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CWCN exam Format | CWCN Course Contents | CWCN Course Outline | CWCN exam Syllabus | CWCN exam Objectives

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

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