Certified Wound Care Nurse (CWCN) Exam Review
The Certified Wound Care Nurse certification indicates specialization in the area of managing and treating patients with various types of wounds. This includes the treatment of wounds that may occur due to chronic disease processes.
In order to be eligible to take the Certified Wound Care Nurse exam, the applicant must be a licensed Registered Nurse who has a Baccalaureate Degree. At least 1,500 hours of employment engaged in caring for patients with wounds must have been completed within the past 5 years, with 375 of those hours obtained during the past year. In addition, at least 50 continuing education hours in wound care should be completed in the past 5 years.
The Certified Wound Care Nurse exam is offered quarterly at various testing centers across the United States. The fee to take the exam is $300 with discounts applied if more than one WOCNCB certification exam is taken at a time.
The exam questions focus on testing the RN's knowledge of care of the patient with skin wounds. These can address the physiological processes involved with chronic wounds, along with the psychosocial and behavioral needs of the patient. The exam also contains questions pertaining to the specific pathophysiologic processes involved with wound formation and repair, along with specific treatment modalities used to treat wounds.
Certification as a Certified Wound Care Nurse is valid for 5 years. At that time, the RN can retake the exam to recertify, or requirements for the Professional Growth Program are met to qualify for recertification. This program utilizes a mixture of direct patient care and continuing education activities to meet specific requirements necessary to maintain certification.
Certified Wound Care Nurse (CWCN) Practice Questions
1. Which of the following extends from a wound under normal tissue and connects two structures, such as the wound and an organ?
2. A patient has a wound on the right hip with tunneling and fistulae. Which of the following is MOST indicative of an abscess formation?
- Increased purulent discharge
- Increased wound pain
- Increased erythema and swelling at wound perimeter
- Erythematous, painful, swollen area 3 cm from wound perimeter
3. Which of the following laboratory tests is the most effective to monitor acute changes in nutritional status?
- Total protein
4. On the eighth day of wound care, granulation tissue is evident about the wound perimeter, and the wound is beginning to contract. The wound is in which of the following phases of healing?
5. Which of the following is the correct procedure for applying Eutectic Mixture of Local Anesthetics (EMLA Cream) to a wound prior to debridement?
- Apply a thin layer (1/8 inch thick) to the wound for 15 minutes, leaving the wound open
- Apply a thick layer (1/4 inch thick) to the wound, extending 1/2 inch past the wound onto surrounding tissue, and cover with plastic wrap for 20 to 60 minutes
- Apply a thick layer (1/4 inch thick) to the wound surface only and cover with plastic wrap for 15 minutes
- Apply a thin layer (1/8 inch thick) to the wound surface only and cover with a loose dry dressing for 20 to 60 minutes
Certified Wound Care Nurse (CWCN) Answer Key
1. Answer: B
A fistula extends under normal tissue away from the wound and connects two structures, such as the wound and an organ or the wound and the skin. Undermining occurs when damaged tissue lies underneath intact skin about the wound perimeter. Tunneling is damaged tissue extending from the wound under normal tissue, but not opening to the skin or other structures. An abscess is a collection of purulent material in a localized area, often occurring with a fistula.
2. Answer: D
Abscesses often form in conjunction with fistulae. Typical indications include erythema, pain, and swelling above the localized area of the abscess. If the abscess is deep within the tissue or within an internal organ, however, obvious signs of abscess formation may not be evident, and symptoms may be less specific, including general malaise, abdominal pain, chills, fever, lethargy, diarrhea, and anorexia. Additional symptoms may be specific to the site of the abscess, for example a perirenal abscess may cause flank pain.
3. Answer: C
Prealbumin is most commonly monitored for acute changes in nutritional status because it has a half-life of only 2 to 3 days. Prealbumin decreases quickly when nutrition is inadequate and rises quickly in response to increased protein intake. Protein intake must be adequate to maintain normal levels of prealbumin. positive reinforcement, may be combined with CIMT.
1. Normal value: 16 to 40 mg/dL.
2. Mild deficiency: 10 to 15mg/dL
3. Moderate deficiency: 5 to 9 mg/dL.
4. Severe deficiency: < 5 mg/dL.
Total protein levels and transferrin levels may be influenced by many factors, so they are not reliable measures of nutritional status. Albumin has a half-life of 18 to 20 days, so it is more sensitive to long-term protein deficiencies than to short-term deficiencies.
4. Answer: A
Proliferation (days 5 to 20) is characterized by granulation tissue starting to form at wound perimeter, contracting the wound, and epithelialization, resulting in scar formation. Hemostasis (within minutes) occurs as platelets seal off the vessels and the clotting mechanism begins. Inflammation (days 1 to days 4 to 6) is characterized by erythema and edema as phagocytosis removes debris. During maturation or remodeling (days 21 plus), scar tissue continues to form until the scar has about 80% of original tissue strength, and the wound closes; the underlying tissue continues to remodel for up to 18 months.
5. Answer: B
Eutectic Mixture of Local Anesthetics (EMLA Cream) is applied thickly (1/4 inch) to both the surface of the wound and surrounding tissue, extending about 1/2 inch past the wound. After application, the wound must be covered with plastic wrap for 20 to 60 minutes to numb the tissue. EMLA cream is effective for about an hour after the wrapping is removed. EMLA can interact with a number of different medications, such as antiarrhythmics, anticonvulsants, and acetaminophen, so medications should be carefully reviewed prior to administration.
Last Updated: 04/18/2018