Wound Care Certification Exam Wound Care Certification Systemic Factors Affecting Healing 5

Question 1

Which hemoglobin A1c (HbA1c) level is generally considered the threshold above which wound healing is significantly compromised in diabetic patients?

Accepted Answer

Above 8.0%

Answer

Above 6.5%

Answer

Above 7.0%

Answer

Above 9.0%

Question 2

A patient on dialysis for end-stage renal disease has a non-healing wound. Beyond uremic toxins, which electrolyte imbalance common in ESRD further impairs wound healing?

Accepted Answer

Hyperphosphatemia causing vascular calcification and reduced tissue perfusion

Answer

Hyponatremia reducing cellular osmotic pressure

Answer

Hyperkalemia directly inhibiting collagen synthesis

Answer

Hypocalcemia blocking platelet activation

Question 3

Which immune condition is associated with neutrophil dysfunction that results in recurrent wound infections and impaired healing despite a normal white blood cell count?

Accepted Answer

Poorly controlled type 2 diabetes mellitus

Answer

HIV/AIDS with CD4 count below 200

Answer

Chronic lymphocytic leukemia

Answer

Systemic lupus erythematosus

Question 4

A patient with protein-calorie malnutrition has a Stage 3 pressure injury. What is the MINIMUM daily protein intake generally recommended to support wound healing in malnourished patients?

Accepted Answer

1.25–1.5 g/kg/day

Answer

0.6–0.8 g/kg/day

Answer

1.0–1.2 g/kg/day

Answer

2.0–2.5 g/kg/day

Question 5

Which mechanism explains how smoking impairs wound healing at the microvascular level?

Accepted Answer

Carbon monoxide binds hemoglobin, reducing oxygen delivery; nicotine causes vasoconstriction

Answer

Nicotine raises blood pH, denaturing collagen enzymes

Answer

Tar particles physically block capillary lumen flow

Answer

Cigarette chemicals elevate serum fibrinogen to wound-toxic levels

Question 6

Depression and chronic psychological stress impair wound healing primarily through which neuroendocrine pathway?

Accepted Answer

Elevated cortisol from HPA axis activation suppresses immune function and collagen synthesis

Answer

Increased serotonin causes vasoconstriction at wound margins

Answer

Dopamine deficiency reduces pain signaling that triggers wound care behavior

Answer

Chronic stress depletes acetylcholine needed for local wound vasodilation

Question 7

A wound care specialist identifies lymphedema as a contributing factor in a patient's non-healing lower extremity wound. Lymphedema impairs healing primarily because:

Accepted Answer

Protein-rich edema fluid creates a hypoxic environment and serves as a bacterial culture medium

Answer

Lymphatic fluid has a high pH that inactivates wound healing enzymes

Answer

Lymphatic obstruction prevents platelet delivery to the wound site

Answer

Excess lymph fluid dilutes growth factors below therapeutic concentrations