Free National Board Certification Examination for the Certified Wound Specialist Physician Practice Questions

Sample Practice Questions

Try these 10 sample questions from the National Board Certification Examination for the Certified Wound Specialist Physician practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A superficial abrasion heals by replenishing epidermal cells. Which epidermal layer supplies the continually dividing cells that move toward the surface?

   1. A.Stratum corneum
   2. B.Stratum granulosum
   3. C.Stratum germinativumCorrect answer: C
   4. D.Stratum lucidum

   Explanation: NCI states, "The basal cells continually divide, and new cells constantly push older ones up toward the surface of the skin, where they are eventually shed." The basal layer, also called the stratum germinativum, supplies the replacement cells.

   Reference: SEER Training: Layers of the Skin — The Epidermis — The Basal Cell Layer

2. 2While obtaining a leg-ulcer history, a physician suspects arterial insufficiency. Which reported pain pattern most directly supports that concern?

   1. A.Discomfort that improves with leg elevation
   2. B.Itching associated with adhesive contact
   3. C.Pain provoked by raising the affected legCorrect answer: C
   4. D.Tenderness confined to dressing removal

   Explanation: The WHF consensus lists arterial symptoms including "pain when a lower extremity is elevated." This history supports ischemia rather than a dressing-related symptom.

   Reference: Chronic wounds: Treatment consensus — 3. Diagnosis, regional arterial contributors

3. 3An ischemic wound is covered by dry eschar without acute infection or wet gangrene. What should guide debridement timing?

   1. A.Remove the eschar sharply before restoring flow
   2. B.Liquefy the eschar before restoring flow
   3. C.Reestablish arterial flow before debriding the escharCorrect answer: C
   4. D.Abrade the eschar before restoring flow

   Explanation: WHS states these wounds "should not be debrided until patient’s arterial flow is reestablished" unless acute infection or wet gangrene ensues. None is present here.

   Reference: WHS Guidelines for the Treatment of Pressure Ulcers – 2023 update — Guideline 4.4, Principle

4. 4A patient with preserved foot pulses develops a thermal injury without feeling pain or excessive heat. Which neuropathic deficit most directly explains the unnoticed injury?

   1. A.Impaired voluntary motor strength
   2. B.Impaired pain and temperature sensationCorrect answer: B
   3. C.Impaired autonomic sweat regulation
   4. D.Impaired joint-position sensation

   Explanation: NIDDK states, "You may also have problems sensing pain or temperature" with peripheral neuropathy. Loss of these protective sensations allows injury without warning.

   Reference: NIDDK: Peripheral Neuropathy — What are the symptoms of peripheral neuropathy?

5. 5A wound physician at a HIPAA-covered practice receives a request for protected health information. Which purpose is exempt from HIPAA's minimum necessary standard?

   1. A.An insurer's payment review
   2. B.A health plan's utilization review
   3. C.Another healthcare provider's treatment of the patientCorrect answer: C
   4. D.A practice's administrative quality review

   Explanation: HHS lists "Disclosures to or requests by a health care provider for treatment purposes" as an exception. Payment and administrative uses generally remain subject to the standard.

   Reference: HHS HIPAA Guidance: Minimum Necessary Requirement — How the Rule Works, exceptions

6. 6During teaching about immune surveillance in damaged skin, a physician describes epidermal cells that bind invading antigens and alert the immune system. Which cells perform this role?

   1. A.Langerhans cellsCorrect answer: A
   2. B.Merkel cells
   3. C.Melanocytes
   4. D.Keratinocytes

   Explanation: NCI states, "The squamous cell layer also contains cells called Langerhans cells. These cells attach themselves to antigens that invade damaged skin and alert the immune system to their presence." This describes Langerhans cells rather than sensory, pigment-producing, or keratin-producing cells.

   Reference: SEER Training: Layers of the Skin — The Epidermis — The Squamous Cell Layer

7. 7A patient reports chronic leg swelling and recurrent ulceration. Which previous event is especially relevant when taking a history for venous disease?

   1. A.Deep vein thrombosisCorrect answer: A
   2. B.Acute arterial embolism
   3. C.Thermal skin injury
   4. D.Peripheral nerve transection

   Explanation: The consensus associates venous disease with "deep vein thromboses (DVTs)." Previous thrombosis is a relevant historical contributor to venous dysfunction.

   Reference: Chronic wounds: Treatment consensus — 3. Diagnosis, venous disease paragraph

8. 8A well-perfused wound requires removal of a large volume of necrotic tissue. Where does WHS recommend performing this surgical debridement?

   1. A.Operating roomCorrect answer: A
   2. B.Outpatient dressing clinic
   3. C.Home wound-care setting
   4. D.Inpatient bedside

   Explanation: WHS states, "Debridement of large amounts of necrotic tissue should be done in the operating room." The volume distinguishes this from limited sharp debridement.

   Reference: WHS Guidelines for the Treatment of Pressure Ulcers – 2023 update — Guideline 4.4, subsection A. Surgical or sharp debridement

9. 9A patient with peripheral neuropathy asks about injury risks beyond unnoticed foot wounds. Which complication is specifically recognized by NIDDK?

   1. A.Loss of venous valve function with increased dependent edema
   2. B.Loss of arterial patency with acute ischemic tissue injury
   3. C.Loss of epidermal adhesion with autoimmune blister formation
   4. D.Loss of balance and falls with increased fracture riskCorrect answer: D

   Explanation: NIDDK states, "Peripheral neuropathy can make you more likely to lose your balance and fall." Falls can increase fractures and other injuries.

   Reference: NIDDK: Peripheral Neuropathy — What problems does peripheral neuropathy cause?

10. 10A HIPAA-covered wound practice receives a patient's request for access to records. No permitted extension is taken. What is the latest deadline under the HIPAA rule for acting on the request?

    1. A.10 days after receipt
    2. B.15 days after receipt
    3. C.60 days after receipt
    4. D.30 days after receiptCorrect answer: D

    Explanation: The rule requires action "no later than 30 days after receipt of the request." The stem excludes the separately permitted extension.

    Reference: 45 CFR § 164.524 — Access of Individuals to Protected Health Information — § 164.524(b)(2)(i)