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Exam Code: CWCN
Exam NAme: WOCNCB CWCN Certified Wound Care Nurse
Number of questions 110 scored questions + 10 non-scored (pre-test) questions = 120 total.
Time allotted: 120 minutes (2 hours) for the exam.
Passing score: The pass mark is based on a scaled score; although many sources state a scaled score of 500 (on a 200-800 scale) is used.

Domain I: Assessment
Task 1: Assess Comprehensive Factors Affecting Wounds
- Psychosocial factors affecting care (e.g., patient and caregiver ability to learn and perform care, economic implications, education, mental status, family dynamics, cultural beliefs)
- Factors affecting wound healing (e.g., nutrition, comorbidities, medications, age, pain, mobility)
- Identifying need for diagnostic studies (e.g., biopsy, blood values, imaging, vascular, toe-brachial index [TBI], anklebrachial index [ABI], duplex scanning)

Task 2: Obtain patient health history through interviews, established medical records, and questionnaires to determine the patients current health and risk status.
- Interview processes
- Basic diagnostic test results (e.g., lab values, imaging studies, vascular studies, wound cultures)
- Performing initial exam (e.g., history and presentation, comorbidities, cultural diversity, age, medications, psychological issues)
- Interpreting nutritional status (e.g., lab values, diet history, BMI, appearance)
- Interpreting pain using verbal and nonverbal tools

Task 3: Perform focused exams to determine current skin status and wound etiology (pressure, venous, arterial, neuropathic, other).
- Dermatological etiology (e.g., contact dermatitis, fungal infection, herpetic lesions)
- Wound etiology (e.g., pressure, LEAD, LEVD, neuropathic, trauma, surgical, atypical, burns)
- Skin and wound classification systems (e.g., pressure injury stages, medical adhesive-related skin injury [MARSI], moisture-associated skin damage [MASD], skin tears, Wagner)
- Periwound characteristics (e.g., induration, temperature, fluctuance, denudation, maceration, cellulitis)
- Wound characteristics (e.g., tissue type, dimensions, location, exudate, odor, wound edges, color, epibole)
- Phases of wound healing (e.g., hemostasis, inflammation, proliferation, maturation)
- Characteristics of healing wounds (e.g., granulation, decreased dimensions, resurfacing)
- Characteristics of non-healing wounds (e.g., infection, biofilm, closed edge)
- Indications and side effects of medications affecting wound healing
- Utilizing risk exam tools (e.g., Braden Scale, Braden Q Scale, Norton Plus Scale)
- Lower extremity exam (e.g., quality of pulses, capillary refill, appearance of skin, elevational pallor, hair and nails, edema, protective sensation, proprioception)
- Identifying the need for wound culture and choosing the most appropriate method


Domain II: Intervention
Task 1: Recommend and/or provide appropriate interventions to promote optimal wound management.
- Principles of wound care (e.g., filling of dead space, moisture balance, periwound skin protection)
- Wound bed preparation (e.g., debridement, infection management, moisture management, wound edge optimization)
- Determining interventions to manage wounds (e.g., adjunctive modalities, offloading, support surfaces, protective footwear, tight glucose control, total contact casting)
- Types, indications, and contraindications of debridement (e.g., biologic, autolytic, chemical, mechanical, surgical, conservative sharp, excisional)
- Recommending appropriate pain management modalities
- Obtain wound cultures (e.g., aspirate, Levine, punch biopsy)
- Recommending and/or performing appropriate studies (e.g., biopsy, laboratory, radiography, toe-brachial index (TBI), ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), duplex scanning)

Task 2: Implement prevention measures to promote optimal skin health and prevent injury.
- Preventive measures based on risk exam (e.g., moisture management, pressure redistribution, offloading, friction and shear management, nutrition)
- Types of support surfaces
- Implementing interventions based on risk exam (e.g., moisture management, pressure redistribution, nutrition, cognition, mobility, offloading)
- Utilizing appropriate skin care products
- Preventing complications of wound healing (e.g., infection, maceration, inappropriate product use)
- Selecting support surfaces

Domain III: Treatment
Task 1: Recommend and/or perform wound bed preparation.
- Recommending appropriate wound cleansing regimen
- Wound bed preparation (e.g., infection management, moisture management, wound edge optimization)

Task 2: Recommend and/or perform debridement to promote wound healing.
- Types of debridement (e.g., biologic, autolytic, chemical, mechanical, surgical, conservative sharp, excisional)
- Identifying indications and contraindications for debridement
- Identifying wounds that require chemical cauterization
- Selecting appropriate debridement modalities

Task 3: Knowledge and application of topical therapies to promote wound healing.
- Topical therapies (e.g., absorbent dressing, antimicrobials, hydrating dressing)
- Recommending appropriate topical treatment to maintain periwound integrity
- Selecting and applying topical therapies for moist wound healing (e.g., containment of drainage, eliminate dead space, reduce bioburden, control odor)

Task 4: Knowledge and application of advanced/adjunctive therapies to promote wound healing.
- Types, indications, and contraindications for compression therapy
- Types of advanced modalities for treatment (e.g., leech therapy, bioengineered tissue, negative pressure wound therapy, hyperbaric oxygen therapy)
- Types of adjunctive modalities (e.g., hydrotherapy, hyperbaric oxygen therapy, pulsed lavage, mist therapy, maggot therapy)
- Recommending compression therapy to manage edema (e.g., dynamic and static compression therapy)
- Applying compression therapy (e.g., dynamic and static compression therapy)
- Recommending and/or performing advanced wound therapies (e.g., leech therapy, bioengineered tissue, negative pressure wound therapy, hyperbaric oxygen therapy)
- Recommending and/or performing adjunctive modalities (e.g., hydrotherapy, hyperbaric oxygen therapy, pulsed lavage, mist therapy, maggot therapy)
- Recommending and/or performing total contact casting

Domain IV: Care Planning
Task 1: Develop a patient-centered plan of care by using health history and exams to establish skin and wound management goals.
- Principles of patient-centered care (e.g., psychosocial issues, access to care, cultural beliefs)
- Identifying and supporting patient and caregiver goals (e.g., preventive, palliative, maintenance, curative)
- Setting patient-focused goals (e.g., preventive, palliative, maintenance, curative)

Task 2: Evaluate the patient-centered plan of care by using periodic exams to promote optimal skin and wound management.
- Evaluating the effectiveness of the current treatment plan
- Interpreting patient responses to interventions
- Modifying interventions based on revised patient needs and goals

Domain V: Education and Referral
Task 1: Educate patients and caregivers by using the individualized skin and wound care plan to prevent complications, maintain optimal skin and wound health, and encourage patient autonomy.
- Education based on health literacy and goals of patient/caregiver
- Factors affecting wound management (e.g., infection control, nutrition, moisture management, repositioning, tobacco cessation, glycemic control, compliance)
- Available resources (e.g., support and advocacy, supply access, post-acute care)
- Educating the patient and family on the procedures, rationale, and significance of diagnostic test results
- Educating the patient and caregivers on wound care procedures and skin care
- Educating patient and caregivers regarding modifiable risk factors (e.g., tobacco cessation, exercise, safety awareness, diet, offloading)
- Educating on factors affecting wound management (e.g., infection control, nutrition, moisture management, repositioning, tobacco cessation, glycemic control, compliance)
- Recommending non-invasive and invasive interventions (e.g., pharmacological, walking program, surgical)

Task 2: Educate other health care professionals on skin and wound care management and prevent complications.
- Factors affecting wound management (e.g., infection control, nutrition, moisture management, repositioning, tobacco cessation, glycemic control, compliance, trauma avoidance)
- Educating health care clinicians and providers on skin and wound care principles, procedures, and treatment goals
- Educating on factors affecting wound management (e.g., infection control, nutrition, moisture management, repositioning, tobacco cessation, glycemic control, compliance, trauma avoidance)

Task 3: Multidisciplinary care collaboration and referrals to support patient-centered care.
- Available resources (e.g., support and advocacy, supply access, post-acute care)
- Referrals for other services (e.g., rehabilitation, nutrition, diabetic education, social services, mental health)
- Referral for appropriate studies (e.g., biopsy, laboratory, radiography, toe-brachial index (TBI), ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), duplex scanning)
- Facilitate appropriate consultations (e.g., surgery, infectious disease, dermatology, podiatry)
- Provide handoff communication