Question 1

A 45-year-old male with remote history of a deep vein thrombosis to the right lower extremity presents with a 3-month history of a shallow, wet ulcer superior to the right medial malleolus. Wound is ruddy red with yellow fibrinous slough. Patient complains of dull aching pain, relieved with elevation. Physical exam is significant for woody leg edema bilaterally, darkened hyperpigmentation and dry scaly skin to the distal lower legs. Distal pulses are 2+ bilaterally. This wound is most likely a description of:

Accepted Answer

The description of the ulcer, its location, and the associated symptoms such as relief with elevation, woody edema, and hyperpigmentation are characteristic of a venous leg ulcer.

Question 2

When treating most open wounds it is important to choose a dressing that will maintain a moist wound environment.

Accepted Answer

Maintaining a moist wound environment is crucial for optimal healing as it promotes cell growth and reduces the risk of infection.

Question 3

You are treating a noninfected chronic ulcer with thick yellow adherent slough covering the wound bed. Which of these actions will best help with wound healing?

Accepted Answer

Debriding the nonviable tissue is essential for wound healing as it removes dead tissue that can impede the healing process and allows for the formation of healthy granulation tissue.

Question 4

What test can be done to assess the protective sensation of the foot to determine the risk of foot ulceration?

Accepted Answer

The Simms-Weinstein monofilament test is used to assess the protective sensation of the foot, which helps determine the risk of foot ulceration, especially in diabetic patients.

Question 5

A 55-year-old female patient with a 20-year history of diabetes noticed new bloody drainage on her sock that started 1 week ago. On exam you note a small, round, moist, pale red, full thickness wound to the plantar surface of the foot under the first metatarsal head. The wound is surrounded by a thick, hard, raised callus. Distal pulses are present. Patient denies pain to the site. This wound is most likely a description of a(n):

Accepted Answer

The description of the wound, including its location on the plantar surface, the presence of callus, and the lack of pain, is characteristic of a neuropathic ulcer, commonly seen in diabetic patients due to peripheral neuropathy.

Question 6

A 45-year-old male presents with a laceration to the left lower leg, which occurred when he fell from his bike a day ago. On physical exam you note a wound whose depth has gone into the subcutaneous tissue. This would be described as a:

Accepted Answer

A full thickness wound is one that extends through the dermis and into the subcutaneous tissue, which matches the description of the wound in this scenario.

Question 7

In aging patients wounds are acquired more easily, wound healing is delayed, and response to infection is decreased. This is due to decreased skin turgor, skin dehydration, and decreased inflammatory response.

Accepted Answer

As people age, their skin loses elasticity and moisture, and the immune response weakens, leading to easier wound acquisition, slower healing, and reduced infection response.

Question 8

In treating a venous leg ulcer, the standard of care is:

Accepted Answer

Compression therapy with a multilayer compression dressing is the standard of care for venous leg ulcers as it helps improve venous return and reduce edema, promoting healing.

Question 9

A 72-year-old male presents with a 1-month history of painful wounds to the distal aspect of the right first and second toes. Patient complains of constant, severe, aching pain that is more acute at night and interferes with sleep. Patient has a history of hypertension, coronary artery disease, and a long history of smoking. Physical exam is notable for two round, well-demarcated wounds covered with dry black eschar. Peripheral pulses are faint on the right extremity and 2+ on the left. The right foot is cool with rubor. This wound is most likely a description of a(n):

Accepted Answer

The patient's symptoms and history are consistent with an arterial ulcer, characterized by painful, well-demarcated wounds with dry black eschar, often due to poor blood supply from peripheral artery disease, especially in a patient with a history of smoking and cardiovascular issues.

Question 10

The definition of a chronic wound is most appropriately described as a wound that:

Accepted Answer

A chronic wound is characterized by its failure to progress through the normal stages of healing in a timely manner, often due to underlying conditions or complications.

Question 11

The mainstay of therapy in treatment of diabetic foot ulcer is:

Accepted Answer

Off-loading pressure to the wound is the mainstay of therapy in treatment of diabetic foot ulcer.

Question 12

Which of these tests is most appropriate prior to initiation of compression treatment in a patient with a venous leg ulcer?

Accepted Answer

The Ankle-Brachial Index (ABI) is used to assess arterial blood flow and rule out significant arterial disease before applying compression therapy for venous leg ulcers.

Quiz 71: Wound Care