Wound Care Certification Exam Wound Care Certification Systemic Factors Affecting Healing 2

Question 1

Which mechanism explains why patients with chronic kidney disease (CKD) experience impaired wound healing?

Accepted Answer

Uremic toxins inhibit fibroblast proliferation and collagen synthesis

Answer

Elevated erythropoietin levels stimulate excess collagen

Answer

Hyperkalemia directly damages keratinocytes

Answer

Decreased renin production reduces tissue perfusion

Question 2

A patient on long-term systemic corticosteroids presents with a non-healing surgical wound. Which cellular process is most directly impaired by corticosteroids?

Accepted Answer

Neutrophil and macrophage inflammatory response

Answer

Platelet aggregation at the wound site

Answer

Endothelial cell apoptosis

Answer

Erythrocyte oxygen transport

Question 3

Which nutritional deficiency most directly impairs hydroxylation of proline and lysine, weakening collagen cross-linking?

Accepted Answer

Vitamin C deficiency

Answer

Vitamin A deficiency

Answer

Zinc deficiency

Answer

Iron deficiency

Question 4

A patient with poorly controlled hypothyroidism has a wound that is healing slowly. What is the primary reason thyroid hormone deficiency impairs healing?

Accepted Answer

Reduced basal metabolic rate decreases cellular energy for repair

Answer

Hypothyroidism raises cortisol, suppressing inflammation

Answer

Thyroid hormone directly cleaves fibrin clots

Answer

Low T3 causes hyperglycemia, damaging capillaries

Question 5

Peripheral arterial disease (PAD) impairs wound healing primarily by:

Accepted Answer

Reducing oxygen and nutrient delivery due to arterial insufficiency

Answer

Increasing venous hypertension and edema at the wound site

Answer

Causing lymphatic obstruction and protein accumulation

Answer

Elevating inflammatory cytokines that degrade collagen

Question 6

Which laboratory value is the BEST indicator of a patient's long-term nutritional status and protein availability for wound healing?

Accepted Answer

Prealbumin (transthyretin)

Answer

Serum albumin

Answer

C-reactive protein

Answer

Hemoglobin A1c

Question 7

Obesity impairs wound healing through which DIRECT mechanism?

Accepted Answer

Adipose tissue is poorly vascularized, reducing oxygen tension at wound edges

Answer

Increased serum lipids coat collagen fibers, preventing cross-linking

Answer

Obesity elevates platelet count, causing excessive clot formation

Answer

High BMI triggers autoimmune destruction of fibroblasts