Download FINAL NAWCO WCC Exam PREP QUESTIONS AND ANSWERS. and more Exams Medicine in PDF only on Docsity!
FINAL NAWCO WCC Exam PREP
QUESTIONS AND ANSWERS.
fibroblast - \The cell responsible for building new granulation tissue keratinocytes - \Cells involved in epithelialization macrophages and polymorphonuclear neutrophils - \Cells which can kill bacteria lightly fill the wound base with gauze to prevent premature epithelialization - \To assist with managing a wound that is hypogranular: high levels of MMPs and low levels of TIMPs - \Chronic wounds contain insufficient collagen tensile strength - \Surgical wound dehiscence is most often due to: secondary wound closure - \A severely contaminated wound should be allowed to close by: Integrins - \cell surface receptors that allow cells to reversibly bind to the extracellular matrix to achieve cell migration 80% - \The maximum strength that a scar tissue can attain after the occurrence of remodeling is: six months to two years. - \The maturation and remodeling phase of wound healing typically lasts for: fibroblasts - \Cells that can be found in the dermis are: epidermis - \The stratum corneum can be found in the: epidermis, dermis, and subcutaneous tissue -
\A full-thickness wound involves the following tissue layers: partial-thickness - \A stage 2 pressure injury can also be described as a ________ lesion. False - \A callus is caused by a build-up of cells within the stratum basale. histamine - \Mast cells produce the following substance: Nonviable joint capsule - \When examining a patient's wound, you notice gray-black, dry, leathery-appearing, irregular fibrous tissue. What do you suspect this structure is? Muscle - \When examining a patient's wound, you notice regularly arranged red tissue. What do you suspect this structure is? adipose tissue and fascia - \The subcutaneous tissue consists of: faster - \Partial-thickness wounds heal ___ than full-thickness wounds warm - \Wounds should heal faster if both the patient and the patient's wound are kept ___. faster - \Surgical wounds heal ___ than traumatic wounds True - \Change in wound surface area can be used to predict wound healing. slowly - \Covering a wound with a dressing facilitates wound healing because a dry wound progresses through the phases of inflammation more ___ than a moist wound. barriers - \Serial debridement facilitates wound healing by removing ___ to healing False - \Wound debridement is vital to wound healing and should be completed despite a patient's pain complaint. granulation -
\A pressure injury should be classified using: visualized - \Contraindications for sharp debridement? Areas that cannot be adequately ___. debridement - \Surgical debridement is indicated for all of the following EXCEPT: when another form of ___ will suffice. necrotic - \Biologic debridement may assist with wound debridement because larvae produce enzymes that degrade ___ tissue without harming living tissue. True - \Traditional gauze dressings have a higher rate of wound infection than covering a wound with a moisture-retentive dressing and leaving it in place for three to five days. Contamination, colonization, infection - \Order the following in order of increasing wound bioburden. Candida - \Organisms that wound be killed by an antifungal agent? seven - \Slow-releasing silver agents maintain their antimicrobial properties for up to ___ days. Specialty Absorptives - \drawtex, ABD. moist healing, absorb exudate, autolytic debridement. can hold up to 60x their weight in fluid. non-adherent, can use with infected wounds. Not recommended for dry wounds, can be costly. Alginates - \Indicated for wounds with moderate to heavy exudate, such as pressure ulcers, infected wounds and venous insufficiency ulcers Antimicrobial - \Dressings that are wound covers that alter the wound bed bioburden. Indicated to help reduce the risk of infection in partial- and full-thickness wounds, over percutaneous line sites and surgical incisions or around tracheostomies. Available as sponges, impregnated woven gauzes, film dressings, absorptive products, island dressings, nylon fabric, non-adherent barriers or a combination of materials Antimicrobial dressings - \Aquacel, prisma, dermablue, opticell AG, urgotul Collagens -
\Wound dressings that are gels, pads, particles, pastes, powders, sheets or solutions derived from bovine, equine, porcine or avian sources. Some interact with wound exudate to form a gel. Indicated for partial- and full-thickness pressure ulcers, venous ulcers, donor sites, surgical wounds, vascular ulcers, diabetic ulcers, second-degree burns, abrasions and traumatic wounds Composites - \Dressings that combine physically distinct components into a single product to provide multiple functions such as a bacterial barrier, absorption and adhesion. Usually, they are composed of multiple layers and incorporate a semi- or non-adherent pad that covers the wound. May also include an adhesive border of non-woven fabric tape or transparent film. Contact Layers - \Dressings that are thin, non-adherent sheets placed on an open wound bed to protect tissue from direct contact with other agents or dressings applied to the wound. They conform to the shape of the wound and are porous to allow exudate to pass through for absorption by an overlying, secondary dressing. Indicated for partial- and full-thickness wounds, infected wounds, donor sites and split-thickness skin grafts Foam Dressings - \Dressings that are sheets and other shapes of foamed polymer solutions (most commonly polyurethane) with small, open cells capable of holding fluids. They may be impregnated or layered in combination with other materials. Indicated for partial- and full-thickness wounds. Some dressings are indicated for pressure injury prevention when used as part of a broader pressure injury prevention protocol. Gauzes & Non-Wovens - \dry woven or non-woven sponges and wraps with varying degrees of absorbency, based on design. Fabric composition may include cotton, polyester or rayon. Available sterile or non-sterile in bulk and with or without an adhesive border. They are used for cleansing, packing and covering a variety of wounds. Medical Grade Honey - \useful for acute and chronic wounds. The dressings help to prepare the wound bed and promote an optimal healing environment. Multiple mechanisms of action include reducing edema, lowering wound pH and debriding slough and eschar. Multiple versions of the dressing are available to handle differing levels of exudates. Indicated for partial- and full-thickness wounds including pressure ulcers, leg ulcers (arterial, venous and diabetic ulcers), burns, donor sites and surgical wounds. Hydrocolloids - \wafers, powders or pastes composed of gelatin, pectin or carboxymethylcellulose. Absorption capability depends on thickness and composition. Wafers are self-adhering and available with or without an adhesive border and in a wide variety of shapes and sizes. Useful on areas that require contouring, such as heels and sacral ulcers.
antimicrobial. Fillers function to maintain a moist environment and manage exudate. Indicated for partial- and full- thickness wounds, infected wounds, draining wounds and deep wounds that require packing. 312 - \Order the following dressings from least absorptive to most absorptive
- semipermeable foam
- alginate
- Semipermeable film occlusive - \An ___ dressing is impermeable to water, vapor, and bacteria. lower - \Moisture-retentive dressings are associated with a ___ rate of infection than gauze dressings water, bacteria - \Hydrocolloid dressings are impermeable to ___ and ___ protect - \Skin sealants ___ the periwound from maceration and adhesives pressurized - \Wound irrigation can be delivered with ___ saline canisters limb - \Whirlpools increase ___ volume granulation - \Pulsed lavage with suction promotes ___ tissue formation cell, collagen - \Electrical stimulation is believed to increase ___ proliferation and ___ synthesis scar - \Ultrasound may be used during the maturation and remodeling phase of wound healing in order to increase ___ mobility transcutaneous oxygen - \Systemic, or chamber, hyperbaric oxygen therapy should be chosen based on the results of a ___ ___ test. 75-200, 80-125 - \parameters for electrical stimulation as an adjunct to wound healing: Intensity of - Volts, frequency of - Hz.
\The irrigant solution used with pulsatile lavage should be warmed to -°F. eschar - \Whirlpool therapy can soften _. ROM - \Whirlpool therapy can assist with ___ exercises four - \Irrigation after whirlpool therapy removes ___ times as many bacteria as whirlpool alone. more - \A positive nitrogen balance is when when ___ nitrogen is ingested than is excreted. dehydration - \A 1% decrease in body weight due to fluid loss. collagen - \Protein deficiency leads to decreased ___ synthesis drainage - \A significant amount of protein can be lost through wound drainage Protein - _ is required for tissue regeneration and repair. Carbohydrates - \provide energy for tissue repair and regeneration Vitamin A - \Patients with open wounds who are taking corticosteroids long term may benefit from supplementation with which of the following vitamins Vitamin K - \Patients taking anticoagulants should NOT initiate supplementation with which of the following vitamins? Vitamin E - \This vitamin may decrease the inflammatory phase of wound healing and enhance immune function: 70-110 - \normal blood glucose level - mg/dL
venous HTN - \Venous insufficiency ulcers are ultimately caused by Irregular, glossy, mild to moderate - \Shape, wound bed, pain characteristics of venous ulcer dermatitis - \Patients with chronic venous insufficiency often have inflammation of the skin associated with itching and redness also known as True - \It is common for patients with chronic venous insufficiency to have allergic reactions or sensitization. Semipermeable foam - \Given the following dressing choices, which would be the most appropriate for a typical patient with a venous insufficiency ulcer? acute infection - \contraindication to the use of compression therapy for patients with venous insufficiency? walk regularly - \When using compression therapy for venous insufficiency ulcer management, the patient should be instructed to: Shear, impaired mobility, and excessive moisture - \risk factors for pressure injuries stage II - \A pressure injury that presents as a shallow crater or blister should be described as a ________ pressure injury. partial thickness - \A stage 3 pressure injury would be classified as impaired integumentary integrity associated with - skin involvement ischium, posterior heel, lateral malleolus - \Pressure injuries are most commonly seen in these locations osteomyelitis - \When assessing your patient's sacral pressure injury, you are able to probe to bone but cannot visualize the bone. This patient is at risk for ___. hydrocolloid -
\Your patient presents with a stage 3 pressure injury over his right greater trochanter without evidence of infection. Which of the following dressings would be most appropriate? odor control - \Charcoal-containing wound dressings may be beneficial for patients with pressure injuries because charcoal dressings can assist in ___ reactive - \support surfaces should be used for patients who can attain a variety of positions without bearing weight on an existing pressure injury. Sharp - \Which of the following methods of debridement would be most appropriate for your patient with a full-thickness eschar-covered pressure injury with signs of infection? Stage III/IV - \Undermining and tunneling may be found in these types of pressure injuries: 2 - \Type ___ diabetes is the most common form of diabetes in the United States. amputation - \About half of patients with a diabetic foot ulcer who have an ___ will eventually have a contralateral amputation. Native Americans - \Hispanic/Latino Americans and ___ ___ are more likely to develop diabetes than non- Hispanic Whites. Callus rim, foot deformities, minimal - \typical characteristics of a neuropathic ulceration? edges, appearance of foot, drainage Autonomic neuropathy - \Your patient with diabetes presents with dry, cracked skin. What is the most likely cause of this? Charcot - \Your patient with diabetes presents with a rocker-bottom foot. This is most likely due to fractures and/or dislocations causing a ___ deformity. increase - \A localized ___ in plantar foot skin temperature is a hallmark of future ulceration or a current deep space infection. Wagner Grade I and II -
prophylactic antibiotics - \Patients with puncture wounds should be prescribed clenched - \Patients with ___ fist human bite wound injuries are at increased risk of infection because the victim's teeth can penetrate into the patient's joint or other deep tissues and are at increased risk of infection because the human mouth has more varied microflora than an animal's mouth. brown recluse spider bite - \Your patient reports the insidious onset of a reddish blister on his thumb that gradually developed into an open wound. The wound now presents with a central necrotic area surrounded by significant erythema. The most likely cause of this skin presentation is: 3-5 - \Spider bite wounds caused by a brown recluse spider generally heal without complications in - days Skin tears - \The Payne-Martin Classification System is used for: Category 1 - \PMCS Skin tears without tissue loss. Full thickness or flap partial thickness. Partial thickness. Epidermis and dermis are separated. Flap can be completely approximated or approximated to expose no more than 1mm of the dermis Category 2 - \PMCS Skin tears with partial tissue loss. 25% or less of the epidermal flap is lost/More than 25% of the epidermal flap is lost. Category 3 - \PMCS Epidermal flap is absent Crohn's, lupus, ulcerative colitis. - \Pyoderma gangrenosum is associated with the following conditions: Irrigation, skin sealant, semipermeable film. - \Your patient presents with a clean partial-thickness abrasion to her extensor forearm from a fall on carpeting. Which of the following interventions would be most appropriate? True - \While generally only superficial or partial-thickness, skin tears may bleed significantly in patients who are on blood thinners.
True - \Sutures are more likely to cause an inflammatory response than staples. lymphedema - \Your patient is going to have a lumpectomy and lymph node biopsy for breast cancer. After surgery, she will have a risk for developing: skin sealant, semipermeable foam, multilayer compression dressing. - \Your patient presents with stage 2 moderate left lower extremity lymphedema and a superficial partial-thickness wound. Given this preliminary information, which of the following dressings would be most appropriate? water, protein, and cellular components - \Lymph fluid consists of: affected - \Patients with lymphedema should not allow injections or blood pressure measurements in their ___ extremity. RUE - \Lymph from which of the following body regions empties into the right lymphatic duct? angiomotoricity - \Sympathetic stimulation can increase lymph ___. Lipedemia - \You are evaluating a patient with bilateral lower extremity swelling. The patient reports her swelling began around puberty. She has no history of surgery or radiation. She reports her legs are tender to touch. On examination, while the patient does appear to have swelling in both legs, the dorsa of both feet appear normal. The patient is most likely to have: Seroma - \You are working with a patient four days after a left mastectomy. You notice a localized accumulation of fluid in the patient's left axilla. You alert the surgeon and notify of a: xerosis - \condition of dryness Xerosis, pruritus - \What are two of the most common problems associated with aging skin? Primary lesions - \Vesicles, pustules, and bullae are considered ___ ___ asymmetrical -
randomized controlled clinical trial - \A study in which the participants are assigned by chance to separate groups that compare different treatments is called a Cohort studies - \take a group of people who have a specific condition or receive a particular treatment over time and compare them with another group that has not been affected by the condition or treatment being studied Quantitative research - \Research based on something that can be accurately and precisely measured. Meta-analysis - \thoroughly examine a number of valid studies on a topic and combine the results using accepted statistical methodology as if they were from one large study ischemic ulcer - \develops within hours of events such as hemorrhage, multisystem trauma, severe burns, heart failure, or sepsis zinc - \In wound healing zinc is needed for stratum basale - \deepest layer of epidermis Stratum lucidum - \a layer of the epidermis found only in the thick skin of the fingers, palms, and soles Stratum germinativum - \also known as the basal cell layer, the deepest live layer of the epidermis that produces new epidermal skin cells and is responsible for growth stratum spinosum - \a layer of the epidermis that provides strength and flexibility to the skin Basement membrane zone - \The epidermis is anchored to the dermis by the Elastin - \responsible for skin recoil Thermoregulation`` - \Which function of the skin involves sweating, vasoconstriction, and vasodilation? Protection -
\Which function of the skin is involved in preventing excessive fluid loss Platelets - \Which cells play a major role in hemostasis? Inflammatory - \In which phase of wound healing do the macrophages destroy bacteria and cleanse the wound site of cellular debris? Proliferative - \In which phase of wound healing are buds of granulation tissue generated? maturation - \the third phase of wound healing, in which scar tissue forms remodeling phase - \Also known as the Maturation Phase Can last up to 1 year post injury Strengthening of scar tissue occurs during this phase collagen - \Where tissue gets its tensile strength and structure from delayed primary intention - \surgical closure after irrigation or drainage secondary intention - \Wound healing where edges can't be easily approximated and wound fills with granulation tertiary intention - \The wound is purposely left open due to heavy infection or contamination initially cleaned, debrided and observed primary intention - \wounds that heal under conditions of minimal tissue loss necrosis, maceration, and infection - \Local factors that impede wound healing include systemic infection, chronic disease, and immunosuppression - \Systemic factors that impede wound healing include: critical colonization - \The theoretical turning point when the bacterial load in the wound reaches a level in which it interferes with healing is called:
\Which stratum is generally absent in the eyelids? Fibroblasts - \The cells that are most abundant in the initial post injury period of a wound are: fever - \systemic sign of infection? wound biopsy - \The gold standard for identifying wound infection is a: Biofilms - \communities of microorganisms that attach to the wound surface encasing themselves in a matrix or glycocalyx Artherosclerosis - \The most common cause of arterial ulcers is: Albumin - \Which laboratory test has a half-life of 18-20 days, making it sensitive to long-term protein deficiencies? 7 days - \Multilayer compression bandaging systems usually provide sustained graduated compression for at least: arterial insufficiency - \Arterial ulcers are caused by a decrease in blood supply, also known as Punched out - \Ischemic ulcers typically have a ___ ___ appearance BMI - \A nutritional assessment should include: contrast angiography - \The best test to evaluate lower extremity arterial occlusive disease when considering arterial reconstruction is which of the following? calcified - \Diabetic patients often have ___ arteries resulting in artificially higher ABI's and no palpable pulses Contamination - \Which term accurately describes the existence of the least harmful levels of bacteria within a wound?
\In the Meggit-Wagner classification system, which grade would be used for a diabetic foot ulcer with osteomyelitis? Low - ___ frequency debrides over time. matrix metalloproteinases (MMPs) - \A family of zinc-containing enzymes that act in the extracellular space to digest various extracellular proteins and proteoglycans Vitamin C - \The most important vitamin required for adequate collagen synthesis during tissue repair is: exceeds - \Lymphedema can occur when the volume of lymph ___ the transport capacity Painful - \Partial-thickness burns are usually ___ foam dressing - \A patient presents with a chronic erythematous traumatic wound on the anterior lower leg. Current care includes use of mupirocin (Bactroban) cream and a four-layer compression wrap. Hypergranulation tissue is present in the wound bed. Which of the following modifications should be made to the treatment program? amorphous hydrogel - -best for: dry wounds, arterial wounds; will add moisture to wound Silver nitrate - \Treats hyper granulation of wound edges ABI (Ankle-brachial index) - \MOST significant assessment parameter in a patient with a lower extremity ischemic ulcer? Surgically - \Eschar is found in full-thickness thermal injuries and must be removed ___ Perfusion - \MOST significant factor in healing an ischemic ulcer? Hydrocolloid -
