Wound Care Certification Exam Wound Care Certification Systemic Factors Affecting Healing 4

Question 1

A patient with venous insufficiency has a wound that is not healing despite local wound care. The underlying systemic mechanism causing delayed healing is BEST described as:

Accepted Answer

Chronic venous hypertension leading to fibrin cuff formation and tissue hypoxia

Answer

Arterial hypoperfusion causing tissue ischemia and necrosis

Answer

Lymphatic obstruction causing immune cell accumulation

Answer

Venous thrombosis blocking growth factor delivery to wound

Question 2

Radiation therapy to a wound area impairs healing primarily because it:

Accepted Answer

Causes obliterative endarteritis, reducing microvascular blood supply

Answer

Activates MMPs that degrade the extracellular matrix excessively

Answer

Directly denatures fibronectin, preventing cell adhesion

Answer

Elevates TGF-β to levels that trigger excessive inflammation

Question 3

Which vitamin plays a key role in keratinocyte differentiation and epithelialization, and its deficiency is associated with delayed wound healing?

Accepted Answer

Vitamin A

Answer

Vitamin K

Answer

Vitamin D

Answer

Vitamin E

Question 4

A patient with sickle cell disease has a chronic leg ulcer. The primary mechanism contributing to impaired healing in this condition is:

Accepted Answer

Sickling of red cells causes vaso-occlusion, leading to tissue ischemia

Answer

Elevated hemoglobin causes hyperviscosity, blocking capillary flow

Answer

Sickle cell anemia reduces platelet count below hemostatic levels

Answer

Abnormal hemoglobin releases excess iron that damages fibroblasts

Question 5

NSAIDs (non-steroidal anti-inflammatory drugs) taken chronically can impair early wound healing because they:

Accepted Answer

Block prostaglandin synthesis, impairing platelet aggregation and early inflammation

Answer

Directly inhibit fibroblast DNA replication

Answer

Cause systemic vitamin C depletion over time

Answer

Reduce hepatic albumin synthesis by inhibiting COX enzymes in hepatocytes

Question 6

Zinc deficiency specifically impairs wound healing by affecting which process?

Accepted Answer

Collagen cross-linking and DNA polymerase activity needed for cell division

Answer

Oxygen transport to wound tissue

Answer

Platelet activation at injury sites

Answer

Lymphocyte-mediated immune surveillance

Question 7

A morbidly obese patient undergoes bariatric surgery and develops a post-operative wound dehiscence. Beyond poor vascularity, which additional obesity-related factor contributes most to dehiscence?

Accepted Answer

Increased mechanical tension on the wound due to abdominal fat mass

Answer

Excess adipose hormones (adipokines) activate collagenase at wound margins

Answer

Hyperlipidemia coats suture material, preventing tissue adhesion

Answer

Elevated leptin levels suppress macrophage recruitment