autolytic debridement (Correct answer)
- Keeping a wound moist is simply more comfortable for the patient
- Moisture prevents scarring by stopping collagen from forming
Correct answer: Moist wound healing speeds epithelialization, reduces pain, and supports autolytic debridement
Moist wound healing accelerates epithelial cell migration, reduces pain at dressing changes, and promotes autolytic debridement of necrotic tissue.
OSCE OSCE Wound Care and Dressings 5
A patient with a venous leg ulcer has an ankle-brachial pressure index (ABPI) of 0.6.
What does this result indicate about wound management?