Free Certified Wound Specialist Practice Test
The certification process for medical health professionals seeking certification from the American Academy of Wound Management is extended to health-care professions with college degrees at the Bachelor of Science, Master's degree, or Doctoral levels. There is an additional three-year experience requirement in clinical wound care for those seeking the AAWM certification. The test takes four hours and consists of 200 multiple-choice questions. All testing centers are located in the United States. Scores for the AAWM certification test are sent by postal mail four to six weeks after the test completion date.
There are seven chief content areas on the certification examination:
- The Anatomy portion of Section 1 accounts for 7% of the test's 200 questions. A familiarity with skin and blood composition is required, along with knowledge of cell tissue, composition, and blood count metrics.
- Diagnosis counts for 20% of the total, and requires knowledge of the diversity of diagnostic techniques. In order to be successful in this area, the test taker must be familiar with techniques for obtaining skin and tissue cultures and for accurately interpreting laboratory results.
- Only 4% of the test is devoted to psychosocial disorders related to wounds; this section deals with many of the common problems experienced by patients after injury or surgical repair of tissues and skin. Pain thresholds, psychological responses (as for instance depression), and quality of life issues are a chief concern in this section.
- There are general areas of concern, which account for 13% of the exam. This general knowledge area requires a base of knowledge in the areas of clinical research, methods and documentation, nutrition, burns, the patient environment, and regulations and laws.
- Physiology comprises 17% of the exam and deals with phases of healing, and the biological and chemical changes occurring in wound areas. This section focuses upon scarring and a variety of other skin changes that impact the medical outcome.
- How the wound fits in with the progression of concurrent illness accounts for 17% of the certification exam. This section covers radiation; chemical and electrical damage; animal and insect bites; and the reaction of the body to foreign substances.
- The final section of the exam falls into the general category of Therapeutics. This focuses on bandaging or other dressings, debridement, physical therapy, hydrotherapy, skin grafting, and a variety of other treatment strategies.
1. When doing a routine dressing change for a healing decubitus ulcer on the right hip, which is the most appropriate cleaning solution?
a. Povidone-iodine solution
b. Hydrogen peroxide
d. Normal saline
2. Which of the following is likely to have the MOST negative effect on wound healing for a 65-year-old woman?
b. BMI of 20.2
c. BMI of 28
d. Vegan diet
3. When calculating the ankle-brachial index (ABI), if the ankle systolic pressure is 90 and the brachial systolic pressure is 120, what is the ABI?
4. Which of the following is a contraindication to negative pressure wound therapy?
a. Chronic Stage IV pressure ulcer
b. Wound malignancy
c. Unresponsive arterial ulcer
d. Dehiscent surgical wound
5. What hyperbaric oxygen therapy (HBOT) treatment regimen is usually recommended for chronic wounds and lower extremity diabetic ulcers?
a. Compression at 2 ATA 3 times 60 minutes daily for 48 hours
b. Compression at 2 to 2.4 ATA for 90 minutes daily for at least 30 treatments
c. Compression at 3 ATA for 2 to 4 hour periods 3 to 4 times daily
d. Compression at 2 to 2.5 ATA for 60 to 90 minutes 2 times daily for 2 to 3 days and then decreasing frequency over 4 to 6 days
Answers and Explanations
1. D: Normal saline is the most appropriate wound-cleansing solution. Antiseptic solutions should be avoided, as they may damage granulation tissue and retard healing, because they interfere with fibroblast cells necessary for healing of the wound, cause increased pain, and do not significantly reduce overall bacterial load. In heavily-contaminated or necrotic wounds, topical antiseptic solutions, such as dilute povidone-iodine or hydrogen peroxide, may be used for a short period of time to reduce surface bacteria and foul odor.
2. A: Hypoalbuminemia is likely to have the most negative effect on wound healing. Hypoalbuminemia is an indication of protein malnutrition (kwashiorkor) and may cause delayed wound healing because of inadequate nutrition. A BMI of 20.2 is within normal range (18.5 to 24.9) and indicates normal weight. A person with a BMI of 29 is overweight, but not obese. Both being underweight (BMI >18.5) and obese (BMI ?30) can interfere with the body's ability to heal. BMI alone is not adequate to assess nutritional status or healing ability and vegan diets can provide adequate nutrition.
3. D: The ankle-brachial index (ABI) examination evaluates peripheral arterial disease of the lower extremities. The ankle and brachial systolic pressures are obtained, and then the ankle systolic pressure is divided by the brachial systolic pressure to obtain the ABI. If the ankle systolic pressure is 90 and the brachial systolic pressure is 120: 90 divided by 120 = 0.75. Normal value is 1 to 1.1 with lower values indicating decreasing perfusion. A value of 0.75 indicates severe disease and ischemia.
4. B: Contraindications to negative pressure wound therapy include wound malignancy, untreated osteomyelitis, exposed blood vessels or organs, and nonenteric, unexplored fistulas. Negative pressure therapy uses subatmospheric (negative) pressure with a suction unit and a semi occlusion vapor-permeable dressing. The suction reduces periwound and interstitial edema, decompressing vessels, improving circulation, stimulating production of new cells, increasing the rate of granulation and reepithelialization and decreasing colonization of bacteria NPWT is used for a variety of difficult-to-heal wounds, especially those that show less than 30% healing in 4 weeks of postdebridement treatment or those with excessive exudate.
5. B: The usual hyperbaric oxygen therapy (HBOT) for chronic wounds and lower extremity diabetic ulcers is compression at 2 to 2.4 ATA for 90 minutes daily, with at least 30 treatments. Oxygen toxicity may occur with treatment over 90 minutes. Hyperbaric oxygen therapy (HBOT) is treatment in a high-pressure chamber while breathing 100% oxygen, which increases available oxygen to tissues by 10 to 20 times, improving perfusion. HBOT results in
- Hyperoxygenation of blood and tissue
- Vasoconstriction, reducing capillary leakage
- Angiogenesis, because of increased fibroblasts and collagen
- Increased effectiveness of antibiotics needing active transport across cell walls (fluoroquinolone, amphotericin B, aminoglycosides)
CWS Exam Review Pressure Ulcers
Last Updated: 03/01/2017