Skin and Wound Care

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. The skin consists of _____ major layers.

a) 2
b) 3
c) 4
d) 5

2. This sublayer is a critical layer that acts as a waterproof barrier and protects against harsh chemical, dirt and pollutants:

a) corneum
b) lucidum
c) grandulosum
d) spinosum
e) germinativum

3. The thickness of the dermis and subcutaneous tissue varies from person to person but remains uniform on different parts of the body.

a) True
b) False

4. For a bed-confined patient with mobility deficit, to minimize the adverse effects of pressure, friction, or shear, you should maintain the head of the bed at the ___________degree of elevation.

a) lowest
b) highest

5. In the wound healing process, the epithelialization step signifies:

a) erythema, heat and pain
b) migration of macrophages that destroy bacteria and clean the wound site
c) generation of red, beefy, shiny granulation tissue
d) migration of cells from the wound margins to the sealing of the wound from the external environment
e) reorganization, remodeling, and maturation of the collagen fibers

6. Wounds heal faster and less painfully in a moist environment than a dry one.

a) True
b) False

7. Surgical wounds heal by __________ intention.

a) primary
b) secondary
c) tertiary

8. Among the most common wound healing complications is dehiscence. Which of the following answers describes dehiscence:

a) purulent drainage and inflamed wound edges
b) internal or external bleeding
c) separation of skin and tissue layers
d) protrusion of visceral organs through a wound opening
e) abnormal passage between two organs

9. Which of the following is not a risk assessment tool for pressure ulcers?

a) Norton
b) Braden
c) Gosnell

10. The Norton Scale in assessing the risk of pressure ulcer formation uses all of the following parameters except:

a) physical condition
b) mental condition
c) activity
d) mobility
e) moisture

11. Wound classification by thickness would yield which of the following?

a) depth of the wound
b) condition of intact skin
c) layers of tissue exposed
d) color of the exposed wound bed

12. In the three-color wound classification system, which color indicates that the wound has begun to heal?

a) red
b) yellow
c) black

13. Identify the stage of the pressure ulcer based on this description: full thickness skin loss involving damage or necrosis of subcutaneous tissue, which does not go through underlying fascia.

a) Stage 1
b) Stage 2
c) Stage 3
d) Stage 4

14. While assessing an ulcer, you observe erythema. Which of the following is a serious sign that tissue destruction is imminent or has occurred?

a) blanching erythema
b) nonblanching erythema

15. In Stage 1 pressure ulcer, there is no skin loss.

a) True
b) False

16. Partial and full-thickness wounds are primarily caused by pressure or pressure in combination with shear and friction.

a) True
b) False

17. The immediate intervention goal in Stage 3 or 4 pressure ulcers is:

a) provide comfort
b) reduce pressure
c) eliminate drainage

18. You notice the following wound characteristics: irregular wound margins, superficial wound, ruddy, granular tissue, may or may not have pain, frequently moderate to heavy exudate. How would you classify this ulcer?

a) arterial
b) diabetic
c) venous
d) cannot be classified

19. Compression therapy should not be used for arterial ulcers.

a) True
b) False

20. Which of the following scales classifies foot ulcers:

a) Norton
b) Braden
c) Wagner
d) none of the above

21. Wound healing occurs in four processes which are:

a) assessing, planning, implementation, and evaluation
b) inflammation, rejuvenation, growth and closure
c) homeostasis, inflammation, proliferation and maturation
d) oxygenation, rejuvenation, maturation and closure

22. Albumin is a building block for cells and tissues and is classified as a(n):

a) protein
b) complex carbohydrate
c) fat
d) amino acid

23. Prealbumin is a better indicator of acute nutritional status changes than albumin.

a) True
b) False

24. This laboratory test result is an indicator of long term glucose control:

a) fasting blood sugar
b) glycogenesis
c) complete blood count
d) hemoglobin A1C

25. Glucose is formed from dietary carbohydrates and is:

a) quickly utilized with activity
b) stored in the liver and muscles as glycogen
c) needed for growth and energy
d) an amino acid which builds and repairs tissue

26. The cell primarily for clotting is the:

a) red blood cell
b) white blood cell
c) platelet
d) hemoglobin cell

27. Lymphocytes are part of which system:

a) integumentary
b) cardiovascular
c) nervous
d) immune

28. This laboratory test is an indicator of renal function and fluid status:

a) blood, urea, nitrogen
b) metabolic panel
c) SGOT, SGPT
d) enzymes

29. The lower the __________ level, the less oxygen is carried to tissues and the less capacity wounds have to heal properly.

a) glucose
b) hematacrit
c) hemoglobin
d) platelet

30. An example of lipoproteins are:

a) fats and sugars
b) cholesterol and triglycerides
c) steroids and amino acids
d) erythrocytes and leukocytes

31. At temperatures below 98.6 F. __________ no longer stay suspended in the blood, but precipitate out and block small blood vessels in the hands and face.

a) phospholipids
b) antibodies
c) cryoglobins
d) thrombocytes

32. The gold standard for diagnosing arterial vascular disease is:

a) angiography
b) transcutaneous oxygen measurement
c) magnetic resonance angiography
d) doppler studies

33. Which of the following would you not use when obtaining a wound culture with a swab?

a) sterile calcium alginate
b) rayon swab
c) cotton-tipped swab

34. Which of the following is not an advantage of alginates?

a) absorbs up to 20 times its weight
b) maintains a moist wound environment
c) is easy to apply and remove
d) recommended for wounds with light exudates or dry eschar

35. Collagen is usually recommended for third degree burns.

a) True
b) False

36. Composite dressings contain two or more physically distinct products in a single dressing and are used for multiple functions.

a) True
b) False

37. Because of their high water content, hydrogels cannot absorb large amounts of exudates.

a) True
b) False

38. When cleansing a wound, which solution should you use?

a) acetic acid
b) hydrogen peroxide
c) sodium hypochlorite
d) povidone iodine
e) normal saline solution

39. Shear separates the skin from underlying tissues and friction abrades the top layer of skin.

a) True
b) False

40. Patients who are sitting in a chair and are able should be taught to shift their weight every:

a) 10 minutes
b) 15 minutes
c) 30 minutes
d) 60 minutes

41. Foam overlays are the most commonly used devices to reduce pressure. The thickness of the foam should be at least:

a) 2 inches
b) 3 inches
c) 4 inches
d) b and c

42. A static air mattress is filled with air using a hand-held pump. When monitoring for inflation the practitioner would check inflation by:

a) using the air gauge
b) measuring the foam for a depth of three to five inches
c) calling the company for a periodic evaluation
d) sliding a hand, palm side up, under the overlay, below a bony prominence

43. Air fluidized therapy products were originally developed for _________ patients.

a) stroke
b) comatose
c) burn
d) multiple trauma

44. According to Centers for Medicare and Medicaid Services, wheelchair modification devices must provide:
  1. postural alignment
  2. pressure redistribution
  3. sitting balance and stability
  4. weight distribution

a) 1 and 2
b) all but 1
c) 3 and 4
d) all the above

45. In order for proper documentation and payment to occur, the facility must practice by:

a) a process
b) guidelines
c) records
d) standards

46. Medicare is a federal health insurance program that provides medical coverage for:
  1. people 65 and older
  2. certain disabled individuals
  3. some individuals with end-stage renal disease
  4. low-income individuals

a) 1 only
b) 1 and 4
c) 2 only
d) 1, 2, and 3

47. When assessing patients’ tissue tolerance to pressure, systemic skin inspections for susceptible individuals should be done:

a) every eight hours
b) daily
c) once a week
d) every four hours

48. One of the disadvantages of composite dressings is that they require a border of intact skin for anchoring the dressing.

a) True
b) False

49. Contact layers are ideal for Stage 1 pressure ulcers.

a) True
b) False

50. Which of the following is not an advantage of foam dressings?

a) are nonadherent
b) are effective for wounds with dry eschar
c) are easy to apply and remove
d) absorb light to heavy amounts of exudates
e) may be used under compression

51. Hydrocolloids are recommended for wounds with heavy exudates.

a) True
b) False

52. Transparent films may be used as a primary or secondary dressing to prevent and manage all pressure ulcers.

a) True
b) False

53. Which of the following is not an advantage of transparent films?

a) retain moisture
b) are impermeable to bacteria and other contaminates
c) do not require secondary dressings
d) absorb drainage
e) allow wound observation

54. Which of the following is not an advantage of wound fillers?

a) do not require a secondary dressing
b) are easy to apply and remove
c) fill dead space
d) promote autolytic debridement