CWCA Practice Questions (2026) — Free Sample Questions with Answers

Answer: B

Low protease levels that leave the extracellular matrix intact: Incorrect. Chronic wounds have high, not low, protease activity.

High matrix metalloproteinase levels that degrade growth factors: Correct. Chronic wounds are often stuck in prolonged inflammation, with elevated MMPs that break down growth factors, receptors and new matrix.

High growth factor levels that speed up epithelial migration: Incorrect. Growth factors are reduced or degraded in chronic wound fluid.

Low bacterial burden that prevents any inflammatory response: Incorrect. Chronic wounds commonly carry biofilm and increased bioburden that sustain inflammation.

Chronic wounds: prolonged inflammation, excess proteases (MMPs), senescent cells, biofilm and depleted growth factors; wound bed preparation aims to correct this.

Answer: D

Stage 2: Incorrect. Stage 2 is partial-thickness loss with exposed dermis; fat is not visible.

Unstageable: Incorrect. Unstageable is used only when slough or eschar obscures the extent of tissue loss; here the base is visible.

Stage 4: Incorrect. Stage 4 requires exposed or directly palpable fascia, muscle, tendon, ligament, cartilage or bone.

Stage 3: Correct. Stage 3 is full-thickness skin loss where fat is visible and granulation may be present, without exposed fascia, muscle, tendon, ligament, cartilage or bone.

NPIAP: Stage 1 intact nonblanchable erythema; Stage 2 partial thickness (dermis); Stage 3 full thickness to fat; Stage 4 exposed deeper structures; Unstageable = base obscured; DTPI = deep purple/maroon intact or blood blister.

Answer: B

0.48; mild disease, so full compression may be applied: Incorrect. This uses the right brachial (132) instead of the higher brachial pressure, and an ABI below 0.5 is not mild disease.

0.45; significant arterial disease, so avoid high compression: Correct. ABI = higher ankle pressure ÷ higher brachial pressure = 63 ÷ 140 = 0.45; this indicates significant PAD, and high (full) compression should not be applied without vascular referral.

0.41; critical ischemia, so emergency surgery is always required: Incorrect. This uses the lower ankle pressure (58 ÷ 140); the standard method uses the higher ankle pressure, and the value does not automatically mandate emergency surgery.

2.22; calcified vessels, so the reading must be ignored: Incorrect. This inverts the ratio (140 ÷ 63); ABI is ankle over brachial.

ABI = highest ankle pressure (DP or PT) ÷ highest brachial pressure. About 0.9–1.3 is normal; lower values indicate PAD; full compression generally requires ABI of about 0.8 or more; >1.3 suggests noncompressible vessels.

Answer: C

Hydrogel sheet: Incorrect. Hydrogels donate moisture and suit dry wounds; they would add to maceration here.

Transparent film: Incorrect. Films are nonabsorbent and would trap exudate against the skin.

Calcium alginate: Correct. Alginates absorb many times their weight in exudate, forming a gel that keeps the bed moist without pooling fluid on intact skin.

Dry woven gauze: Incorrect. Gauze wicks fluid poorly, can adhere and disrupt tissue, and does not support moist healing.

Match dressing to exudate: dry → add moisture (hydrogel); heavy → absorb (alginate, foam, hydrofiber); protect the periwound with a barrier product.

Answer: A

Keep it dry and intact, offload the heel, and monitor: Correct. Stable, dry eschar on an ischemic heel acts as a natural biological cover; it should be left intact, protected and monitored, with vascular referral.

Cross-hatch it and apply an enzymatic debriding agent: Incorrect. Enzymatic debridement of stable ischemic eschar removes a protective cover from tissue with poor blood flow.

Soften it with hydrogel under a film so it can lift off: Incorrect. Softening stable eschar on an ischemic limb opens a wound that may not heal and can invite infection.

Start compression wraps to improve venous return: Incorrect. Compression can further reduce arterial flow and is avoided in severe PAD.

Stable dry eschar on an ischemic limb or heel: do not soften or debride; keep dry, offload, monitor for infection signs, and refer for vascular evaluation.

Answer: C

Perform it, because the CWCA credential expands the LPN's scope: Incorrect. ABWM states that certification verifies knowledge but does not permit practice beyond the individual's license; scope is set by state practice acts.

Perform it only if the physician is on site and gives verbal approval: Incorrect. A physician's verbal approval cannot authorize a task outside the LPN's legal scope.

Decline the task, explain the scope limit and offer to help within scope: Correct. Practice boundaries come from the state practice act, not the certification; the LPN should decline and assist in ways that are within scope.

Perform it but leave it out of the record to avoid licensing issues: Incorrect. Practicing outside scope and omitting documentation are both serious legal and ethical violations.

A certification shows knowledge; it never expands legal scope of practice, which is set by state law and employer policy.