Wound Care Certification Exam Wound Care Certification Atypical Wound Etiologies 3

Question 1

A patient with systemic lupus erythematosus (SLE) develops painful digital ulcers and skin necrosis. Antiphospholipid antibodies are detected. Which mechanism best explains this wound presentation?

Accepted Answer

Hypercoagulability causing thrombotic occlusion of microvasculature

Answer

Antiphospholipid syndrome promotes a hypercoagulable state leading to thrombosis of small and medium vessels, resulting in ischemic ulcers and digital necrosis.

Question 2

Epidermolysis bullosa (EB) wounds are best managed with which primary dressing consideration?

Accepted Answer

Non-adherent, silicone-based dressings to minimize trauma at removal

Answer

EB skin is extremely fragile; non-adherent silicone dressings prevent the trauma of dressing removal, which can shear new epithelium and create additional wounds.

Question 3

A patient with chronic hepatitis C presents with palpable purpura, arthralgias, and lower extremity ulcers. Serum immunofixation shows a type II cryoglobulin. The underlying wound etiology is:

Accepted Answer

Cryoglobulinemic vasculitis

Answer

Hepatitis C-associated cryoglobulinemia causes immune complex deposition in vessel walls, triggering small vessel vasculitis that produces purpura and ulceration.

Question 4

Necrobiosis lipoidica diabeticorum (NLD) most commonly presents in which anatomical location?

Accepted Answer

Pretibial area of the lower leg

Answer

NLD classically appears on the pretibial surface as waxy, yellow-brown plaques with a violaceous border that may ulcerate in the center.

Question 5

A clinician suspects a factitious wound (dermatitis artefacta) in a patient with a geometric wound pattern that does not fit any known vascular distribution. The most important next step in management is:

Accepted Answer

Psychiatric evaluation and a non-confrontational therapeutic approach

Answer

Factitious wounds are self-inflicted; addressing the underlying psychiatric condition and building patient trust is essential before any wound intervention.

Wound Care Certification Exam Practice Test

Wound Care Certification Exam Practice Test

Wound Care Certification Exam Wound Care Certification Atypical Wound Etiologies 3