Wound Care Certification Exam Wound Care Certification Systemic Factors Affecting Healing 3

Question 1

A patient receiving chemotherapy develops a wound that fails to progress through the proliferative phase. Chemotherapy most likely impairs healing by:

Accepted Answer

Suppressing rapidly dividing cells including fibroblasts and keratinocytes

Answer

Increasing platelet-derived growth factor (PDGF) to toxic levels

Answer

Causing direct collagenase release from tumor cells

Answer

Elevating serum calcium, which inhibits angiogenesis

Question 2

Which hematologic condition most directly impairs the inflammatory phase of wound healing by reducing the supply of growth factors released during clot formation?

Accepted Answer

Thrombocytopenia

Answer

Polycythemia vera

Answer

Leukocytosis

Answer

Hypercoagulable state

Question 3

A wound care nurse notes that a patient with rheumatoid arthritis on methotrexate has impaired wound healing. Methotrexate contributes primarily by:

Accepted Answer

Inhibiting folate metabolism required for DNA synthesis and cell proliferation

Answer

Blocking TNF-α receptors on fibroblasts

Answer

Directly lysing collagen type I fibers

Answer

Stimulating excess MMP-9 activity

Question 4

In a patient with liver cirrhosis, which specific mechanism most impairs wound healing?

Accepted Answer

Impaired hepatic synthesis of clotting factors and albumin reduces healing capacity

Answer

Portal hypertension increases wound exudate volume

Answer

Elevated ammonia directly inactivates matrix metalloproteinases

Answer

Jaundice causes bilirubin to inhibit keratinocyte migration

Question 5

Which effect of uncontrolled diabetes MOST directly reduces the tensile strength of a healing wound?

Accepted Answer

Hyperglycemia glycates collagen, impairing its structural integrity

Answer

High glucose causes cellular dehydration, thinning wound edges

Answer

Diabetes increases sebaceous gland secretion, blocking collagen deposition

Answer

Elevated insulin resistance activates keratinocyte apoptosis

Question 6

An elderly patient's wound heals significantly slower than a younger adult with the same injury. Which age-related change is the PRIMARY contributor?

Accepted Answer

Decreased macrophage function and reduced growth factor production slow repair

Answer

Increased skin sebum production traps bacteria at wound edges

Answer

Aging causes excess scar tissue formation, blocking epithelialization

Answer

Elevated estrogen in elderly patients inhibits collagen synthesis

Question 7

Which nutritional marker best reflects a patient's IMMEDIATE (within 48–72 hours) response to nutritional intervention in wound care?

Accepted Answer

Prealbumin (transthyretin)

Answer

Serum albumin

Answer

Transferrin

Answer

Total lymphocyte count