OSCE Wound Care and Dressings 5 — Questions and Answers
Question 1: A patient with a burn injury has a wound that is painful, moist, red, and blistering with blanching on pressure. This is classified as:
- Superficial (first-degree) burn
- Superficial partial-thickness (second-degree) burn (Correct answer)
- Deep partial-thickness burn
- Full-thickness (third-degree) burn
Correct answer: Superficial partial-thickness (second-degree) burn
Superficial partial-thickness burns affect the epidermis and superficial dermis, presenting with blistering, moist appearance, redness, and blanching with preserved pain sensation.
Question 2: Which sign is MOST specific for identifying wound infection rather than simple colonization?
- Wound odor
- Increased exudate
- Erythema, warmth, and purulent discharge with delayed healing (Correct answer)
- Wound size that has not decreased in 2 weeks
Correct answer: Erythema, warmth, and purulent discharge with delayed healing
Classic signs of wound infection include erythema, warmth, edema, pain, purulent discharge, and wound breakdown, distinguishing infection from colonization.
Question 3: A patient has a wound with hypergranulation (proud flesh) above the wound surface level. The appropriate management is:
- Apply foam dressing to compress and reduce the hypergranulation (Correct answer)
- Irrigate more aggressively
- Apply hydrogel to keep it moist
- Increase dressing change frequency
Correct answer: Apply foam dressing to compress and reduce the hypergranulation
Hypergranulation is managed by applying gentle pressure with foam or silicone dressings, or topical corticosteroids, to allow epithelialization to occur over the wound surface.
Question 4: When documenting a wound using the PUSH tool (Pressure Ulcer Scale for Healing), which THREE parameters are assessed?
- Color, odor, and depth
- Surface area, exudate amount, and tissue type (Correct answer)
- Pain level, wound temperature, and edge appearance
- Undermining, tunneling, and wound age
Correct answer: Surface area, exudate amount, and tissue type
The PUSH tool scores wound surface area (length × width), exudate amount (none/light/moderate/heavy), and tissue type (closed to necrotic) to track healing progression.
Question 5: A patient has a wound with a low-adherent dressing in place. The PRIMARY advantage of low-adherent dressings is:
- Maximum absorption of exudate
- Prevention of wound desiccation and trauma-free removal (Correct answer)
- Antimicrobial properties
- Ability to stay in place for 7+ days
Correct answer: Prevention of wound desiccation and trauma-free removal
Low-adherent dressings minimize trauma to new tissue on removal while reducing pain, making them suitable for wounds where trauma-free dressing changes are a priority.
Question 6: A patient who smokes has chronic non-healing wounds. The MAIN mechanism by which smoking impairs wound healing is:
- Smoking increases wound exudate
- Nicotine causes vasoconstriction reducing oxygen delivery to wound tissue (Correct answer)
- Smoking increases risk of wound infection only
- Carbon monoxide stimulates excessive granulation tissue
Correct answer: Nicotine causes vasoconstriction reducing oxygen delivery to wound tissue
Nicotine causes vasoconstriction and reduces tissue oxygenation while carbon monoxide competes with oxygen on hemoglobin, significantly impairing all phases of wound healing.
Question 7: During an OSCE station on wound care, a patient has a sutured wound on day 3 with mild redness confined to the wound edges. The MOST appropriate action is:
- Start systemic antibiotics immediately
- Document the finding, reassess in 24-48 hours, and monitor for spreading erythema (Correct answer)
- Remove the sutures immediately
- Apply topical antiseptic and redress
Correct answer: Document the finding, reassess in 24-48 hours, and monitor for spreading erythema
Mild periwound erythema on day 3 may be normal inflammation; monitor for spreading cellulitis, increased warmth, purulent discharge, or systemic signs before initiating antibiotics.
OSCE Wound Care and Dressings 5
A patient with a burn injury has a wound that is painful, moist, red, and blistering with blanching on pressure.
This is classified as: