Wound Care Certification Systemic Factors Affecting Healing Questions and Answers

Question 1

A patient with a chronic venous ulcer has been on long-term, high-dose corticosteroid therapy for an autoimmune condition. Which phase of wound healing is MOST significantly impaired by this medication?

Accepted Answer

Inflammatory phase

Answer

Corticosteroids are potent anti-inflammatory agents that suppress the initial inflammatory response crucial for healing. They inhibit the migration and function of key immune cells like neutrophils and macrophages, which are essential for clearing debris and signaling the start of the repair process.

Question 2

An 82-year-old resident of a long-term care facility has a non-healing pressure injury. A nutritional assessment reveals a low pre-albumin level and inadequate protein consumption. A deficiency in protein will primarily disrupt which aspect of wound healing?

Accepted Answer

Angiogenesis and collagen synthesis

Answer

Protein and its constituent amino acids are the fundamental building blocks for new tissue. They are essential for fibroblast proliferation, the synthesis of collagen (the primary structural protein in the wound matrix), and angiogenesis (the formation of new blood vessels).

Question 3

A 65-year-old patient with uncontrolled type 2 diabetes mellitus (HbA1c of 10.5%) presents with a full-thickness wound on their lower leg. All of the following are mechanisms by which hyperglycemia directly impairs wound healing EXCEPT:

Accepted Answer

Enhanced fibroblast proliferation

Answer

Hyperglycemia impairs, rather than enhances, fibroblast function. High glucose levels reduce fibroblast proliferation and their ability to synthesize collagen, leading to a weaker and poorly formed wound matrix. The other options are all known negative effects of hyperglycemia on healing.

Question 4

Which of the following is the primary mechanism by which smoking systemically impairs wound healing?

Accepted Answer

Reducing oxygen-carrying capacity and causing vasoconstriction

Answer

Nicotine is a potent vasoconstrictor, which reduces blood flow and perfusion to the wound. Additionally, carbon monoxide from smoke binds to hemoglobin with a much higher affinity than oxygen, reducing the blood's oxygen-carrying capacity and leading to tissue hypoxia, which is detrimental to all phases of healing.

Question 5

A clinician is developing a plan of care for a non-healing wound on an elderly patient. Which age-related physiological change is a key systemic factor that contributes to delayed wound repair?

Accepted Answer

Reduced collagen synthesis and fibroblast activity

Answer

With advanced age, there is a natural decline in the number and activity of fibroblasts. This leads to decreased and disorganized collagen synthesis, resulting in a slower rate of healing and reduced tensile strength of the repaired tissue. The inflammatory response is often delayed and prolonged in older adults.

Wound Care Certification Exam Practice Test

Wound Care Certification Exam Practice Test

Wound Care Certification Systemic Factors Affecting Healing Questions and Answers