NPTE-PT Integumentary System and Wounds 2 — Questions and Answers
Question 1: A patient has a wound with 100% yellow slough covering the wound bed. Which debridement method is most appropriate when the patient has poor circulation and cannot tolerate sharp debridement?
- Enzymatic debridement (Correct answer)
- Sharp/surgical debridement
- Wet-to-dry dressing
- UV-C therapy
Correct answer: Enzymatic debridement
Enzymatic debridement uses topical agents (e.g., collagenase) to selectively dissolve necrotic tissue and is appropriate when sharp debridement is contraindicated.
Question 2: Which layer of the skin contains the Meissner's corpuscles and is responsible for most immune defense?
- Stratum corneum
- Stratum granulosum
- Dermis (Correct answer)
- Hypodermis
Correct answer: Dermis
The dermis houses mechanoreceptors such as Meissner's corpuscles, as well as immune cells, blood vessels, and collagen fibers.
Question 3: A PT is treating a patient with a venous insufficiency ulcer. Which characteristic finding is most consistent with this diagnosis?
- Pale, punched-out ulcer on the heel
- Shallow ulcer with irregular edges around the medial malleolus (Correct answer)
- Deep ulcer with undermining over a bony prominence
- Dry, gangrenous tissue on the toes
Correct answer: Shallow ulcer with irregular edges around the medial malleolus
Venous insufficiency ulcers classically appear as shallow, irregular wounds around the medial malleolus with surrounding hemosiderin staining and edema.
Question 4: A patient presents with a stage 2 pressure injury. What is the correct description of this injury?
- Intact skin with non-blanchable erythema
- Partial-thickness skin loss with a shallow open wound (Correct answer)
- Full-thickness skin loss with visible subcutaneous fat
- Full-thickness tissue loss with exposed bone or tendon
Correct answer: Partial-thickness skin loss with a shallow open wound
A stage 2 pressure injury involves partial-thickness loss of the dermis, presenting as a shallow open ulcer or an intact or ruptured seroma-filled blister.
Question 5: Which dressing type provides a moist wound environment, is self-adhesive, and is most appropriate for a clean stage 2 pressure injury with minimal exudate?
- Alginate dressing
- Hydrocolloid dressing (Correct answer)
- Wet-to-dry gauze
- Calcium alginate rope
Correct answer: Hydrocolloid dressing
Hydrocolloid dressings maintain a moist environment, are self-adhesive, and are ideal for low-exudate wounds such as stage 2 pressure injuries.
Question 6: A patient with diabetes has neuropathy and presents with a plantar forefoot ulcer. The wound is surrounded by callus and has no signs of infection. What is the first priority in management?
- Hyperbaric oxygen therapy
- Debridement of the surrounding callus and offloading (Correct answer)
- Wet-to-dry dressings twice daily
- Topical antibiotic ointment application
Correct answer: Debridement of the surrounding callus and offloading
Offloading pressure and debriding the callus (which concentrates stress) are the primary interventions for neuropathic diabetic foot ulcers.
Question 7: When assessing a wound using the RYB (Red-Yellow-Black) classification, which color indicates the presence of infection or fibrinous slough requiring cleaning?
- Red
- Yellow (Correct answer)
- Black
- Pink
Correct answer: Yellow
In the RYB system, yellow indicates the presence of fibrinous slough, purulent exudate, or infection that must be cleaned before healing can progress.
