Integ Exam #2 Flashcards
Which modality is contraindicated for clean, granulating wounds?
- A. Pulsed Lavage
- B. Whirlpool Therapy
- C. Wound Irrigation
- D. Electrical Stimulation
- Correct: B. Whirlpool Therapy Whirlpool is contraindicated for clean, granulating wounds as it can disrupt healing tissue.
- Incorrect: A. Pulsed Lavage Pulsed lavage can be used for irrigation and is not contraindicated.
- Incorrect: C. Wound Irrigation Irrigation is suitable for clean wounds.
- Incorrect: D. Electrical Stimulation Electrical stimulation is indicated for granulating wounds.
What is the primary effect of pulsed lavage with suction?
- A. Thermal insulation
- B. Reduction of bioburden
- C. Pain management
- D. Enhance oxygen perfusion
- Correct: B. Reduction of bioburden Pulsed lavage removes necrotic tissue and debris, reducing bioburden.
- Incorrect: A. Thermal insulation Pulsed lavage does not provide thermal effects.
- Incorrect: C. Pain management Pain relief is not a primary effect of pulsed lavage.
- Incorrect: D. Enhance oxygen perfusion Oxygenation is improved by other modalities like hyperbaric oxygen therapy.
Which modality facilitates wound contraction and reduces bioburden using subatmospheric pressure?
- A. Negative Pressure Wound Therapy
- B. Pulsed Lavage
- C. Hyperbaric Oxygen Therapy
- D. Electrical Stimulation
- Correct: A. Negative Pressure Wound Therapy NPWT applies subatmospheric pressure, promoting granulation tissue and reducing bioburden.
- Incorrect: B. Pulsed Lavage Pulsed lavage uses irrigation, not subatmospheric pressure.
- Incorrect: C. Hyperbaric Oxygen Therapy HBO involves oxygenation, not pressure reduction.
- Incorrect: D. Electrical Stimulation Electrical stimulation does not involve subatmospheric pressure.
Which modality uses monophasic high-voltage pulsed current to stimulate healing?
- A. Electrical Stimulation
- B. Diathermy
- C. Ultrasound
- D. Negative Pressure Wound Therapy
- Correct: A. Electrical Stimulation Electrical stimulation uses high-voltage pulsed current to enhance wound healing.
- Incorrect: B. Diathermy Diathermy uses electromagnetic energy, not electrical currents.
- Incorrect: C. Ultrasound Ultrasound uses sound waves, not electrical currents.
- Incorrect: D. Negative Pressure Wound Therapy NPWT involves suction, not electrical stimulation.
What is a contraindication for using whirlpool therapy?
- A. Thick eschar
- B. Infected wounds
- C. Clean, granulating wounds
- D. Pain management
- Correct: C. Clean, granulating wounds Whirlpool therapy can disrupt healing in clean, granulating wounds.
- Incorrect: A. Thick eschar Whirlpool therapy can help soften eschar.
- Incorrect: B. Infected wounds Whirlpool therapy can aid in managing infected wounds.
- Incorrect: D. Pain management Pain management is a benefit, not a contraindication, of whirlpool therapy.
What is the primary purpose of ultraviolet C (UVC) therapy?
- A. Promote oxygen perfusion
- B. Reduce bacterial bioburden
- C. Manage granulation tissue
- D. Enhance scar pliability
- Correct: B. Reduce bacterial bioburden UVC therapy is primarily bactericidal and helps reduce bioburden in wounds.
- Incorrect: A. Promote oxygen perfusion Oxygenation is not a primary effect of UVC therapy.
- Incorrect: C. Manage granulation tissue UVC is not focused on granulation tissue.
- Incorrect: D. Enhance scar pliability Scar pliability is not a goal of UVC therapy.
Which therapy uses sound waves to facilitate wound debridement and healing?
- A. Pulsed Lavage
- B. Electrical Stimulation
- C. Ultrasound
- D. Diathermy
- Correct: C. Ultrasound Ultrasound uses sound waves to facilitate debridement and healing.
- Incorrect: A. Pulsed Lavage Pulsed lavage uses pressurized irrigation, not sound waves.
- Incorrect: B. Electrical Stimulation Electrical stimulation involves electrical currents, not sound waves.
- Incorrect: D. Diathermy Diathermy uses electromagnetic energy.
Which therapy is contraindicated for wounds with untreated osteomyelitis?
- A. Negative Pressure Wound Therapy
- B. Electrical Stimulation
- C. Hyperbaric Oxygen Therapy
- D. Wound Irrigation
- Correct: A. Negative Pressure Wound Therapy NPWT is contraindicated for wounds with untreated osteomyelitis.
- Incorrect: B. Electrical Stimulation Electrical stimulation may be used with caution in osteomyelitis cases.
- Incorrect: C. Hyperbaric Oxygen Therapy HBO is often used to treat osteomyelitis.
- Incorrect: D. Wound Irrigation Wound irrigation is not contraindicated for osteomyelitis.
Which modality enhances healing by increasing oxygen concentration in the wound bed?
- A. Hyperbaric Oxygen Therapy
- B. Electrical Stimulation
- C. Pulsed Lavage
- D. Diathermy
- Correct: A. Hyperbaric Oxygen Therapy HBO increases oxygen levels in the wound bed to facilitate healing.
- Incorrect: B. Electrical Stimulation Electrical stimulation does not directly increase oxygen concentration.
- Incorrect: C. Pulsed Lavage Pulsed lavage is for irrigation and bioburden reduction.
- Incorrect: D. Diathermy Diathermy uses heat, not oxygen concentration.
Which therapy utilizes electromagnetic energy to heat tissue and promote wound healing?
- A. Diathermy
- B. Ultrasound
- C. Electrical Stimulation
- D. Negative Pressure Wound Therapy
- Correct: A. Diathermy Diathermy uses electromagnetic energy to improve circulation, fibroblast activity, and nitric oxide release.
- Incorrect: B. Ultrasound Ultrasound uses sound waves, not electromagnetic energy.
- Incorrect: C. Electrical Stimulation Electrical stimulation uses electrical currents, not heat.
- Incorrect: D. Negative Pressure Wound Therapy NPWT uses suction, not heat.
Which modality combines irrigation with suction to facilitate debridement and bioburden reduction?
- A. Pulsed Lavage
- B. Negative Pressure Wound Therapy
- C. Whirlpool Therapy
- D. Ultrasound
- Correct: A. Pulsed Lavage Pulsed lavage combines pressurized irrigation with suction to reduce bioburden and debride wounds.
- Incorrect: B. Negative Pressure Wound Therapy NPWT applies subatmospheric pressure but does not use irrigation.
- Incorrect: C. Whirlpool Therapy Whirlpool therapy softens necrotic tissue but does not use suction.
- Incorrect: D. Ultrasound Ultrasound uses sound waves, not irrigation and suction.
Which modality uses noncontact low-frequency to gently debride wounds?
- A. Ultrasound Mist
- B. High-Frequency Ultrasound
- C. Pulsed Lavage
- D. Electrical Stimulation
- Correct: A. Ultrasound Mist Noncontact low-frequency ultrasound (Mist) gently debrides wounds while reducing bioburden.
- Incorrect: B. High-Frequency Ultrasound High-frequency ultrasound is used for deeper tissue effects, not noncontact debridement.
- Incorrect: C. Pulsed Lavage Pulsed lavage involves irrigation, not ultrasound.
- Incorrect: D. Electrical Stimulation Electrical stimulation does not involve ultrasound.
Which therapy is most appropriate for a wound with thick eschar and heavy bioburden?
- A. Whirlpool Therapy
- B. Negative Pressure Wound Therapy
- C. Electrical Stimulation
- D. Wound Irrigation
- Correct: A. Whirlpool Therapy Whirlpool therapy softens eschar and reduces bioburden, making it effective for wounds with thick necrotic tissue.
- Incorrect: B. Negative Pressure Wound Therapy NPWT requires a clean wound bed and is not suitable for thick eschar.
- Incorrect: C. Electrical Stimulation Electrical stimulation does not soften eschar or reduce heavy bioburden.
- Incorrect: D. Wound Irrigation While useful, irrigation alone is less effective for thick eschar.
What is a contraindication for using hyperbaric oxygen therapy (HBO)?
- A. Claustrophobia
- B. Gas gangrene
- C. Peripheral ischemia
- D. Crush injuries
- Correct: A. Claustrophobia Patients with claustrophobia may struggle with the enclosed environment required for HBO therapy.
- Incorrect: B. Gas gangrene HBO is indicated for gas gangrene.
- Incorrect: C. Peripheral ischemia HBO is used to treat ischemic wounds.
- Incorrect: D. Crush injuries HBO is indicated for crush injuries.
Which modality stimulates mitochondria and growth factor production to enhance wound healing?
- A. Low-Intensity Laser Therapy
- B. Electrical Stimulation
- C. Pulsed Lavage
- D. Diathermy
- Correct: A. Low-Intensity Laser Therapy Low-intensity laser therapy stimulates cellular activity, including mitochondrial function and growth factor release.
- Incorrect: B. Electrical Stimulation Electrical stimulation attracts cells to the wound site but does not directly stimulate mitochondria.
- Incorrect: C. Pulsed Lavage Pulsed lavage does not affect cellular functions like mitochondria or growth factors.
- Incorrect: D. Diathermy Diathermy promotes circulation but does not target mitochondria or growth factors.
What is a primary advantage of cold atmospheric plasma (CAP) therapy?
- A. Promotes fibroblast proliferation
- B. Provides thermal effects
- C. Directly softens necrotic tissue
- D. Increases oxygen delivery
- Correct: A. Promotes fibroblast proliferation CAP therapy supports fibroblast and keratinocyte proliferation, promoting wound healing.
- Incorrect: B. Provides thermal effects CAP therapy is not thermal.
- Incorrect: C. Directly softens necrotic tissue CAP does not physically debride tissue.
- Incorrect: D. Increases oxygen delivery Oxygen delivery is not a primary effect of CAP.
Which therapy is contraindicated for wounds with exposed organs?
- A. Negative Pressure Wound Therapy
- B. Whirlpool Therapy
- C. Electrical Stimulation
- D. Pulsed Lavage
- Correct: A. Negative Pressure Wound Therapy NPWT is contraindicated for wounds with exposed organs unless specialized systems are used.
- Incorrect: B. Whirlpool Therapy Whirlpool therapy does not directly harm exposed organs.
- Incorrect: C. Electrical Stimulation Electrical stimulation is not directly contraindicated for wounds with exposed organs.
- Incorrect: D. Pulsed Lavage Pulsed lavage can be used cautiously but is not contraindicated.
Which modality reduces wound edema while promoting angiogenesis and granulation tissue formation?
- A. Negative Pressure Wound Therapy
- B. Hyperbaric Oxygen Therapy
- C. Ultrasound
- D. Electrical Stimulation
- Correct: A. Negative Pressure Wound Therapy NPWT decreases edema and promotes granulation and angiogenesis.
- Incorrect: B. Hyperbaric Oxygen Therapy HBO promotes angiogenesis but does not reduce edema.
- Incorrect: C. Ultrasound Ultrasound facilitates healing but does not directly reduce edema.
- Incorrect: D. Electrical Stimulation Electrical stimulation improves circulation but is less effective for edema reduction.
Which therapy is particularly useful for reducing bioburden in critically colonized category III/IV pressure ulcers?
- A. Ultraviolet C Therapy
- B. Electrical Stimulation
- C. Low-Intensity Laser Therapy
- D. Whirlpool Therapy
- Correct: A. Ultraviolet C Therapy UVC therapy is bactericidal and helps reduce bioburden in critically colonized pressure ulcers.
- Incorrect: B. Electrical Stimulation Electrical stimulation promotes healing but does not directly reduce bioburden.
- Incorrect: C. Low-Intensity Laser Therapy Laser therapy has limited evidence for bioburden reduction.
- Incorrect: D. Whirlpool Therapy Whirlpool therapy is not as specific for bioburden in pressure ulcers.
What is the primary goal of using a support surface in pressure relief?
- A. To reduce edema in the lower extremities
- B. To redistribute body weight and protect skin tissue
- C. To prevent heat loss in patients
- D. To assist with pulmonary therapy
- Correct: B. To redistribute body weight and protect skin tissue Support surfaces are designed to redistribute pressure and protect vulnerable areas, like bony prominences, from breakdown.
- Incorrect: A. To reduce edema in the lower extremities Edema reduction is not the main goal of support surfaces.
- Incorrect: C. To prevent heat loss in patients Preventing heat loss is unrelated to pressure relief.
- Incorrect: D. To assist with pulmonary therapy Pulmonary therapy may involve different types of support but is not the primary goal here.
What tissue interface pressure is considered the threshold for skin breakdown?
- A. 15 mmHg
- B. 23 mmHg
- C. 32 mmHg
- D. 45 mmHg
- Correct: C. 32 mmHg Tissue interface pressures above 32 mmHg are associated with impaired capillary blood flow, leading to tissue breakdown.
- Incorrect: A. 15 mmHg This pressure is too low to cause significant breakdown.
- Incorrect: B. 23 mmHg This is the range for pressure-relieving devices, not the breakdown threshold.
- Incorrect: D. 45 mmHg This is above the threshold but not a commonly cited value for breakdown risk.
What is the purpose of pressure mapping in pressure relief management?
- A. To diagnose existing pressure ulcers
- B. To map patient mobility patterns
- C. To assess how interface pressure affects tissue loading
- D. To design custom support surfaces
- Correct: C. To assess how interface pressure affects tissue loading Pressure mapping evaluates tissue loading by measuring interface pressure between the patient and the surface.
- Incorrect: A. To diagnose existing pressure ulcers Diagnosis of ulcers is based on clinical assessment, not pressure mapping.
- Incorrect: B. To map patient mobility patterns Pressure mapping focuses on static pressure, not mobility.
- Incorrect: D. To design custom support surfaces While it provides data, it is not directly used to design surfaces.
Which type of support surface provides continuous air circulation to manage heat and moisture?
- A. Low Air Loss
- B. Alternating Pressure
- C. Air-Fluidized Beds
- D. Viscoelastic Foam
- Correct: A. Low Air Loss Low air loss mattresses continuously circulate air to manage heat and moisture at the patient-surface interface.
- Incorrect: B. Alternating Pressure Alternating pressure redistributes pressure through cyclic inflation, not air circulation.
- Incorrect: C. Air-Fluidized Beds These beds use air to create a fluid-like medium but do not focus on moisture control.
- Incorrect: D. Viscoelastic Foam Foam does not provide active air circulation.
What is a major disadvantage of lateral rotation beds in pressure management?
- A. They are uncomfortable for most patients
- B. They increase the risk of shear injuries
- C. They are ineffective for pulmonary therapy
- D. They are too costly for most healthcare settings
- Correct: B. They increase the risk of shear injuries Lateral rotation beds can cause excessive shear forces, increasing the risk of tissue injury.
- Incorrect: A. They are uncomfortable for most patients Discomfort is not commonly cited as a major disadvantage.
- Incorrect: C. They are ineffective for pulmonary therapy These beds are often used for pulmonary therapy.
- Incorrect: D. They are too costly for most healthcare settings While they are costly, this is not their primary disadvantage in pressure management.
Which type of support surface is most appropriate for a patient with a stage III or IV pressure ulcer who is bedridden?
- A. Standard Foam Mattress
- B. Low Air Loss Mattress
- C. Air-Fluidized Bed
- D. Alternating Pressure Mattress
- Correct: C. Air-Fluidized Bed Air-fluidized beds provide advanced pressure relief and are indicated for stage III or IV pressure ulcers.
- Incorrect: A. Standard Foam Mattress These mattresses do not provide sufficient pressure relief for advanced ulcers.
- Incorrect: B. Low Air Loss Mattress While effective, these are typically used for less severe cases.
- Incorrect: D. Alternating Pressure Mattress Alternating pressure mattresses are appropriate but less effective than air-fluidized beds for advanced cases.
Which support surface technology minimizes shear forces while maintaining immersion and envelopment?
- A. Air-Fluidized Beds
- B. Alternating Pressure Mattresses
- C. Low Air Loss Mattresses
- D. Foam Mattresses
- Correct: A. Air-Fluidized Beds These beds reduce shear while providing excellent immersion and envelopment.
- Incorrect: B. Alternating Pressure Mattresses These redistribute pressure but do not significantly minimize shear forces.
- Incorrect: C. Low Air Loss Mattresses Low air loss mattresses focus on heat and moisture control rather than shear reduction.
- Incorrect: D. Foam Mattresses Foam mattresses may reduce pressure but are less effective at shear reduction.
Which type of positioning is recommended to minimize pressure on the sacrum and coccyx?
- A. Semi-Recumbent
- B. 30-Degree Tilted Side-Lying
- C. 90-Degree Side-Lying
- D. Supine
- Correct: B. 30-Degree Tilted Side-Lying This position offloads pressure from the sacrum and coccyx, reducing risk of pressure injury.
- Incorrect: A. Semi-Recumbent This position increases pressure on the sacrum and coccyx.
- Incorrect: C. 90-Degree Side-Lying This position increases pressure on the greater trochanter.
- Incorrect: D. Supine Supine positioning places direct pressure on the sacrum and coccyx.
How often should patients who are immobile be repositioned to prevent pressure ulcers?
- A. Every 30 minutes
- B. Every 1–2 hours
- C. Every 4 hours
- D. Every 6 hours
- Correct: B. Every 1–2 hours Immobile patients should be repositioned every 1–2 hours to prevent pressure ulcers.
- Incorrect: A. Every 30 minutes While more frequent repositioning is beneficial, it is not standard practice.
- Incorrect: C. Every 4 hours This frequency may increase the risk of pressure injuries.
- Incorrect: D. Every 6 hours This is too infrequent to effectively prevent ulcers.
What is the purpose of a viscoelastic foam mattress?
- A. To prevent heat loss
- B. To redistribute pressure and conform to body contours
- C. To reduce shear forces
- D. To enhance moisture evaporation
- Correct: B. To redistribute pressure and conform to body contours Viscoelastic foam molds to the body, redistributing pressure.
- Incorrect: A. To prevent heat loss Foam mattresses are not designed for heat management.
- Incorrect: C. To reduce shear forces Foam does not significantly reduce shear forces.
- Incorrect: D. To enhance moisture evaporation Foam does not actively manage moisture.
Which type of mattress is most appropriate for patients with multiple stage II pressure ulcers that have not improved with standard care?
- A. Air-Fluidized Mattress
- B. Low Air Loss Mattress
- C. Alternating Pressure Mattress
- D. Viscoelastic Foam Mattress
- Correct: B. Low Air Loss Mattress Low air loss mattresses are indicated for patients with stage II ulcers that have not improved with standard care.
- Incorrect: A. Air-Fluidized Mattress These are typically reserved for advanced stage III or IV ulcers.
- Incorrect: C. Alternating Pressure Mattress Alternating pressure mattresses are often a step before low air loss mattresses.
- Incorrect: D. Viscoelastic Foam Mattress Foam mattresses are for prevention and less severe cases.
What is the primary advantage of using an alternating pressure mattress?
- A. Continuous air circulation
- B. Cyclic redistribution of pressure
- C. Reduced moisture at the wound site
- D. Enhanced immersion and envelopment
- Correct: B. Cyclic redistribution of pressure Alternating pressure mattresses cyclically inflate and deflate to redistribute pressure across different body areas.
- Incorrect: A. Continuous air circulation This is a feature of low air loss mattresses, not alternating pressure systems.
- Incorrect: C. Reduced moisture at the wound site Moisture management is not the primary function of alternating pressure.
- Incorrect: D. Enhanced immersion and envelopment This is more typical of air-fluidized beds.
Which positioning technique reduces pressure on the ischial tuberosities in a wheelchair?
- A. Reclining backward
- B. Side-lean
- C. Forward lean
- D. Push-up pressure relief
- Correct: C. Forward lean Leaning forward effectively offloads the ischial tuberosities.
- Incorrect: A. Reclining backward Reclining may redistribute pressure but does not specifically offload the ischial tuberosities.
- Incorrect: B. Side-lean Side-lean redistributes pressure to one side but not from the ischial tuberosities.
- Incorrect: D. Push-up pressure relief This offloads the buttocks entirely, not specifically the ischial tuberosities.
What is the purpose of the 30-degree tilted side-lying position?
- A. To offload the greater trochanter
- B. To reduce moisture accumulation
- C. To minimize shear forces
- D. To facilitate pulmonary drainage
- Correct: A. To offload the greater trochanter The 30-degree tilted side-lying position reduces pressure on the greater trochanter.
- Incorrect: B. To reduce moisture accumulation This position does not directly address moisture control.
- Incorrect: C. To minimize shear forces Shear reduction is not the primary goal of this position.
- Incorrect: D. To facilitate pulmonary drainage Pulmonary drainage is not the intended outcome.
What type of support surface uses air-filled bladders to redistribute pressure evenly?
- A. Low Air Loss Mattress
- B. Fluid-Filled Bladders
- C. Air-Fluidized Mattress
- D. Alternating Pressure Mattress
- Correct: B. Fluid-Filled Bladders Fluid-filled bladders evenly distribute pressure across the surface area.
- Incorrect: A. Low Air Loss Mattress These manage heat and moisture but do not use fluid-filled bladders.
- Incorrect: C. Air-Fluidized Mattress These create a fluid-like medium using air, not fluid bladders.
- Incorrect: D. Alternating Pressure Mattress These rely on cyclic inflation and deflation, not fluid-filled components.
Which type of support surface is contraindicated for patients with active bleeding?
- A. Air-Fluidized Mattress
- B. Alternating Pressure Mattress
- C. Low Air Loss Mattress
- D. Foam Mattress
- Correct: A. Air-Fluidized Mattress Air-fluidized beds are contraindicated for patients with active bleeding due to their effect on moisture evaporation and potential for bleeding exacerbation.
- Incorrect: B. Alternating Pressure Mattress These are not contraindicated for active bleeding.
- Incorrect: C. Low Air Loss Mattress Low air loss mattresses are suitable for patients with active bleeding.
- Incorrect: D. Foam Mattress Foam mattresses are not contraindicated.
How often should wheelchair-bound patients perform pressure relief techniques?
- A. Every 15–30 minutes
- B. Every 1–2 hours
- C. Every 4 hours
- D. Every 6 hours
- Correct: A. Every 15–30 minutes Wheelchair users should perform pressure relief techniques every 15–30 minutes to prevent pressure injuries.
- Incorrect: B. Every 1–2 hours This frequency is recommended for bed-bound patients, not wheelchair users.
- Incorrect: C. Every 4 hours This is too infrequent to prevent pressure injuries.
- Incorrect: D. Every 6 hours This is insufficient to prevent pressure injuries.
Which type of ulcer requires elevation and offloading of the heels to prevent further damage?
- A. Trochanteric ulcer
- B. Sacral ulcer
- C. Heel ulcer
- D. Coccygeal ulcer
- Correct: C. Heel ulcer Elevating and offloading the heels is critical for managing and preventing further damage to heel ulcers.
- Incorrect: A. Trochanteric ulcer Trochanteric ulcers require offloading from the greater trochanter, not the heels.
- Incorrect: B. Sacral ulcer Sacral ulcers require offloading from the sacrum.
- Incorrect: D. Coccygeal ulcer Coccygeal ulcers also require offloading but not from the heels.
What is a disadvantage of gel overlays used in support surfaces?
- A. They are costly to manufacture
- B. They retain body heat and can warm over time
- C. They lack pressure redistribution capabilities
- D. They are ineffective for multiple pressure ulcers
- Correct: B. They retain body heat and can warm over time Gel overlays absorb body heat, initially feeling cool but warming over time, which can cause discomfort.
- Incorrect: A. They are costly to manufacture Cost is not a primary disadvantage.
- Incorrect: C. They lack pressure redistribution capabilities Gel overlays do provide pressure redistribution.
- Incorrect: D. They are ineffective for multiple pressure ulcers Gel overlays can be effective for multiple ulcers.
What is a key feature of lateral rotation beds that makes them beneficial for pulmonary therapy?
- A. Pressure redistribution
- B. Cyclic inflation and deflation
- C. Positioning one lung higher than the other
- D. Managing heat and moisture
- Correct: C. Positioning one lung higher than the other Lateral rotation beds assist in pulmonary therapy by positioning one lung higher to prevent pneumonia.
- Incorrect: A. Pressure redistribution While they redistribute pressure, this is not specific to pulmonary therapy.
- Incorrect: B. Cyclic inflation and deflation This is a feature of alternating pressure beds, not lateral rotation beds.
- Incorrect: D. Managing heat and moisture This is not the primary function of lateral rotation beds.
What is the primary function of the tunica media in arteries?
- A. Protect vessel walls from trauma
- B. Regulate vessel diameter
- C. Facilitate oxygen exchange
- D. Provide structural support
- Correct: B. Regulate vessel diameter The tunica media, composed of smooth muscle, modulates vessel diameter to regulate blood flow.
- Incorrect: A. Protect vessel walls from trauma This is the function of the tunica externa.
- Incorrect: C. Facilitate oxygen exchange Oxygen exchange occurs at the capillaries.
- Incorrect: D. Provide structural support Structural support is the role of the tunica externa.
Which condition is the most common cause of arterial ulcers?
- A. Diabetes mellitus
- B. Arteriosclerosis
- C. Thromboangiitis obliterans
- D. Trauma
- Correct: B. Arteriosclerosis Arteriosclerosis leads to thickening and hardening of the arterial walls, decreasing perfusion and causing ulcers.
- Incorrect: A. Diabetes mellitus Diabetes contributes to arterial insufficiency but is not the most common direct cause.
- Incorrect: C. Thromboangiitis obliterans This is a rare condition associated with arterial ulcers.
- Incorrect: D. Trauma Trauma may precipitate arterial ulcers but is not the primary cause.
What is intermittent claudication?
- A. Pain at rest caused by ischemia
- B. Activity-induced discomfort relieved by rest
- C. Burning pain exacerbated by elevation
- D. Pain caused by venous insufficiency
- Correct: B. Activity-induced discomfort relieved by rest Intermittent claudication is ischemic pain triggered by activity and relieved within minutes of rest.
- Incorrect: A. Pain at rest caused by ischemia This describes ischemic rest pain, not claudication.
- Incorrect: C. Burning pain exacerbated by elevation This also describes ischemic rest pain.
- Incorrect: D. Pain caused by venous insufficiency Claudication is specific to arterial insufficiency, not venous issues.
Where are arterial ulcers most commonly located?
- A. Medial malleolus
- B. Anterior leg and lateral malleolus
- C. Popliteal fossa
- D. Thigh
- Correct: B. Anterior leg and lateral malleolus Arterial ulcers are typically found in the lower extremities, particularly the anterior leg and lateral malleolus.
- Incorrect: A. Medial malleolus This is a common location for venous ulcers.
- Incorrect: C. Popliteal fossa Arterial ulcers are rarely found in this area.
- Incorrect: D. Thigh Arterial ulcers are uncommon in the thigh.
Which symptom is most indicative of arterial insufficiency?
- A. Swelling and edema
- B. Dependent rubor and elevational pallor
- C. Varicose veins
- D. Warm skin temperature
- Correct: B. Dependent rubor and elevational pallor These signs indicate impaired arterial perfusion and are hallmark symptoms of arterial insufficiency.
- Incorrect: A. Swelling and edema These are more indicative of venous insufficiency.
- Incorrect: C. Varicose veins These are associated with venous insufficiency.
- Incorrect: D. Warm skin temperature Cool skin temperature is a characteristic of arterial insufficiency.
What are the characteristic features of arterial ulcers?
- A. Irregular, shallow wounds with heavy exudate
- B. Well-defined, dry, and “punched out” wounds
- C. Circular, moist wounds with granulation tissue
- D. Large, weeping wounds above the knee
- Correct: B. Well-defined, dry, and “punched out” wounds Arterial ulcers often have smooth edges and are associated with dry necrosis.
- Incorrect: A. Irregular, shallow wounds with heavy exudate These are features of venous ulcers.
- Incorrect: C. Circular, moist wounds with granulation tissue Moist wounds are more indicative of pressure or mixed ulcers.
- Incorrect: D. Large, weeping wounds above the knee Arterial ulcers are usually located below the knee.
What is the primary purpose of measuring the Ankle-Brachial Index (ABI)?
- A. Assess oxygenation of tissues
- B. Diagnose venous insufficiency
- C. Determine the severity of arterial insufficiency
- D. Identify neuropathic involvement
- Correct: C. Determine the severity of arterial insufficiency ABI compares upper and lower extremity pressures to evaluate arterial perfusion.
- Incorrect: A. Assess oxygenation of tissues Oxygenation is measured with tcpO2, not ABI.
- Incorrect: B. Diagnose venous insufficiency ABI assesses arterial insufficiency, not venous issues.
- Incorrect: D. Identify neuropathic involvement ABI is unrelated to neuropathic assessment.
Which dressing is most appropriate for an arterial ulcer with dry necrotic tissue and adequate perfusion?
- A. Hydrogel with a secondary dressing
- B. Foam dressing
- C. Alginate
- D. Hydrocolloid
- Correct: A. Hydrogel with a secondary dressing Hydrogel provides moisture to the wound bed, softening necrotic tissue for autolytic debridement.
- Incorrect: B. Foam dressing Foam dressings are not typically used for dry necrotic wounds.
- Incorrect: C. Alginate Alginate is better suited for wounds with heavy exudate.
- Incorrect: D. Hydrocolloid Hydrocolloids are not ideal for arterial ulcers with dry necrosis.
What is a contraindication for debridement of arterial ulcers?
- A. Presence of slough
- B. ABI < 0.5
- C. Toe pressure >50 mmHg
- D. Moderate exudate
- Correct: B. ABI < 0.5 Debridement is contraindicated when perfusion is insufficient to support healing (ABI < 0.5).
- Incorrect: A. Presence of slough Slough may require debridement if perfusion is adequate.
- Incorrect: C. Toe pressure >50 mmHg This indicates sufficient perfusion for debridement.
- Incorrect: D. Moderate exudate Exudate level does not contraindicate debridement.
What is the recommended intervention goal for arterial ulcers with impaired perfusion?
- A. Apply compression therapy
- B. Maintain warmth and avoid compression
- C. Aggressively debride necrotic tissue
- D. Use foam dressings for heavy exudate
- Correct: B. Maintain warmth and avoid compression Maintaining warmth supports circulation, while compression is contraindicated for impaired perfusion.
- Incorrect: A. Apply compression therapy Compression is contraindicated in arterial insufficiency.
- Incorrect: C. Aggressively debride necrotic tissue Debridement is contraindicated with impaired perfusion.
- Incorrect: D. Use foam dressings for heavy exudate Foam dressings are not ideal for dry wounds.
Which risk factor is most strongly associated with the progression of arterial insufficiency ulcers?
- A. Smoking
- B. Advanced age
- C. Trauma
- D. Hypertension
- Correct: A. Smoking Smoking significantly contributes to arterial insufficiency by causing vasoconstriction, increasing clot formation, and reducing oxygen availability.
- Incorrect: B. Advanced age While age is a risk factor, smoking has a stronger association with progression.
- Incorrect: C. Trauma Trauma is often a precipitating factor but not the primary contributor to progression.
- Incorrect: D. Hypertension Hypertension contributes but less significantly than smoking.
What is the purpose of the Rubor of Dependency test?
- A. Assess venous reflux
- B. Evaluate arterial flow in the lower extremities
- C. Determine capillary refill time
- D. Measure oxygenation in tissues
- Correct: B. Evaluate arterial flow in the lower extremities The Rubor of Dependency test evaluates arterial blood flow by observing color changes with leg elevation and dependency.
- Incorrect: A. Assess venous reflux This test does not evaluate venous function.
- Incorrect: C. Determine capillary refill time Capillary refill is assessed separately using nail bed pressure.
- Incorrect: D. Measure oxygenation in tissues Tissue oxygenation is measured with tcpO2, not this test.
Which finding indicates severe arterial insufficiency on an Ankle-Brachial Index (ABI) test?
- A. ABI ≥ 1.3
- B. ABI 0.95–1.0
- C. ABI 0.5–0.8
- D. ABI < 0.5
- Correct: D. ABI < 0.5 An ABI value below 0.5 indicates severe arterial insufficiency, often associated with rest pain or tissue loss.
- Incorrect: A. ABI ≥ 1.3 This suggests calcified, non-compressible vessels, common in diabetes or CKD.
- Incorrect: B. ABI 0.95–1.0 This range is considered normal.
- Incorrect: C. ABI 0.5–0.8 This range indicates moderate arterial disease.
What adjunctive modality is most appropriate for arterial ulcers with adequate perfusion?
- A. Negative Pressure Wound Therapy
- B. Hyperbaric Oxygen Therapy
- C. Low-Intensity Laser Therapy
- D. Electrical Stimulation
- Correct: B. Hyperbaric Oxygen Therapy HBO improves oxygenation and promotes healing in well-perfused arterial ulcers.
- Incorrect: A. Negative Pressure Wound Therapy NPWT is contraindicated for poorly perfused wounds.
- Incorrect: C. Low-Intensity Laser Therapy While helpful, HBO is more directly beneficial for arterial ulcers.
- Incorrect: D. Electrical Stimulation Electrical stimulation is useful but secondary to HBO in arterial ulcers.
What is the clinical significance of dependent rubor in arterial insufficiency?
- A. Indicates venous congestion
- B. Suggests collateral circulation is intact
- C. Demonstrates arterial insufficiency with reactive hyperemia
- D. Confirms the presence of neuropathy
- Correct: C. Demonstrates arterial insufficiency with reactive hyperemia Dependent rubor is a classic sign of arterial insufficiency and indicates poor perfusion.
- Incorrect: A. Indicates venous congestion Venous congestion does not cause dependent rubor.
- Incorrect: B. Suggests collateral circulation is intact Dependent rubor suggests inadequate arterial perfusion, not sufficient collateral circulation.
- Incorrect: D. Confirms the presence of neuropathy Neuropathy does not typically cause dependent rubor.
What is the primary indication for transcutaneous oxygen pressure (tcpO2) testing in arterial ulcers?
- A. To assess venous insufficiency
- B. To evaluate oxygen diffusion across the skin
- C. To measure ankle pressure
- D. To determine the risk of neuropathy
- Correct: B. To evaluate oxygen diffusion across the skin TcpO2 measures oxygen diffusion to assess tissue perfusion.
- Incorrect: A. To assess venous insufficiency TcpO2 is used for arterial, not venous, evaluation.
- Incorrect: C. To measure ankle pressure Ankle pressures are measured using ABI, not tcpO2.
- Incorrect: D. To determine the risk of neuropathy TcpO2 does not assess neuropathy risk.
What is the recommended treatment goal for arterial ulcers with ischemic rest pain?
- A. Aggressive debridement
- B. Revascularization
- C. Compression therapy
- D. Autolytic debridement
- Correct: B. Revascularization Revascularization is essential to restore blood flow and relieve ischemic rest pain.
- Incorrect: A. Aggressive debridement Debridement is contraindicated without adequate perfusion.
- Incorrect: C. Compression therapy Compression is contraindicated in arterial insufficiency.
- Incorrect: D. Autolytic debridement Autolytic debridement is not effective without adequate perfusion.
Which dressing is contraindicated for arterial ulcers with dry necrosis and inadequate perfusion?
- A. Hydrocolloid
- B. Non-adherent foam
- C. Hydrogel
- D. Alginate
- Correct: A. Hydrocolloid Hydrocolloids are occlusive and not recommended for dry necrotic arterial ulcers.
- Incorrect: B. Non-adherent foam Foam dressings are suitable for protecting dry necrotic areas.
- Incorrect: C. Hydrogel Hydrogel is appropriate for moistening dry necrotic tissue.
- Incorrect: D. Alginate Alginate is inappropriate for dry wounds but is not contraindicated.
Which factor contributes most significantly to arterial ulcer progression?
- A. Hyperlipidemia
- B. Impaired wound healing
- C. Smoking
- D. Poor glycemic control
- Correct: C. Smoking Smoking exacerbates arterial insufficiency by increasing clot formation, vasoconstriction, and reducing oxygen delivery.
- Incorrect: A. Hyperlipidemia While significant, hyperlipidemia contributes less directly than smoking.
- Incorrect: B. Impaired wound healing Impaired healing is a consequence, not a primary contributor.
- Incorrect: D. Poor glycemic control Glycemic control impacts arterial health but less than smoking.
What is the best initial step in managing arterial ulcers with ABI < 0.5?
- A. Compression therapy
- B. Surgical debridement
- C. Revascularization consultation
- D. Apply hydrogel dressing
- Correct: C. Revascularization consultation Immediate revascularization is required for severe arterial insufficiency.
- Incorrect: A. Compression therapy Compression is contraindicated with ABI < 0.5.
- Incorrect: B. Surgical debridement Debridement is unsafe without adequate perfusion.
- Incorrect: D. Apply hydrogel dressing Hydrogel does not address perfusion issues.
What is the primary cause of neuropathic ulcers in patients with diabetes?
- A. Venous insufficiency
- B. Peripheral neuropathy
- C. Arterial insufficiency
- D. Pressure injuries
- Correct: B. Peripheral neuropathy Peripheral neuropathy leads to loss of sensation, making patients unaware of injuries and pressure, which can lead to ulceration.
- Incorrect: A. Venous insufficiency Venous insufficiency causes different types of ulcers.
- Incorrect: C. Arterial insufficiency Arterial insufficiency is not the primary cause of neuropathic ulcers.
- Incorrect: D. Pressure injuries Pressure injuries can contribute but are secondary to neuropathy.
Which factor contributes most significantly to delayed wound healing in patients with diabetes?
- A. Poor glycemic control
- B. Advanced age
- C. Inadequate protein intake
- D. Lack of exercise
- Correct: A. Poor glycemic control Hyperglycemia impairs immune function, collagen synthesis, and angiogenesis, delaying wound healing.
- Incorrect: B. Advanced age While age is a factor, poor glycemic control is more significant in diabetes.
- Incorrect: C. Inadequate protein intake Protein deficiency affects healing but is not the primary issue in diabetes.
- Incorrect: D. Lack of exercise Exercise affects overall health but is less directly linked to delayed wound healing.
What is the hallmark characteristic of a neuropathic ulcer?
- A. Irregular edges with heavy exudate
- B. Well-defined margins with surrounding callus
- C. Painful wound with erythematous base
- D. Punched-out appearance with dry necrosis
- Correct: B. Well-defined margins with surrounding callus Neuropathic ulcers typically have well-defined margins and callus around the wound due to repetitive trauma and pressure.
- Incorrect: A. Irregular edges with heavy exudate These are characteristics of venous ulcers.
- Incorrect: C. Painful wound with erythematous base Neuropathic ulcers are often painless due to sensory loss.
- Incorrect: D. Punched-out appearance with dry necrosis This describes arterial ulcers.
Where are neuropathic ulcers most commonly located?
- A. Dorsum of the foot
- B. Medial malleolus
- C. Plantar aspect of the foot
- D. Popliteal fossa
- Correct: C. Plantar aspect of the foot Neuropathic ulcers commonly occur on weight-bearing areas like the plantar surface.
- Incorrect: A. Dorsum of the foot This location is less typical for neuropathic ulcers.
- Incorrect: B. Medial malleolus This is a common site for venous ulcers.
- Incorrect: D. Popliteal fossa Neuropathic ulcers do not typically occur in this area.
What is the purpose of a 10-gram monofilament test? * A. Assess motor neuropathy * B. Evaluate arterial blood flow * C. Identify loss of protective sensation * D. Determine autonomic dysfunction
- Correct: C. Identify loss of protective sensation The monofilament test assesses sensory function to identify areas of diminished sensation. * Incorrect: A. Assess motor neuropathy Motor neuropathy involves muscle weakness, not sensory loss. * Incorrect: B. Evaluate arterial blood flow The monofilament test does not assess circulation. * Incorrect: D. Determine autonomic dysfunction The test does not evaluate autonomic functions.
What is the gold standard off-loading device for neuropathic ulcers? * A. Total contact cast * B. Diabetic shoes * C. Gel heel cushion * D. Knee scooter
- Correct: A. Total contact cast Total contact casting evenly redistributes pressure, protecting the ulcer and promoting healing. * Incorrect: B. Diabetic shoes Diabetic shoes are effective for prevention but not the gold standard for treatment. * Incorrect: C. Gel heel cushion Heel cushions reduce pressure locally but are not comprehensive solutions. * Incorrect: D. Knee scooter Knee scooters are used for mobility, not pressure off-loading.
Which type of neuropathy is responsible for autonomic dysfunction in diabetic patients? * A. Sensory neuropathy * B. Motor neuropathy * C. Autonomic neuropathy * D. Mixed neuropathy
- Correct: C. Autonomic neuropathy Autonomic neuropathy affects involuntary functions, such as sweat production and blood flow, contributing to diabetic wound pathology. * Incorrect: A. Sensory neuropathy Sensory neuropathy involves loss of protective sensation, not autonomic function. * Incorrect: B. Motor neuropathy Motor neuropathy causes muscle weakness, not autonomic dysfunction. * Incorrect: D. Mixed neuropathy While mixed neuropathy may involve autonomic dysfunction, the specific cause here is autonomic neuropathy.
What is the significance of elevated plantar pressure in diabetic patients? * A. Increased risk of arterial insufficiency ulcers * B. Decreased callus formation * C. Increased risk of neuropathic ulcers * D. Improved blood flow to the toes
- Correct: C. Increased risk of neuropathic ulcers Elevated plantar pressure exacerbates tissue damage, leading to ulcer formation in patients with sensory loss. * Incorrect: A. Increased risk of arterial insufficiency ulcers Arterial ulcers are not caused by plantar pressure. * Incorrect: B. Decreased callus formation Plantar pressure increases callus formation. * Incorrect: D. Improved blood flow to the toes Elevated pressure does not improve circulation.
What is a contraindication for total contact casting? * A. Plantar ulcers with moderate exudate * B. Presence of infection or osteomyelitis * C. Neuropathic ulcers in non-weight-bearing areas * D. Patients with normal sensation
- Correct: B. Presence of infection or osteomyelitis Total contact casting is contraindicated when infection or osteomyelitis is present, as it can exacerbate the condition. * Incorrect: A. Plantar ulcers with moderate exudate Total contact casting can still be used for exudative ulcers with appropriate dressings. * Incorrect: C. Neuropathic ulcers in non-weight-bearing areas Off-loading is not required for non-weight-bearing areas. * Incorrect: D. Patients with normal sensation Total contact casting is primarily for those with sensory loss.
What is the recommended frequency for diabetic foot inspections to prevent ulcer development? * A. Weekly * B. Biweekly * C. Daily * D. Monthly
- Correct: C. Daily Diabetic patients should inspect their feet daily to identify early signs of injury or ulceration. * Incorrect: A. Weekly Weekly inspections may miss early signs of injury. * Incorrect: B. Biweekly This frequency is insufficient for high-risk patients. * Incorrect: D. Monthly Monthly inspections are not frequent enough for prevention.
What is the role of autonomic neuropathy in the development of diabetic foot ulcers? * A. Increases tissue oxygenation * B. Reduces sweat production, causing dry and cracked skin * C. Enhances vascular dilation * D. Strengthens plantar muscles
- Correct: B. Reduces sweat production, causing dry and cracked skin Autonomic neuropathy reduces sweat production, leading to dry skin and fissures that increase ulcer risk. * Incorrect: A. Increases tissue oxygenation Autonomic dysfunction reduces perfusion rather than improving oxygenation. * Incorrect: C. Enhances vascular dilation It impairs vascular regulation, not dilation. * Incorrect: D. Strengthens plantar muscles Motor neuropathy affects muscles, not autonomic neuropathy.
What is the first step in managing a diabetic foot ulcer with signs of infection? * A. Apply an alginate dressing * B. Start broad-spectrum antibiotics * C. Perform surgical debridement * D. Initiate total contact casting
- Correct: B. Start broad-spectrum antibiotics Antibiotics address infection, which must be managed before other interventions like debridement or casting. * Incorrect: A. Apply an alginate dressing Dressings alone do not manage infections. * Incorrect: C. Perform surgical debridement Debridement can spread infection if not controlled first. * Incorrect: D. Initiate total contact casting Casting is contraindicated in the presence of infection.
Which test is most commonly used to evaluate protective sensation in diabetic patients? * A. Tuning fork test * B. 10-gram monofilament test * C. Ankle-brachial index (ABI) * D. Transcutaneous oxygen pressure (tcpO2)
- Correct: B. 10-gram monofilament test The monofilament test is the gold standard for identifying loss of protective sensation. * Incorrect: A. Tuning fork test The tuning fork evaluates vibratory sensation, not protective sensation. * Incorrect: C. Ankle-brachial index (ABI) ABI assesses arterial perfusion, not sensation. * Incorrect: D. Transcutaneous oxygen pressure (tcpO2) TcpO2 measures tissue oxygenation, not sensory function.
What is a primary characteristic of motor neuropathy in diabetic patients? * A. Loss of sensation * B. Muscle atrophy and foot deformities * C. Increased sweat production * D. Elevated plantar pressures
- Correct: B. Muscle atrophy and foot deformities Motor neuropathy causes intrinsic muscle weakness, leading to deformities like claw toes. * Incorrect: A. Loss of sensation This is a feature of sensory neuropathy, not motor neuropathy. * Incorrect: C. Increased sweat production Autonomic neuropathy reduces, not increases, sweat production. * Incorrect: D. Elevated plantar pressures This results from foot deformities caused by motor neuropathy but is not a direct characteristic.
What is the purpose of a Charcot restraint orthotic walker (CROW)? * A. Enhance vascular flow to the foot * B. Off-load pressure and immobilize the foot * C. Improve ankle joint mobility * D. Reduce sweat production in autonomic neuropathy
- Correct: B. Off-load pressure and immobilize the foot The CROW device redistributes pressure and immobilizes the foot to facilitate healing. * Incorrect: A. Enhance vascular flow to the foot It does not improve vascular flow. * Incorrect: C. Improve ankle joint mobility The CROW is designed for immobilization, not mobility. * Incorrect: D. Reduce sweat production in autonomic neuropathy It does not address autonomic dysfunction.
Which intervention is most effective in preventing recurrence of neuropathic ulcers? * A. Total contact casting * B. Daily foot inspections and protective footwear * C. Routine whirlpool therapy * D. Application of hydrogel dressings
- Correct: B. Daily foot inspections and protective footwear Regular inspections and appropriate footwear prevent injury and reduce recurrence risk. * Incorrect: A. Total contact casting Casting is effective for treatment but not prevention. * Incorrect: C. Routine whirlpool therapy Whirlpool therapy is not indicated for prevention. * Incorrect: D. Application of hydrogel dressings Dressings are for wound management, not prevention.
What is the best strategy to reduce plantar pressures in diabetic patients? * A. Custom-molded orthotics * B. Heel cushions * C. Increased walking activity * D. Surgical intervention
- Correct: A. Custom-molded orthotics Orthotics redistribute plantar pressure, reducing the risk of ulceration. * Incorrect: B. Heel cushions Cushions only address localized pressure and are not sufficient alone. * Incorrect: C. Increased walking activity Excessive activity may increase plantar pressures and injury risk. * Incorrect: D. Surgical intervention Surgery is reserved for severe cases or deformities.
Which sign is most indicative of infection in a diabetic foot ulcer? * A. Presence of granulation tissue * B. Increased exudate and erythema * C. Dry wound bed * D. Reduced wound size
- Correct: B. Increased exudate and erythema These signs indicate inflammation and possible infection in a diabetic ulcer. * Incorrect: A. Presence of granulation tissue Granulation tissue is a sign of healing, not infection. * Incorrect: C. Dry wound bed A dry wound bed does not necessarily indicate infection. * Incorrect: D. Reduced wound size Reduction in size is a sign of healing.
Which off-loading device is appropriate for a patient who cannot tolerate total contact casting? * A. Charcot restraint orthotic walker (CROW) * B. Diabetic shoes with custom inserts * C. Gel heel cushion * D. Ankle-foot orthosis (AFO)
- Correct: A. Charcot restraint orthotic walker (CROW) The CROW is an alternative off-loading device for patients unable to tolerate casting. * Incorrect: B. Diabetic shoes with custom inserts These are preventive measures, not substitutes for casting. * Incorrect: C. Gel heel cushion Cushions provide localized relief but are insufficient for significant off-loading. * Incorrect: D. Ankle-foot orthosis (AFO) AFOs are used for support but do not redistribute pressure.
What is the ideal ABI range for safe compression therapy in diabetic patients? * A. 0.9–1.2 * B. 0.8–1.0 * C. 0.5–0.7 * D. <0.5
- Correct: B. 0.8–1.0 ABI values in this range indicate sufficient arterial perfusion for safe compression. * Incorrect: A. 0.9–1.2 While normal, this range may not include all diabetic patients. * Incorrect: C. 0.5–0.7 This range indicates moderate arterial insufficiency, making compression risky. * Incorrect: D. <0.5 ABI below 0.5 is contraindicated for compression therapy.
What is the primary function of venous valves? * A. Propel blood forward using muscle contraction * B. Prevent backflow of blood * C. Facilitate oxygen exchange * D. Regulate venous blood pressure
- Correct: B. Prevent backflow of blood Venous valves ensure unidirectional flow of blood toward the heart. * Incorrect: A. Propel blood forward using muscle contraction Propulsion is achieved by the muscle pump, not valves. * Incorrect: C. Facilitate oxygen exchange Oxygen exchange occurs in capillaries, not veins. * Incorrect: D. Regulate venous blood pressure Pressure regulation involves multiple factors, not solely valves.
Which of the following is a primary risk factor for venous insufficiency? * A. Prolonged standing * B. Low blood pressure * C. Sedentary lifestyle * D. Low BMI
- Correct: A. Prolonged standing Standing for extended periods increases venous pressure and contributes to valve dysfunction. * Incorrect: B. Low blood pressure Low blood pressure does not cause venous insufficiency. * Incorrect: C. Sedentary lifestyle While relevant, it is less directly linked than prolonged standing. * Incorrect: D. Low BMI High BMI is a more significant risk factor.
What is the hallmark clinical sign of venous insufficiency? * A. Intermittent claudication * B. Dependent edema * C. Cool, pale skin * D. Thickened toenails
- Correct: B. Dependent edema Dependent edema is a hallmark of venous insufficiency, caused by increased venous pressure and fluid leakage. * Incorrect: A. Intermittent claudication This is associated with arterial insufficiency. * Incorrect: C. Cool, pale skin These symptoms suggest arterial disease. * Incorrect: D. Thickened toenails Thickened toenails are not a primary sign of venous insufficiency.
What is the purpose of the Trendelenburg test in venous insufficiency? * A. Evaluate arterial perfusion * B. Assess valve competency * C. Measure capillary refill time * D. Determine risk of neuropathy
- Correct: B. Assess valve competency The Trendelenburg test evaluates venous valve function and retrograde blood flow. * Incorrect: A. Evaluate arterial perfusion This is unrelated to the Trendelenburg test. * Incorrect: C. Measure capillary refill time Capillary refill is assessed using different methods. * Incorrect: D. Determine risk of neuropathy Neuropathy is unrelated to venous insufficiency.
What is the significance of a venous filling time of less than 5 seconds? * A. Normal venous return * B. Venous reflux or insufficiency * C. Delayed arterial perfusion * D. Elevated capillary pressure
- Correct: B. Venous reflux or insufficiency Rapid venous filling indicates valve incompetence and venous reflux. * Incorrect: A. Normal venous return Normal filling time is 5–15 seconds. * Incorrect: C. Delayed arterial perfusion Delayed filling (>20 seconds) suggests arterial disease. * Incorrect: D. Elevated capillary pressure Capillary pressure is not directly measured in this test.
Where are venous ulcers most commonly located? * A. Medial malleolus * B. Plantar surface of the foot * C. Dorsum of the foot * D. Anterior leg
- Correct: A. Medial malleolus Venous ulcers frequently develop near the medial malleolus due to high venous pressure. * Incorrect: B. Plantar surface of the foot This is common for neuropathic ulcers. * Incorrect: C. Dorsum of the foot This location is associated with arterial ulcers. * Incorrect: D. Anterior leg This is less typical for venous ulcers.
What is the characteristic appearance of venous ulcers? * A. Punched-out, dry, with black eschar * B. Shallow, irregular, with moderate exudate * C. Well-defined, calloused edges * D. Circular, deep, with minimal drainage
- Correct: B. Shallow, irregular, with moderate exudate Venous ulcers typically appear shallow, irregularly shaped, and moderately exudative. * Incorrect: A. Punched-out, dry, with black eschar This describes arterial ulcers. * Incorrect: C. Well-defined, calloused edges These are characteristics of neuropathic ulcers. * Incorrect: D. Circular, deep, with minimal drainage This describes pressure ulcers.
What is the primary intervention goal for venous ulcers? * A. Promote arterial perfusion * B. Reduce venous hypertension * C. Enhance sensory perception * D. Decrease oxygen demand
- Correct: B. Reduce venous hypertension Lowering venous pressure promotes healing and reduces ulcer recurrence. * Incorrect: A. Promote arterial perfusion This is relevant for arterial ulcers, not venous. * Incorrect: C. Enhance sensory perception Sensory deficits are not a primary concern in venous ulcers. * Incorrect: D. Decrease oxygen demand This is unrelated to venous ulcer management.
Which compression therapy is most appropriate for managing venous insufficiency ulcers? * A. Short-stretch bandages * B. Low air loss mattress * C. Total contact cast * D. Hydrocolloid dressing
- Correct: A. Short-stretch bandages These provide graduated compression, reducing venous hypertension and promoting healing. * Incorrect: B. Low air loss mattress This is for pressure management, not compression. * Incorrect: C. Total contact cast This is used for off-loading neuropathic ulcers. * Incorrect: D. Hydrocolloid dressing This addresses moisture but does not provide compression.
What is a contraindication for compression therapy in venous insufficiency? * A. ABI <0.8 * B. Swelling and edema * C. Presence of exudate * D. Irregular wound edges
- Correct: A. ABI <0.8 Compression is contraindicated when ABI indicates moderate or severe arterial insufficiency. * Incorrect: B. Swelling and edema Compression is indicated for edema management. * Incorrect: C. Presence of exudate Compression can help manage venous ulcers with exudate. * Incorrect: D. Irregular wound edges Compression therapy is not contraindicated for irregular wounds.
What is the purpose of the CEAP classification system in venous insufficiency? * A. Evaluate arterial insufficiency * B. Determine risk of neuropathy * C. Classify severity of venous disorders * D. Identify underlying infection
- Correct: C. Classify severity of venous disorders CEAP (Clinical, Etiological, Anatomical, Pathophysiological) categorizes venous disease for standardized assessment. * Incorrect: A. Evaluate arterial insufficiency CEAP is not used for arterial disorders. * Incorrect: B. Determine risk of neuropathy Neuropathy is unrelated to CEAP. * Incorrect: D. Identify underlying infection CEAP does not assess infection.
What is the clinical significance of hemosiderin staining in venous insufficiency? * A. Indicates arterial insufficiency * B. Suggests reduced tissue oxygenation * C. Reflects chronic venous hypertension * D. Confirms neuropathy
- Correct: C. Reflects chronic venous hypertension Hemosiderin staining occurs due to chronic leakage of red blood cells and venous pressure. * Incorrect: A. Indicates arterial insufficiency Hemosiderin staining is unrelated to arterial conditions. * Incorrect: B. Suggests reduced tissue oxygenation Oxygenation issues are more common in arterial insufficiency. * Incorrect: D. Confirms neuropathy Hemosiderin staining is not related to neuropathy.
Which factor is most critical for the development of venous ulcers? * A. Increased venous pressure * B. Loss of protective sensation * C. Arterial ischemia * D. Muscle atrophy
- Correct: A. Increased venous pressure Chronic venous hypertension leads to tissue damage and ulcer formation. * Incorrect: B. Loss of protective sensation This is a key factor in neuropathic ulcers. * Incorrect: C. Arterial ischemia Ischemia contributes to arterial ulcers, not venous ulcers. * Incorrect: D. Muscle atrophy Muscle atrophy is not a primary factor in venous ulcer development.
What is the primary role of the calf muscle pump in venous circulation? * A. Prevent venous reflux * B. Propel blood toward the heart * C. Enhance capillary oxygen exchange * D. Maintain valve integrity
- Correct: B. Propel blood toward the heart The calf muscle pump assists in venous return by contracting and pushing blood toward the heart. * Incorrect: A. Prevent venous reflux Valves, not muscles, prevent reflux. * Incorrect: C. Enhance capillary oxygen exchange Oxygen exchange occurs in capillaries, not veins. * Incorrect: D. Maintain valve integrity Valve integrity is not directly affected by the muscle pump.
Which intervention is most appropriate for managing large, shallow venous ulcers with heavy exudate? * A. Hydrocolloid dressing * B. Alginate dressing * C. Foam dressing * D. Transparent film
- Correct: B. Alginate dressing Alginates absorb large amounts of exudate, making them suitable for heavily draining venous ulcers. * Incorrect: A. Hydrocolloid dressing Hydrocolloids are not ideal for heavily exudative wounds. * Incorrect: C. Foam dressing Foam dressings absorb moderate exudate but may not be sufficient for heavy drainage. * Incorrect: D. Transparent film Films are unsuitable for exudative wounds.
What is a common skin change associated with chronic venous insufficiency? * A. Erythema * B. Lipodermatosclerosis * C. Cyanosis * D. Pallor
- Correct: B. Lipodermatosclerosis This condition involves skin thickening and inflammation due to chronic venous hypertension. * Incorrect: A. Erythema Erythema is nonspecific and not unique to venous disease. * Incorrect: C. Cyanosis Cyanosis is more indicative of arterial or systemic issues. * Incorrect: D. Pallor Pallor is associated with arterial insufficiency, not venous disease.
Which compression therapy technique provides the highest level of sustained compression? * A. Elastic stockings * B. Multi-layer bandaging * C. Tubular bandages * D. Unna boot
- Correct: B. Multi-layer bandaging Multi-layer bandages deliver sustained, graduated compression for venous insufficiency management. * Incorrect: A. Elastic stockings Stockings provide compression but not as effectively as multi-layer systems. * Incorrect: C. Tubular bandages Tubular bandages offer light compression. * Incorrect: D. Unna boot Unna boots are effective but less adjustable than multi-layer systems.
What is the purpose of a duplex ultrasound in venous insufficiency evaluation? * A. Assess arterial perfusion * B. Visualize venous valve function and flow * C. Measure tissue oxygenation * D. Determine ABI
- Correct: B. Visualize venous valve function and flow Duplex ultrasound provides real-time imaging to assess valve competency and venous flow. * Incorrect: A. Assess arterial perfusion Duplex ultrasound is not primarily used for arterial evaluation. * Incorrect: C. Measure tissue oxygenation TcpO2 evaluates oxygenation, not duplex ultrasound. * Incorrect: D. Determine ABI ABI measures arterial pressure, not venous flow.
Which venous ulcer intervention improves lymphatic drainage and venous return? * A. Compression therapy * B. Negative pressure wound therapy * C. Hyperbaric oxygen therapy * D. Electrical stimulation
- Correct: A. Compression therapy Compression promotes venous return and lymphatic drainage, reducing edema and enhancing healing. * Incorrect: B. Negative pressure wound therapy NPWT does not directly enhance venous return or lymphatic drainage. * Incorrect: C. Hyperbaric oxygen therapy HBO is for oxygenation, not venous return. * Incorrect: D. Electrical stimulation Electrical stimulation is not a primary treatment for venous insufficiency.
What is the recommended frequency for compression garment use in venous insufficiency? * A. Daily, during waking hours * B. Every other day * C. Only when swelling is present * D. During sleep only
- Correct: A. Daily, during waking hours Compression garments should be worn daily to manage venous pressure and prevent ulcer recurrence. * Incorrect: B. Every other day Intermittent use is ineffective for venous insufficiency. * Incorrect: C. Only when swelling is present Consistent use is required regardless of swelling. * Incorrect: D. During sleep only Compression is typically avoided during sleep.
Which surgical intervention is used to eliminate reflux in superficial veins? * A. Endovenous ablation * B. Vein stripping * C. Sclerotherapy * D. Subfascial endoscopic perforator surgery (SEPS)
- Correct: A. Endovenous ablation Endovenous ablation uses thermal energy to close incompetent superficial veins. * Incorrect: B. Vein stripping This is a more invasive procedure than ablation. * Incorrect: C. Sclerotherapy Sclerotherapy involves chemical closure, not thermal energy. * Incorrect: D. Subfascial endoscopic perforator surgery (SEPS) SEPS targets perforator veins, not superficial veins.
What is a contraindication for Unna boot application? * A. Active infection * B. Edema * C. ABI >1.0 * D. Hemosiderin staining
- Correct: A. Active infection Unna boots are contraindicated in the presence of infection due to the risk of exacerbation. * Incorrect: B. Edema Unna boots are effective for edema management. * Incorrect: C. ABI >1.0 Normal ABI is not a contraindication. * Incorrect: D. Hemosiderin staining Staining does not contraindicate Unna boot use.
What is the clinical purpose of a Subfascial Endoscopic Perforator Surgery (SEPS)? * A. Remove superficial varicose veins * B. Treat incompetent perforator veins * C. Increase venous pressure * D. Improve oxygen diffusion to tissues
- Correct: B. Treat incompetent perforator veins SEPS targets perforator veins to reduce venous reflux and improve circulation. * Incorrect: A. Remove superficial varicose veins SEPS is not designed for superficial vein treatment. * Incorrect: C. Increase venous pressure The goal is to reduce venous pressure, not increase it. * Incorrect: D. Improve oxygen diffusion to tissues SEPS does not directly affect oxygen diffusion.
What is the primary goal of venous insufficiency management? * A. Reduce venous hypertension * B. Enhance arterial flow * C. Increase oxygen delivery * D. Prevent neuropathic changes
- Correct: A. Reduce venous hypertension Managing venous hypertension is critical to healing and preventing venous ulcer recurrence. * Incorrect: B. Enhance arterial flow Arterial flow is not the focus of venous management. * Incorrect: C. Increase oxygen delivery Oxygen delivery is not directly addressed in venous ulcer management. * Incorrect: D. Prevent neuropathic changes Neuropathy is not the primary concern in venous insufficiency.
What is the primary physiological effect of compression therapy? * A. Increase arterial blood flow * B. Promote venous return and reduce edema * C. Decrease oxygen demand in tissues * D. Prevent skin breakdown
- Correct: B. Promote venous return and reduce edema Compression therapy enhances venous return, reduces venous hypertension, and decreases edema. * Incorrect: A. Increase arterial blood flow Compression primarily targets the venous system, not arterial flow. * Incorrect: C. Decrease oxygen demand in tissues Compression does not directly affect oxygen demand. * Incorrect: D. Prevent skin breakdown Prevention of skin breakdown is a secondary benefit.
Which type of compression bandage is most appropriate for active ambulatory patients? * A. Long-stretch bandages * B. Short-stretch bandages * C. Elastic stockings * D. Unna’s Boot
- Correct: B. Short-stretch bandages Short-stretch bandages provide high working pressure during movement, making them ideal for active patients. * Incorrect: A. Long-stretch bandages Long-stretch bandages provide more resting pressure, suitable for less active patients. * Incorrect: C. Elastic stockings These are used for maintenance, not primary therapy. * Incorrect: D. Unna’s Boot This is effective but less adjustable for activity levels.
What is the minimum Ankle-Brachial Index (ABI) required for safe compression therapy? * A. 0.5 * B. 0.6 * C. 0.8 * D. 1.0
- Correct: C. 0.8 ABI ≥0.8 indicates sufficient arterial perfusion for safe compression therapy. * Incorrect: A. 0.5 ABI <0.8 suggests significant arterial insufficiency and risks ischemia with compression. * Incorrect: B. 0.6 This value indicates borderline safety, requiring caution. * Incorrect: D. 1.0 ABI of 1.0 is normal but not a minimum requirement.
What is a contraindication for compression therapy? * A. Mild edema * B. Cellulitis * C. Lymphedema * D. Venous ulcers
- Correct: B. Cellulitis Active cellulitis is a contraindication as compression can exacerbate infection. * Incorrect: A. Mild edema Compression is indicated for edema management. * Incorrect: C. Lymphedema Compression is a cornerstone of lymphedema treatment. * Incorrect: D. Venous ulcers Compression is essential for venous ulcer management.
What is the effect of higher stiffness in compression bandages? * A. Increases resting pressure * B. Reduces working pressure * C. Improves venous return during movement * D. Enhances skin hydration
- Correct: C. Improves venous return during movement Higher stiffness creates greater pressure differences, improving venous return during activity. * Incorrect: A. Increases resting pressure Stiff bandages have lower resting pressure. * Incorrect: B. Reduces working pressure Higher stiffness increases working pressure. * Incorrect: D. Enhances skin hydration Compression does not directly affect hydration.
Which compression system provides the greatest pressure gradient from distal to proximal? * A. Multi-layer bandage system * B. Elastic stockings * C. Intermittent pneumatic compression * D. Long-stretch bandages
- Correct: A. Multi-layer bandage system Multi-layer bandages create a strong pressure gradient, optimizing venous return. * Incorrect: B. Elastic stockings Stockings provide a consistent gradient but are less adjustable than multi-layer systems. * Incorrect: C. Intermittent pneumatic compression This provides intermittent rather than static gradient pressure. * Incorrect: D. Long-stretch bandages These lack the strong gradient of multi-layer systems.
What is the primary purpose of Unna’s Boot? * A. Prevent arterial insufficiency * B. Maintain skin hydration * C. Treat venous ulcers * D. Reduce muscle fatigue
- Correct: C. Treat venous ulcers Unna’s Boot provides consistent compression and supports healing in venous ulcers. * Incorrect: A. Prevent arterial insufficiency Compression does not address arterial insufficiency. * Incorrect: B. Maintain skin hydration While the zinc oxide in Unna’s Boot can support skin integrity, hydration is not its main purpose. * Incorrect: D. Reduce muscle fatigue Unna’s Boot is unrelated to muscle fatigue management.
Which compression garment is recommended for long-term venous insufficiency management? * A. Compression wraps * B. Elastic stockings * C. Pneumatic compression device * D. Gel heel cushions
- Correct: B. Elastic stockings Elastic stockings are commonly used for maintenance therapy in chronic venous insufficiency. * Incorrect: A. Compression wraps Wraps are more appropriate for acute or short-term management. * Incorrect: C. Pneumatic compression device These are used for specific conditions, not general maintenance. * Incorrect: D. Gel heel cushions Cushions do not provide therapeutic compression.
What is the pressure range typically required to treat venous insufficiency? * A. 10–20 mmHg * B. 20–30 mmHg * C. 30–40 mmHg * D. 40–50 mmHg
- Correct: C. 30–40 mmHg This range provides effective therapeutic compression for venous insufficiency. * Incorrect: A. 10–20 mmHg This range is insufficient for venous insufficiency. * Incorrect: B. 20–30 mmHg This range is used for mild conditions, not venous insufficiency. * Incorrect: D. 40–50 mmHg This range may be excessive for many patients.
Which device combines sequential compression with mobility to reduce edema? * A. Multi-layer bandage * B. Intermittent pneumatic compression pump * C. Short-stretch bandage * D. Toe wraps
- Correct: B. Intermittent pneumatic compression pump These pumps enhance venous return by sequentially compressing different sections. * Incorrect: A. Multi-layer bandage Bandages provide static compression, not sequential. * Incorrect: C. Short-stretch bandage These create high working pressure during movement but are not sequential. * Incorrect: D. Toe wraps These address localized compression but do not provide sequential compression.
What is the recommended compression for patients with mild lymphedema? * A. 15–20 mmHg * B. 20–30 mmHg * C. 30–40 mmHg * D. 40–50 mmHg
- Correct: B. 20–30 mmHg This range is appropriate for managing mild lymphedema. * Incorrect: A. 15–20 mmHg This range is typically used for prevention or minor swelling. * Incorrect: C. 30–40 mmHg This range is for moderate to severe conditions. * Incorrect: D. 40–50 mmHg This range is generally too high for mild lymphedema.
Which patient factor is most critical for ensuring compression therapy success? * A. BMI * B. Skin hydration * C. Compliance with wearing schedules * D. Age
- Correct: C. Compliance with wearing schedules Consistent use is essential for the effectiveness of compression therapy. * Incorrect: A. BMI BMI may affect selection but is not critical for success. * Incorrect: B. Skin hydration While important for comfort, hydration is secondary to compliance. * Incorrect: D. Age Age is not a direct determinant of success.
Which type of compression is most suitable for treating active venous ulcers with heavy exudate? * A. Elastic stockings * B. Multi-layer bandage system * C. Pneumatic compression pump * D. Long-stretch bandage
- Correct: B. Multi-layer bandage system Multi-layer systems provide effective compression and manage exudate with absorbent layers. * Incorrect: A. Elastic stockings Stockings are better suited for maintenance therapy. * Incorrect: C. Pneumatic compression pump Pumps are not first-line therapy for active ulcers. * Incorrect: D. Long-stretch bandage These lack sufficient working pressure for venous ulcers.
What is the primary function of short-stretch bandages in compression therapy? * A. Maintain consistent pressure at rest * B. Provide high working pressure during activity * C. Reduce arterial perfusion * D. Prevent muscle fatigue
- Correct: B. Provide high working pressure during activity Short-stretch bandages increase pressure during muscle contraction, enhancing venous return. * Incorrect: A. Maintain consistent pressure at rest They provide low resting pressure. * Incorrect: C. Reduce arterial perfusion Compression does not aim to reduce arterial perfusion. * Incorrect: D. Prevent muscle fatigue Muscle fatigue is not directly addressed by compression.
Which compression product is best for localized edema in toes or forefoot? * A. Elastic stockings * B. Toe wraps * C. Pneumatic compression pump * D. Multi-layer bandage system
- Correct: B. Toe wraps Toe wraps effectively target localized swelling in the toes or forefoot. * Incorrect: A. Elastic stockings Stockings provide general compression but may not address localized edema. * Incorrect: C. Pneumatic compression pump Pumps are not ideal for small, localized areas. * Incorrect: D. Multi-layer bandage system Multi-layer systems address larger areas, not localized edema.
What is the key mechanism of intermittent pneumatic compression (IPC) in managing lymphedema? * A. Reduces venous hypertension * B. Enhances lymphatic drainage * C. Increases arterial perfusion * D. Prevents muscle atrophy
- Correct: B. Enhances lymphatic drainage IPC stimulates lymphatic flow, reducing fluid accumulation in lymphedema. * Incorrect: A. Reduces venous hypertension IPC can reduce venous pressure, but its primary mechanism in lymphedema is lymphatic drainage. * Incorrect: C. Increases arterial perfusion IPC does not directly affect arterial flow. * Incorrect: D. Prevents muscle atrophy Muscle atrophy is unrelated to IPC use.
What is a contraindication for intermittent pneumatic compression? * A. Peripheral edema * B. DVT or thrombophlebitis * C. Post-surgical swelling * D. Chronic venous insufficiency
- Correct: B. DVT or thrombophlebitis IPC is contraindicated in active DVT or thrombophlebitis due to the risk of embolism. * Incorrect: A. Peripheral edema IPC is commonly used to manage edema. * Incorrect: C. Post-surgical swelling IPC is often beneficial in post-surgical edema management. * Incorrect: D. Chronic venous insufficiency IPC is an effective adjunct in managing venous insufficiency.
Which compression pressure is recommended for managing moderate lymphedema? * A. 10–20 mmHg * B. 20–30 mmHg * C. 30–40 mmHg * D. 40–50 mmHg
- Correct: C. 30–40 mmHg This range is effective for managing moderate lymphedema. * Incorrect: A. 10–20 mmHg This range is insufficient for moderate lymphedema. * Incorrect: B. 20–30 mmHg This range is used for mild lymphedema. * Incorrect: D. 40–50 mmHg This range may be excessive for moderate cases.
What is the purpose of graduated compression in venous insufficiency management? * A. Equalize pressure throughout the limb * B. Create a distal-to-proximal pressure gradient * C. Increase muscle contraction * D. Prevent arterial ischemia
- Correct: B. Create a distal-to-proximal pressure gradient Graduated compression improves venous return by increasing pressure distally and decreasing proximally. * Incorrect: A. Equalize pressure throughout the limb Compression is not equal across the limb. * Incorrect: C. Increase muscle contraction Compression indirectly supports muscle function but does not increase contraction. * Incorrect: D. Prevent arterial ischemia Compression does not address arterial issues.
Which material is commonly used in short-stretch bandages? * A. Zinc oxide * B. Elastic fibers * C. Cotton and non-elastic fibers * D. Silicone gel
- Correct: C. Cotton and non-elastic fibers Short-stretch bandages use materials that provide low stretch and high stiffness. * Incorrect: A. Zinc oxide Zinc oxide is used in Unna boots, not short-stretch bandages. * Incorrect: B. Elastic fibers Elastic fibers are characteristic of long-stretch bandages. * Incorrect: D. Silicone gel Silicone gel is used in scar management, not bandages.
What is the key difference between static and dynamic compression? * A. Static compression uses pumps * B. Dynamic compression adjusts pressure with movement * C. Static compression requires patient activity * D. Dynamic compression is contraindicated for venous ulcers
- Correct: B. Dynamic compression adjusts pressure with movement Dynamic compression, such as IPC, changes pressure during use, unlike static compression. * Incorrect: A. Static compression uses pumps Static compression does not involve pumps. * Incorrect: C. Static compression requires patient activity Static compression works regardless of activity level. * Incorrect: D. Dynamic compression is contraindicated for venous ulcers Dynamic compression is not contraindicated.
What is the typical lifespan of compression stockings before replacement is recommended? * A. 1 month * B. 3 months * C. 6 months * D. 12 months
- Correct: C. 6 months Compression stockings typically lose elasticity after 6 months and should be replaced. * Incorrect: A. 1 month One month is too short for typical stocking use. * Incorrect: B. 3 months Stockings usually last longer than 3 months. * Incorrect: D. 12 months Elasticity is often insufficient after 12 months.
Which compression therapy is most appropriate for managing acute edema after surgery? * A. Elastic stockings * B. Intermittent pneumatic compression * C. Hydrocolloid dressings * D. Short-stretch bandages
- Correct: B. Intermittent pneumatic compression IPC effectively reduces acute post-surgical edema. * Incorrect: A. Elastic stockings Stockings are for maintenance, not acute edema. * Incorrect: C. Hydrocolloid dressings These address wound moisture, not edema. * Incorrect: D. Short-stretch bandages Bandages are less effective for acute swelling compared to IPC.
What is the key consideration when selecting compression therapy for elderly patients? * A. High working pressure * B. Low resting pressure * C. Skin integrity and tolerance * D. High compression gradients
- Correct: C. Skin integrity and tolerance Elderly patients often have fragile skin, requiring careful selection of compression materials. * Incorrect: A. High working pressure High working pressure may not be well-tolerated by elderly patients. * Incorrect: B. Low resting pressure This is less critical than skin integrity. * Incorrect: D. High compression gradients Compression gradients should be adjusted based on patient needs, not age alone.
What is the primary function of the lymphatic system? * A. Transport oxygen to tissues * B. Remove interstitial fluid and transport immune cells * C. Regulate blood pressure * D. Maintain muscle tone
- Correct: B. Remove interstitial fluid and transport immune cells The lymphatic system manages fluid balance and immune responses. * Incorrect: A. Transport oxygen to tissues Oxygen transport is handled by the circulatory system. * Incorrect: C. Regulate blood pressure This is a function of the cardiovascular system. * Incorrect: D. Maintain muscle tone Muscle tone is unrelated to the lymphatic system.
What is the most common cause of secondary lymphedema worldwide? * A. Malignancy * B. Filariasis * C. Obesity * D. Trauma
- Correct: B. Filariasis Filariasis, a parasitic infection, is the leading cause of secondary lymphedema globally. * Incorrect: A. Malignancy Cancer is a leading cause in developed countries but not worldwide. * Incorrect: C. Obesity Obesity contributes to secondary lymphedema but is not the primary global cause. * Incorrect: D. Trauma Trauma is a potential cause but less common than filariasis.
Which structure is responsible for collecting lymph from the lower body? * A. Thoracic duct * B. Cisterna chyli * C. Axillary nodes * D. Right lymphatic duct
- Correct: B. Cisterna chyli The cisterna chyli collects lymph from the lower body and drains into the thoracic duct. * Incorrect: A. Thoracic duct The thoracic duct transports lymph to the venous system but does not collect from the lower body. * Incorrect: C. Axillary nodes These nodes manage lymph from the upper extremities and chest. * Incorrect: D. Right lymphatic duct This duct drains lymph from the right upper body, not the lower body.
Which condition is characterized by non-pitting edema and fibrosis in advanced stages? * A. Venous insufficiency * B. Lymphedema * C. Lipedema * D. Arterial insufficiency
- Correct: B. Lymphedema Advanced lymphedema causes non-pitting edema and fibrosis due to chronic lymph stasis. * Incorrect: A. Venous insufficiency Venous edema is typically pitting, not non-pitting. * Incorrect: C. Lipedema Lipedema involves fat deposition and is not characterized by fibrosis. * Incorrect: D. Arterial insufficiency Arterial insufficiency leads to ischemic symptoms, not lymphedema.
What is the hallmark characteristic of primary lymphedema? * A. Sudden onset after infection * B. Congenital or hereditary origin * C. Symmetric bilateral swelling * D. Associated with venous ulcers
- Correct: B. Congenital or hereditary origin Primary lymphedema is caused by congenital or hereditary lymphatic abnormalities. * Incorrect: A. Sudden onset after infection This is more indicative of secondary lymphedema. * Incorrect: C. Symmetric bilateral swelling Lymphedema is often asymmetric. * Incorrect: D. Associated with venous ulcers Venous ulcers are not a hallmark of primary lymphedema.
What is a common risk factor for secondary lymphedema? * A. Family history of edema * B. History of cancer treatment with lymph node dissection * C. Low BMI * D. Regular physical activity
- Correct: B. History of cancer treatment with lymph node dissection Lymph node dissection disrupts lymphatic pathways, increasing lymphedema risk. * Incorrect: A. Family history of edema This is more relevant to primary lymphedema. * Incorrect: C. Low BMI Obesity, not low BMI, is a risk factor. * Incorrect: D. Regular physical activity Physical activity is protective, not a risk factor.
Which test measures lymphatic insufficiency by assessing protein concentration in tissue fluid? * A. Stemmer’s sign * B. Bioimpedance spectroscopy * C. Fluoroscopy * D. Lymphoscintigraphy
- Correct: B. Bioimpedance spectroscopy This test evaluates tissue fluid composition to identify lymphatic insufficiency. * Incorrect: A. Stemmer’s sign This is a clinical test for skin thickening. * Incorrect: C. Fluoroscopy Fluoroscopy visualizes lymphatic anatomy but does not assess protein concentration. * Incorrect: D. Lymphoscintigraphy This imaging test assesses lymphatic flow, not fluid protein levels.
What is the clinical significance of a positive Stemmer’s sign? * A. Indicates arterial insufficiency * B. Suggests venous stasis * C. Confirms lymphedema * D. Diagnoses neuropathy
- Correct: C. Confirms lymphedema A positive Stemmer’s sign, indicated by inability to pinch the skin, is a reliable diagnostic sign of lymphedema. * Incorrect: A. Indicates arterial insufficiency Arterial insufficiency does not cause skin thickening. * Incorrect: B. Suggests venous stasis Venous stasis edema does not typically present with Stemmer’s sign. * Incorrect: D. Diagnoses neuropathy Neuropathy is unrelated to Stemmer’s sign.
Which stage of lymphedema is characterized by spontaneous reversibility with elevation? * A. Stage 0 * B. Stage 1 * C. Stage 2 * D. Stage 3
- Correct: B. Stage 1 In Stage 1 lymphedema, swelling is reversible with elevation and does not involve fibrosis. * Incorrect: A. Stage 0 Stage 0 involves latent lymphedema with no visible swelling. * Incorrect: C. Stage 2 Stage 2 involves irreversible swelling and fibrosis. * Incorrect: D. Stage 3 Stage 3 is the most advanced, with severe fibrosis and deformity.
What is the purpose of manual lymphatic drainage (MLD) in lymphedema management? * A. Break down fibrotic tissue * B. Increase lymphatic flow and reduce fluid buildup * C. Promote angiogenesis * D. Improve muscle strength
- Correct: B. Increase lymphatic flow and reduce fluid buildup MLD uses gentle techniques to stimulate lymphatic drainage and reduce edema. * Incorrect: A. Break down fibrotic tissue MLD does not directly address fibrosis. * Incorrect: C. Promote angiogenesis MLD focuses on lymphatic, not vascular, flow. * Incorrect: D. Improve muscle strength MLD does not target muscle function.
What is a contraindication for manual lymphatic drainage? * A. Mild edema * B. Active infection * C. Fibrosis * D. Venous insufficiency
- Correct: B. Active infection MLD is contraindicated in active infections to avoid spreading pathogens. * Incorrect: A. Mild edema MLD is effective for reducing mild edema. * Incorrect: C. Fibrosis MLD is not contraindicated for fibrosis. * Incorrect: D. Venous insufficiency MLD can complement venous insufficiency management.
Which compression class is recommended for managing moderate lymphedema? * A. Class I (15–20 mmHg) * B. Class II (20–30 mmHg) * C. Class III (30–40 mmHg) * D. Class IV (>40 mmHg)
- Correct: C. Class III (30–40 mmHg) This level provides adequate pressure for moderate lymphedema management. * Incorrect: A. Class I (15–20 mmHg) This is insufficient for moderate cases. * Incorrect: B. Class II (20–30 mmHg) This is appropriate for mild cases. * Incorrect: D. Class IV (>40 mmHg) This is used for severe or refractory cases.
Which exercise type is most beneficial for lymphedema management? * A. Isometric exercises * B. Resistance training * C. Aerobic exercise * D. Gentle, rhythmic movements
- Correct: D. Gentle, rhythmic movements Gentle exercises stimulate lymphatic flow and reduce fluid accumulation without increasing strain. * Incorrect: A. Isometric exercises Isometric exercises do not promote lymphatic flow effectively. * Incorrect: B. Resistance training Resistance training can be used cautiously but is less beneficial than gentle movements. * Incorrect: C. Aerobic exercise Aerobic exercise benefits overall health but is less targeted for lymphedema.
What is the primary purpose of compression bandaging in lymphedema management? * A. Increase arterial blood flow * B. Promote lymphatic return and prevent fluid reaccumulation * C. Improve skin elasticity * D. Reduce muscle fatigue
- Correct: B. Promote lymphatic return and prevent fluid reaccumulation Compression reduces edema by promoting lymphatic drainage and preventing fluid accumulation. * Incorrect: A. Increase arterial blood flow Compression targets the lymphatic system, not arterial flow. * Incorrect: C. Improve skin elasticity Skin elasticity is not directly improved by compression. * Incorrect: D. Reduce muscle fatigue Compression does not address muscle fatigue.
Which stage of lymphedema is characterized by irreversible swelling and fibrosis? * A. Stage 0 * B. Stage 1 * C. Stage 2 * D. Stage 3
- Correct: C. Stage 2 Stage 2 lymphedema involves irreversible swelling and the onset of fibrosis. * Incorrect: A. Stage 0 This stage involves latent lymphedema with no visible symptoms. * Incorrect: B. Stage 1 Swelling is still reversible in Stage 1. * Incorrect: D. Stage 3 Stage 3 is the most advanced, with severe fibrosis and deformity.
What is the significance of a negative Stemmer’s sign in lymphedema assessment? * A. Confirms early-stage lymphedema * B. Suggests another cause of swelling * C. Indicates venous insufficiency * D. Confirms primary lymphedema
- Correct: B. Suggests another cause of swelling A negative Stemmer’s sign suggests that swelling may not be due to lymphedema. * Incorrect: A. Confirms early-stage lymphedema A positive, not negative, Stemmer’s sign supports lymphedema diagnosis. * Incorrect: C. Indicates venous insufficiency Venous insufficiency does not correlate directly with Stemmer’s sign. * Incorrect: D. Confirms primary lymphedema A positive Stemmer’s sign is indicative, not negative.
Which type of lymphedema is most commonly associated with obesity? * A. Congenital lymphedema * B. Secondary lymphedema * C. Primary lymphedema tarda * D. Idiopathic lymphedema
- Correct: B. Secondary lymphedema Obesity is a common risk factor for secondary lymphedema due to mechanical compression and inflammation. * Incorrect: A. Congenital lymphedema This occurs due to genetic abnormalities, unrelated to obesity. * Incorrect: C. Primary lymphedema tarda This develops later in life but is not specifically linked to obesity. * Incorrect: D. Idiopathic lymphedema Idiopathic cases have no identifiable cause.
What is a primary benefit of aquatic exercise for patients with lymphedema? * A. Increased resistance for muscle strengthening * B. Reduced gravity effects aiding lymphatic flow * C. Improved cardiovascular endurance * D. Enhanced joint mobility
- Correct: B. Reduced gravity effects aiding lymphatic flow Water immersion supports lymphatic flow by reducing gravitational forces and providing gentle compression. * Incorrect: A. Increased resistance for muscle strengthening Resistance training is not the primary benefit for lymphedema. * Incorrect: C. Improved cardiovascular endurance Cardiovascular benefits are secondary. * Incorrect: D. Enhanced joint mobility Joint mobility is not specific to lymphedema.
Which manual therapy technique is contraindicated in patients with cardiac edema? * A. Effleurage * B. Manual lymphatic drainage (MLD) * C. Petrissage * D. Trigger point therapy
- Correct: B. Manual lymphatic drainage (MLD) MLD is contraindicated in cardiac edema as it may exacerbate fluid overload. * Incorrect: A. Effleurage Effleurage does not specifically target the lymphatic system. * Incorrect: C. Petrissage Petrissage focuses on muscle manipulation, not lymphatics. * Incorrect: D. Trigger point therapy This is unrelated to lymphatic drainage.
What is the purpose of multilayer compression bandaging in lymphedema management? * A. Provide uniform compression * B. Maintain low resting pressure * C. Deliver graduated compression for lymphatic flow * D. Improve arterial circulation
- Correct: C. Deliver graduated compression for lymphatic flow Multilayer bandages provide a pressure gradient to promote lymphatic drainage. * Incorrect: A. Provide uniform compression Compression is graduated, not uniform. * Incorrect: B. Maintain low resting pressure Resting pressure varies based on the bandage system. * Incorrect: D. Improve arterial circulation The focus is on lymphatic flow, not arterial circulation.
What is the recommended daily duration for wearing compression garments in lymphedema? * A. 6 hours * B. 8 hours * C. 12–16 hours * D. 20–24 hours
- Correct: C. 12–16 hours Compression garments should be worn during waking hours to manage lymphedema effectively. * Incorrect: A. 6 hours This is insufficient for therapeutic outcomes. * Incorrect: B. 8 hours Eight hours may not provide optimal results. * Incorrect: D. 20–24 hours Continuous wear, including sleep, is typically unnecessary.
What distinguishes lymphedema from lipedema? * A. Lymphedema involves symmetrical swelling * B. Lipedema spares the hands and feet * C. Lymphedema is triggered by trauma * D. Lipedema leads to fibrosis
- Correct: B. Lipedema spares the hands and feet Lipedema affects the lower body but spares the extremities, unlike lymphedema. * Incorrect: A. Lymphedema involves symmetrical swelling Lymphedema is often asymmetrical. * Incorrect: C. Lymphedema is triggered by trauma This can apply to secondary lymphedema but is not diagnostic. * Incorrect: D. Lipedema leads to fibrosis Fibrosis is more characteristic of advanced lymphedema.
Which imaging modality is most effective for assessing lymphatic system abnormalities? * A. X-ray * B. MRI * C. Lymphoscintigraphy * D. Ultrasound
- Correct: C. Lymphoscintigraphy Lymphoscintigraphy provides detailed imaging of lymphatic flow and blockages. * Incorrect: A. X-ray X-rays do not visualize the lymphatic system. * Incorrect: B. MRI MRI may show tissue edema but lacks specificity for lymphatics. * Incorrect: D. Ultrasound Ultrasound evaluates fluid accumulation but not lymphatic pathways.
What is a common early symptom of lymphedema? * A. Painful swelling * B. Skin fibrosis * C. Feeling of heaviness in the limb * D. Visible discoloration
- Correct: C. Feeling of heaviness in the limb Heaviness and tightness are early symptoms of lymphedema. * Incorrect: A. Painful swelling Lymphedema is typically painless in early stages. * Incorrect: B. Skin fibrosis Fibrosis occurs in advanced stages. * Incorrect: D. Visible discoloration Discoloration is not an early symptom.
What is the most common cause of thermal burns? * A. Open flames * B. Chemicals * C. Electricity * D. Radiation
- Correct: A. Open flames Open flames are the leading cause of thermal burns. * Incorrect: B. Chemicals Chemical burns are less common than thermal burns. * Incorrect: C. Electricity Electrical burns are rare and specific to occupational or accidental exposure. * Incorrect: D. Radiation Radiation burns are uncommon in general populations.
Which burn classification involves damage to the epidermis and dermis with blister formation? * A. Superficial * B. Superficial partial-thickness * C. Deep partial-thickness * D. Full-thickness
- Correct: B. Superficial partial-thickness This type of burn affects the epidermis and dermis, resulting in blisters. * Incorrect: A. Superficial Superficial burns only involve the epidermis. * Incorrect: C. Deep partial-thickness These burns damage deeper dermal layers and may not form blisters. * Incorrect: D. Full-thickness Full-thickness burns extend through the dermis into subcutaneous tissue.
What is the primary method used to estimate burn size in adults? * A. Lund-Browder chart * B. Rule of Nines * C. Palmar method * D. Parkland formula
- Correct: B. Rule of Nines The Rule of Nines is a quick method to estimate burn size in adults. * Incorrect: A. Lund-Browder chart This is more detailed and used primarily for children. * Incorrect: C. Palmar method The Palmar method estimates small burns using the patient’s palm size. * Incorrect: D. Parkland formula This is used for fluid resuscitation, not burn size estimation.
Which zone in the pathophysiology of a burn is most likely to recover? * A. Zone of coagulation * B. Zone of stasis * C. Zone of hyperemia * D. Zone of necrosis
- Correct: C. Zone of hyperemia The zone of hyperemia typically recovers due to adequate blood supply. * Incorrect: A. Zone of coagulation This zone is irreversibly damaged. * Incorrect: B. Zone of stasis This zone is at risk of further damage without intervention. * Incorrect: D. Zone of necrosis Necrosis is not a term used in burn zones.
What is the hallmark characteristic of an electrical burn? * A. Blister formation * B. Entry and exit wounds * C. Charring of skin * D. Radiation effects
- Correct: B. Entry and exit wounds Electrical burns typically present with distinct entry and exit points. * Incorrect: A. Blister formation Blisters are more characteristic of superficial partial-thickness burns. * Incorrect: C. Charring of skin Charring may occur but is not specific to electrical burns. * Incorrect: D. Radiation effects Radiation effects are unrelated to electrical burns.
Which layer is affected in a full-thickness burn? * A. Epidermis only * B. Epidermis and dermis * C. Dermis and subcutaneous tissue * D. Epidermis, dermis, and deeper structures
- Correct: D. Epidermis, dermis, and deeper structures Full-thickness burns extend through the skin into underlying tissues. * Incorrect: A. Epidermis only This describes superficial burns. * Incorrect: B. Epidermis and dermis Partial-thickness burns involve these layers. * Incorrect: C. Dermis and subcutaneous tissue This description is incomplete for full-thickness burns.
What is the purpose of the Parkland formula in burn management? * A. Estimate burn size * B. Calculate fluid resuscitation needs * C. Assess infection risk * D. Determine grafting requirements
- Correct: B. Calculate fluid resuscitation needs The Parkland formula calculates the volume of fluids needed for initial resuscitation. * Incorrect: A. Estimate burn size Burn size is estimated using methods like the Rule of Nines. * Incorrect: C. Assess infection risk The formula does not evaluate infection. * Incorrect: D. Determine grafting requirements Grafting decisions are based on wound depth and size.
Which type of topical agent is commonly used to prevent infection in burn wounds? * A. Bacitracin * B. Mupirocin * C. Silver sulfadiazine * D. Hydrocortisone
- Correct: C. Silver sulfadiazine This agent is widely used for its antimicrobial properties in burn care. * Incorrect: A. Bacitracin Bacitracin is effective for minor wounds but not first-line for burns. * Incorrect: B. Mupirocin Mupirocin targets specific infections, not general burn care. * Incorrect: D. Hydrocortisone This is an anti-inflammatory, not an antimicrobial.
What is the primary complication associated with circumferential burns? * A. Increased infection risk * B. Restricted blood flow and compartment syndrome * C. Reduced immune response * D. Delayed healing time
- Correct: B. Restricted blood flow and compartment syndrome Circumferential burns can constrict blood flow, leading to compartment syndrome. * Incorrect: A. Increased infection risk This is a complication of all burns, not specific to circumferential burns. * Incorrect: C. Reduced immune response Immune effects are systemic, not specific to circumferential burns. * Incorrect: D. Delayed healing time Delayed healing is a general burn concern.
What intervention is indicated for eschar restricting chest expansion in burn patients? * A. Skin grafting * B. Escharotomy * C. Wound debridement * D. Negative pressure wound therapy
- Correct: B. Escharotomy Escharotomy relieves pressure and restores chest expansion. * Incorrect: A. Skin grafting Grafting is a later-stage intervention. * Incorrect: C. Wound debridement Debridement removes necrotic tissue but does not relieve pressure. * Incorrect: D. Negative pressure wound therapy This is not used for acute restriction relief.
Which burn classification requires grafting for wound closure? * A. Superficial burns * B. Partial-thickness burns * C. Deep partial-thickness burns * D. Full-thickness burns
- Correct: D. Full-thickness burns Grafting is often required for full-thickness burns due to the loss of all skin layers. * Incorrect: A. Superficial burns These heal without intervention. * Incorrect: B. Partial-thickness burns Partial-thickness burns typically heal with conservative care. * Incorrect: C. Deep partial-thickness burns These may require grafting but not always.
Which scar management strategy involves pressure garments? * A. Reduce pain * B. Prevent contractures * C. Minimize hypertrophic scarring * D. Promote moisture retention
- Correct: C. Minimize hypertrophic scarring Pressure garments help remodel collagen and reduce scarring. * Incorrect: A. Reduce pain Pain management involves other modalities. * Incorrect: B. Prevent contractures ROM exercises and splints address contractures. * Incorrect: D. Promote moisture retention Pressure garments do not impact moisture.
What is the typical healing time for superficial partial-thickness burns? * A. 2–5 days * B. 7–21 days * C. 3–4 weeks * D. More than 4 weeks
- Correct: B. 7–21 days Superficial partial-thickness burns heal within this time frame. * Incorrect: A. 2–5 days This time frame is too short for superficial partial-thickness burns. * Incorrect: C. 3–4 weeks This applies to deeper burns. * Incorrect: D. More than 4 weeks This is typical of chronic wounds, not superficial partial-thickness burns.
What is the primary concern with chemical burns? * A. Heat damage * B. Ongoing tissue destruction * C. Pain management * D. Risk of infection
- Correct: B. Ongoing tissue destruction Chemical burns continue to damage tissue until the chemical is neutralized. * Incorrect: A. Heat damage Heat is unrelated to chemical burns. * **Incorrect:
Which method is most appropriate for estimating burn size in children? * A. Rule of Nines * B. Palmar method * C. Lund-Browder chart * D. Parkland formula
- Correct: C. Lund-Browder chart This method accounts for differences in body proportions in children. * Incorrect: A. Rule of Nines This is less accurate in children due to their body proportion differences. * Incorrect: B. Palmar method This is used for small, localized burns. * Incorrect: D. Parkland formula This calculates fluid resuscitation needs, not burn size.
What is the first step in treating chemical burns? * A. Apply a topical antibiotic * B. Irrigate with copious amounts of water * C. Cover the burn with a sterile dressing * D. Neutralize the chemical with an antidote
- Correct: B. Irrigate with copious amounts of water Immediate irrigation dilutes and removes the chemical, minimizing tissue damage. * Incorrect: A. Apply a topical antibiotic This is not the first step in chemical burn management. * Incorrect: C. Cover the burn with a sterile dressing This follows irrigation. * Incorrect: D. Neutralize the chemical with an antidote Neutralization is rarely recommended due to risks.
Which burn depth is characterized by white, leathery skin with no sensation? * A. Superficial partial-thickness * B. Deep partial-thickness * C. Full-thickness * D. Subdermal
- Correct: C. Full-thickness Full-thickness burns destroy nerve endings, resulting in white, leathery, insensate skin. * Incorrect: A. Superficial partial-thickness These burns retain sensation and are pink with blisters. * Incorrect: B. Deep partial-thickness These burns may be red or white and still have some sensation. * Incorrect: D. Subdermal Subdermal burns involve underlying structures like muscle or bone.
What is the most reliable indicator of adequate fluid resuscitation in burn patients? * A. Blood pressure * B. Heart rate * C. Urine output * D. Skin turgor
- Correct: C. Urine output Monitoring urine output ensures sufficient perfusion and fluid balance. * Incorrect: A. Blood pressure Blood pressure can be misleading in early burn shock. * Incorrect: B. Heart rate Tachycardia may persist despite adequate resuscitation. * Incorrect: D. Skin turgor This is a less specific indicator of fluid status.
Which type of graft is sourced from the patient’s own skin? * A. Allograft * B. Xenograft * C. Autograft * D. Synthetic graft
- Correct: C. Autograft Autografts use the patient’s skin and are ideal for permanent coverage. * Incorrect: A. Allograft Allografts are temporary grafts from human donors. * Incorrect: B. Xenograft Xenografts are temporary grafts from animal sources. * Incorrect: D. Synthetic graft Synthetic grafts are man-made materials for temporary use.
What is the primary purpose of escharotomy in burn patients? * A. Remove necrotic tissue * B. Prevent infection * C. Relieve pressure and restore circulation * D. Prepare for skin grafting
- Correct: C. Relieve pressure and restore circulation Escharotomy is performed to relieve pressure from circumferential burns and prevent ischemia. * Incorrect: A. Remove necrotic tissue Debridement addresses necrotic tissue, not escharotomy. * Incorrect: B. Prevent infection While beneficial, this is not the primary goal of escharotomy. * Incorrect: D. Prepare for skin grafting Escharotomy is not directly related to graft preparation.
Which type of burn is most likely to require an escharotomy? * A. Superficial burns * B. Partial-thickness burns * C. Full-thickness circumferential burns * D. Electrical burns
- Correct: C. Full-thickness circumferential burns These burns can restrict circulation, necessitating escharotomy. * Incorrect: A. Superficial burns These do not penetrate deeply enough to cause pressure complications. * Incorrect: B. Partial-thickness burns These are less likely to require escharotomy. * Incorrect: D. Electrical burns These may require escharotomy but not as commonly as circumferential full-thickness burns.
Which systemic effect is common in severe burn injuries? * A. Hypervolemia * B. Hypometabolism * C. Hypermetabolism * D. Hyperthermia
- Correct: C. Hypermetabolism Severe burns trigger a hypermetabolic state to support healing and energy needs. * Incorrect: A. Hypervolemia Hypovolemia is common due to fluid loss. * Incorrect: B. Hypometabolism The opposite, hypermetabolism, occurs. * Incorrect: D. Hyperthermia Hyperthermia is not a direct systemic effect of burns.
What intervention reduces the risk of joint contractures in burn patients? * A. Immobilization * B. Pressure garments * C. Range of motion exercises * D. Topical antibiotics
- Correct: C. Range of motion exercises Regular ROM exercises prevent joint contractures in burn patients. * Incorrect: A. Immobilization Prolonged immobilization increases the risk of contractures. * Incorrect: B. Pressure garments Pressure garments minimize scarring but do not prevent contractures. * Incorrect: D. Topical antibiotics These address infection but do not impact contracture prevention.
Which complication is most associated with inhalation injuries in burn patients? * A. Pneumothorax * B. Respiratory distress * C. Pleural effusion * D. Pulmonary fibrosis
- Correct: B. Respiratory distress Inhalation injuries can cause airway edema and respiratory distress. * Incorrect: A. Pneumothorax This is unrelated to inhalation injuries. * Incorrect: C. Pleural effusion Pleural effusion is not commonly associated with burns. * Incorrect: D. Pulmonary fibrosis Fibrosis is a chronic, not acute, condition.
Which intervention helps reduce the risk of hypertrophic scarring in burn patients? * A. Daily wound debridement * B. Pressure garment use * C. Skin grafting * D. ROM exercises
- Correct: B. Pressure garment use Pressure garments help remodel collagen and minimize hypertrophic scarring. * Incorrect: A. Daily wound debridement Debridement prevents infection but does not directly reduce scarring. * Incorrect: C. Skin grafting Grafting covers wounds but does not prevent hypertrophic scarring. * Incorrect: D. ROM exercises ROM prevents contractures but does not directly reduce scarring.
What is a characteristic sign of superficial burns? * A. Blister formation * B. Dry, red skin without blisters * C. Leathery, white appearance * D. Absence of pain
- Correct: B. Dry, red skin without blisters Superficial burns cause redness and dry skin without blistering. * Incorrect: A. Blister formation This occurs in superficial partial-thickness burns. * Incorrect: C. Leathery, white appearance This is characteristic of full-thickness burns. * Incorrect: D. Absence of pain Pain is present in superficial burns.
Which method prevents wound desiccation during burn care? * A. Applying antimicrobial creams * B. Using occlusive dressings * C. Frequent dressing changes * D. Administering systemic antibiotics
- Correct: B. Using occlusive dressings Occlusive dressings retain moisture and prevent wound desiccation. * Incorrect: A. Applying antimicrobial creams These prevent infection but do not retain moisture. * Incorrect: C. Frequent dressing changes Frequent changes can increase desiccation. * Incorrect: D. Administering systemic antibiotics These address systemic infection but do not impact wound moisture.
What is the defining characteristic of a skin tear? * A. Complete loss of skin layers * B. Separation of epidermis from dermis * C. Deep wound extending to muscle * D. Irregular wound with necrotic tissue
- Correct: B. Separation of epidermis from dermis Skin tears occur when the epidermis separates from the dermis, often due to friction or shear forces. * Incorrect: A. Complete loss of skin layers This describes full-thickness wounds. * Incorrect: C. Deep wound extending to muscle This is not characteristic of a skin tear. * Incorrect: D. Irregular wound with necrotic tissue Necrosis is not typical of skin tears.
Which classification system is used to categorize skin tears? * A. CEAP * B. Payne-Martin * C. Wagner * D. Braden Scale
- Correct: B. Payne-Martin This system categorizes skin tears based on the extent of tissue damage. * Incorrect: A. CEAP CEAP is used for venous disorders. * Incorrect: C. Wagner Wagner classification is for diabetic foot ulcers. * Incorrect: D. Braden Scale Braden assesses pressure ulcer risk, not skin tears.
What is the primary management goal for animal bite wounds? * A. Immediate closure with sutures * B. Prevent infection through debridement and cleaning * C. Use occlusive dressings * D. Apply compression therapy
- Correct: B. Prevent infection through debridement and cleaning Animal bites are prone to infection and require thorough cleaning and debridement. * Incorrect: A. Immediate closure with sutures Immediate closure is often avoided due to infection risk. * Incorrect: C. Use occlusive dressings Occlusive dressings may trap bacteria. * Incorrect: D. Apply compression therapy Compression is not appropriate for bite wounds.
Which spider bite is associated with a necrotic wound and systemic symptoms? * A. Black Widow * B. Brown Recluse * C. Tarantula * D. Hobo Spider
- Correct: B. Brown Recluse Brown Recluse bites can cause necrotic wounds and systemic effects such as fever and malaise. * Incorrect: A. Black Widow Black Widow bites cause neurological symptoms, not necrosis. * Incorrect: C. Tarantula Tarantula bites are typically not medically significant. * Incorrect: D. Hobo Spider Hobo Spider bites are controversial in causing necrosis.
What is the appropriate first-line treatment for frostbite? * A. Debridement of necrotic tissue * B. Rapid rewarming in warm water * C. Applying topical antibiotics * D. Immersion in ice water
- Correct: B. Rapid rewarming in warm water Warm water immersion restores blood flow and minimizes tissue damage. * Incorrect: A. Debridement of necrotic tissue This is not the first-line treatment. * Incorrect: C. Applying topical antibiotics Antibiotics are secondary to rewarming. * Incorrect: D. Immersion in ice water Ice water worsens frostbite damage.
What is the hallmark feature of wound dehiscence? * A. Erythema and swelling * B. Separation of surgical wound edges * C. Presence of exudate * D. Formation of granulation tissue
- Correct: B. Separation of surgical wound edges Dehiscence occurs when surgical wound edges separate before healing is complete. * Incorrect: A. Erythema and swelling These are signs of inflammation, not dehiscence. * Incorrect: C. Presence of exudate Exudate may accompany dehiscence but is not its hallmark. * Incorrect: D. Formation of granulation tissue Granulation tissue is a sign of healing, not dehiscence.
What is the primary indication for flap surgery in wound management? * A. Addressing minor skin tears * B. Covering large wounds with poor vascular supply * C. Treating superficial abrasions * D. Preventing hypertrophic scars
- Correct: B. Covering large wounds with poor vascular supply Flaps are used to provide vascularized tissue to large or poorly healing wounds. * Incorrect: A. Addressing minor skin tears Skin tears do not typically require flaps. * Incorrect: C. Treating superficial abrasions Abrasions heal without flaps. * Incorrect: D. Preventing hypertrophic scars Scar prevention is not the primary purpose of flaps.
What is the primary goal of residual limb shaping after amputation? * A. Promote rapid healing * B. Prepare the limb for prosthetic fitting * C. Prevent infection * D. Reduce phantom limb pain
- Correct: B. Prepare the limb for prosthetic fitting Shaping ensures optimal prosthetic fit and function. * Incorrect: A. Promote rapid healing Shaping indirectly aids healing but is not its primary goal. * Incorrect: C. Prevent infection Infection prevention involves other interventions. * Incorrect: D. Reduce phantom limb pain Shaping does not address phantom limb pain directly.
Which surgical wound classification carries the highest risk of infection? * A. Clean * B. Clean-contaminated * C. Contaminated * D. Dirty or infected
- Correct: D. Dirty or infected These wounds are associated with active infection or necrotic tissue, posing the highest infection risk. * Incorrect: A. Clean Clean wounds have minimal infection risk. * Incorrect: B. Clean-contaminated These carry moderate infection risk. * Incorrect: C. Contaminated Contaminated wounds have a higher risk but not as much as dirty wounds.
What is the primary intervention for a deep abscess? * A. Systemic antibiotics * B. Drainage and debridement * C. Application of topical antiseptics * D. Compression therapy
- Correct: B. Drainage and debridement Abscesses require drainage to remove pus and prevent further infection. * Incorrect: A. Systemic antibiotics Antibiotics are supportive but do not address the abscess directly. * Incorrect: C. Application of topical antiseptics Antiseptics are insufficient for deep abscesses. * Incorrect: D. Compression therapy Compression is not used for abscess management.
Which wound is most likely to develop necrotizing fasciitis if untreated? * A. Puncture wound * B. Abrasion * C. Skin tear * D. Superficial burn
- Correct: A. Puncture wound Deep puncture wounds can introduce bacteria into fascia, increasing the risk of necrotizing fasciitis. * Incorrect: B. Abrasion Abrasions are superficial and less likely to lead to this condition. * Incorrect: C. Skin tear Skin tears are unlikely to develop necrotizing fasciitis. * Incorrect: D. Superficial burn These rarely progress to necrotizing fasciitis.
What is the purpose of a negative pressure wound therapy (NPWT) system? * A. Provide high-pressure irrigation * B. Promote wound healing by reducing edema and enhancing perfusion * C. Prevent scar tissue formation * D. Improve nerve regeneration
- Correct: B. Promote wound healing by reducing edema and enhancing perfusion NPWT creates a vacuum that enhances healing by improving blood flow and reducing fluid buildup. * Incorrect: A. Provide high-pressure irrigation NPWT does not irrigate wounds. * Incorrect: C. Prevent scar tissue formation While helpful for healing, it does not prevent scarring. * Incorrect: D. Improve nerve regeneration NPWT does not directly impact nerves.
What is the primary concern with human bite wounds? * A. Delayed healing * B. High infection risk * C. Severe tissue necrosis * D. Excessive scarring
- Correct: B. High infection risk Human bites carry a significant infection risk due to oral bacteria. * Incorrect: A. Delayed healing Healing can be delayed, but infection risk is the primary concern. * Incorrect: C. Severe tissue necrosis Necrosis is less common than infection. * Incorrect: D. Excessive scarring Scarring is not the primary concern with human bites.
Which intervention is critical for managing necrotic tissue in traumatic wounds? * A. Topical antibiotics * B. Autolytic debridement * C. Surgical debridement * D. Compression therapy
- Correct: C. Surgical debridement Surgical debridement is essential for removing necrotic tissue to prevent infection and promote healing. * Incorrect: A. Topical antibiotics While antibiotics may help prevent infection, they do not remove necrotic tissue. * Incorrect: B. Autolytic debridement Autolytic debridement is slower and less effective for extensive necrosis. * Incorrect: D. Compression therapy Compression does not address necrotic tissue.
What is the recommended intervention for controlling bleeding in a traumatic wound? * A. Apply pressure and elevate the wound * B. Use compression therapy * C. Irrigate with saline * D. Apply a tourniquet immediately
- Correct: A. Apply pressure and elevate the wound Direct pressure and elevation help control bleeding effectively. * Incorrect: B. Use compression therapy Compression is for edema management, not acute bleeding. * Incorrect: C. Irrigate with saline Irrigation is secondary to stopping the bleeding. * Incorrect: D. Apply a tourniquet immediately Tourniquets are a last resort.
What is the primary goal of wound irrigation? * A. Hydrate dry tissue * B. Remove debris and reduce bacterial load * C. Prevent granulation tissue formation * D. Increase vascular perfusion
- Correct: B. Remove debris and reduce bacterial load Irrigation cleanses the wound and decreases the risk of infection. * Incorrect: A. Hydrate dry tissue This is not the primary purpose of irrigation. * Incorrect: C. Prevent granulation tissue formation Granulation tissue is desirable in wound healing. * Incorrect: D. Increase vascular perfusion Irrigation does not affect perfusion.
Which type of wound is most likely to require prophylactic antibiotics? * A. Clean surgical wound * B. Contaminated traumatic wound * C. Closed laceration * D. Superficial abrasion
- Correct: B. Contaminated traumatic wound Contaminated wounds have a high infection risk, warranting prophylactic antibiotics. * Incorrect: A. Clean surgical wound These wounds have a low infection risk. * Incorrect: C. Closed laceration Closed wounds generally do not require antibiotics. * Incorrect: D. Superficial abrasion Abrasions rarely require antibiotics.
What is the primary intervention for a puncture wound caused by a rusty nail? * A. Apply a pressure dressing * B. Administer a tetanus booster * C. Perform immediate suturing * D. Apply negative pressure therapy
- Correct: B. Administer a tetanus booster Tetanus prophylaxis is critical for puncture wounds with potential contamination. * Incorrect: A. Apply a pressure dressing Pressure dressings are unnecessary for puncture wounds. * Incorrect: C. Perform immediate suturing Puncture wounds are typically left open to prevent infection. * Incorrect: D. Apply negative pressure therapy NPWT is not appropriate for puncture wounds.
What is the clinical significance of tunneling in traumatic wounds? * A. Indicates granulation tissue formation * B. Suggests underlying infection or tissue loss * C. Improves wound healing time * D. Reduces the need for debridement
- Correct: B. Suggests underlying infection or tissue loss Tunneling may indicate hidden damage or infection, requiring thorough assessment. * Incorrect: A. Indicates granulation tissue formation Tunneling does not correlate with granulation tissue. * Incorrect: C. Improves wound healing time Tunneling complicates wound healing. * Incorrect: D. Reduces the need for debridement Tunneling often necessitates additional debridement.
What is the most effective way to manage biofilm in a chronic wound? * A. Frequent dressing changes * B. Sharp debridement * C. Application of silver dressings * D. Use of systemic antibiotics
- Correct: B. Sharp debridement Debridement physically disrupts biofilm and improves wound healing. * Incorrect: A. Frequent dressing changes Dressing changes alone do not remove biofilm. * Incorrect: C. Application of silver dressings Antimicrobial dressings help prevent biofilm formation but do not eliminate established biofilm. * Incorrect: D. Use of systemic antibiotics Antibiotics have limited effectiveness against biofilm.
Which flap type is commonly used for reconstructing pressure ulcers? * A. Pedicle flap * B. Free flap * C. Rotational flap * D. Z-plasty
- Correct: C. Rotational flap Rotational flaps provide coverage and vascular supply for pressure ulcer reconstruction. * Incorrect: A. Pedicle flap Pedicle flaps are less commonly used for pressure ulcers. * Incorrect: B. Free flap Free flaps are more complex and used for extensive defects. * Incorrect: D. Z-plasty Z-plasty is for scar revision, not pressure ulcers.
What is the key consideration when treating a wound with exposed bone? * A. Apply a dry gauze dressing * B. Ensure moist wound healing with hydrogel or NPWT * C. Use compression bandages * D. Avoid debridement
- Correct: B. Ensure moist wound healing with hydrogel or NPWT Moisture promotes healing and protects exposed bone. * Incorrect: A. Apply a dry gauze dressing Dry dressings may delay healing and increase infection risk. * Incorrect: C. Use compression bandages Compression is not appropriate for exposed bone wounds. * Incorrect: D. Avoid debridement Debridement may still be necessary to remove necrotic tissue.
Which type of wound debridement involves the use of enzymatic agents? * A. Sharp debridement * B. Autolytic debridement * C. Enzymatic debridement * D. Mechanical debridement
- Correct: C. Enzymatic debridement Enzymatic agents break down necrotic tissue selectively. * Incorrect: A. Sharp debridement This uses surgical tools, not chemicals. * Incorrect: B. Autolytic debridement Autolysis relies on the body’s natural enzymes. * Incorrect: D. Mechanical debridement Mechanical methods include wet-to-dry dressings or irrigation.
What is the primary indication for wet-to-dry dressings? * A. Promote granulation tissue growth * B. Remove necrotic tissue * C. Increase wound hydration * D. Reduce bacterial load
- Correct: B. Remove necrotic tissue Wet-to-dry dressings mechanically debride necrotic tissue when removed. * Incorrect: A. Promote granulation tissue growth These dressings are not designed to support granulation tissue. * Incorrect: C. Increase wound hydration They often dry out wounds rather than hydrate them. * Incorrect: D. Reduce bacterial load They are not primarily antimicrobial.
What is the first priority when managing a traumatic wound with active bleeding? * A. Clean the wound * B. Control the bleeding * C. Apply a sterile dressing * D. Assess for infection
- Correct: B. Control the bleeding Bleeding control takes precedence to stabilize the patient. * Incorrect: A. Clean the wound Cleaning follows bleeding control. * Incorrect: C. Apply a sterile dressing Dressings are secondary to hemostasis. * Incorrect: D. Assess for infection Infection assessment occurs after bleeding is managed.
Which type of traumatic wound is most likely to result from a high-energy impact? * A. Abrasion * B. Laceration * C. Avulsion * D. Puncture wound
- Correct: C. Avulsion Avulsion wounds occur when high-energy forces tear tissue away from underlying structures. * Incorrect: A. Abrasion Abrasions are caused by friction. * Incorrect: B. Laceration Lacerations result from sharp objects. * Incorrect: D. Puncture wound Puncture wounds are caused by narrow, pointed objects.
What is the role of occlusive dressings in surgical wound management? * A. Maintain moisture and promote autolytic debridement * B. Provide compression to reduce edema * C. Deliver topical antibiotics * D. Absorb heavy exudate
- Correct: A. Maintain moisture and promote autolytic debridement Occlusive dressings support moist wound healing and autolysis. * Incorrect: B. Provide compression to reduce edema Compression dressings are not occlusive. * Incorrect: C. Deliver topical antibiotics Occlusive dressings do not deliver medications directly. * Incorrect: D. Absorb heavy exudate They are less effective for highly exudative wounds.
