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The CWSP exam has 180 questions and runs 3 hours 30 minutes.
These 10 free CWSP questions are organized by exam domain, so you can see how each part of the Certified Wound Specialist Physician (CWSP) blueprint is tested. Reveal the answer and explanation under each question.
An investigator compares fluid from a stalled venous ulcer with fluid from an acute wound progressing normally. The stalled ulcer has persistently elevated matrix metalloproteinase activity relative to their tissue inhibitors. What consequence of this imbalance would impair repair?
Correct answer: D - Excess degradation of extracellular matrix and repair signaling proteins.
Six weeks after elective abdominal surgery, a patient's incision remains friable despite adequate perfusion and control of infection. Dietary review reveals almost no fruit or vegetables for several months; gingival bleeding and perifollicular hemorrhages are also present. Which biochemical defect most directly connects the nutritional history with impaired repair?
Correct answer: A - Impaired hydroxylation of proline and lysine in collagen.
After loose surface slough is removed from a sacral pressure injury, adipose tissue is visible and a narrow tract remains at the base. The sacrum is directly palpable through the tract, although it cannot be seen. No remaining slough or eschar prevents assessment of the wound's extent. The appropriate NPIAP classification is:
Correct answer: A - Stage 4 pressure injury
During debridement, a diabetic plantar ulcer is found to reach a flexor tendon but not bone or joint. Purulence is present, and vascular testing has established ischemia. Select the University of Texas classification that records both the depth and the complicating conditions.
Correct answer: D - Grade 2, stage D
Digital planimetry of a neuropathic plantar ulcer in a patient with diabetes shows an area of 12.0 cm² at treatment initiation and 4.8 cm² four weeks later. Depth and drainage have also decreased. Perfusion is adequate, there is no infection, and prescribed offloading is being used. How should the four-week response influence the plan?
Correct answer: B - A 60% area reduction supports continuing the current treatment with serial reassessment.
A 58-year-old man with type 2 diabetes has a shallow plantar ulcer beneath the first metatarsal head, loss of protective sensation, and a toe pressure of 82 mm Hg. There are no signs of infection. He removes his knee-high walker for most steps taken at home. He walks safely in the device and has transportation for weekly follow-up. Which change is most likely to improve healing?
Correct answer: C - Convert his fitted knee-high walker to a non-removable offloading device.
An ambulatory woman has a heavily exudative medial-ankle ulcer, hemosiderin staining, and duplex-confirmed venous reflux. Her ABI is 0.64, ankle systolic pressure is 96 mm Hg, and toe pressure is 62 mm Hg. She has no rest pain. Vascular assessment supports a monitored compression trial rather than immediate revascularization. Under the WOCN venous-ulcer algorithm, which prescription fits these findings?
Correct answer: B - Modified compression at 20-30 mm Hg, with checks for ischemic symptoms.
A routine surface swab from a superficial plantar diabetic ulcer grows methicillin-resistant Staphylococcus aureus. At review, the ulcer is smaller, with a clean granulating bed and scant serous drainage. There is no erythema, warmth, induration, purulence, or systemic illness. Toe pressure is 78 mm Hg, and the patient takes no immunosuppressive medication. How should the culture result affect treatment?
Correct answer: D - Continue wound care and offloading without systemic or topical antibiotics.
At a dressing review for a 5-week-old infant with a partial-thickness scald, a physician cancels an order for silver sulfadiazine 1%. Which adverse effect explains the age-specific contraindication?
Correct answer: C - Kernicterus associated with neonatal sulfonamide exposure
Eighteen hours after a puncture wound, a man taking prednisone develops rapidly worsening calf pain and edema. Tenderness extends beyond the erythema, and hemorrhagic bullae have appeared. His blood pressure is 104/66 mm Hg and lactate is 3.2 mmol/L. CT shows fascial edema but no gas or drainable collection. What should be done next?
Correct answer: A - Start broad-spectrum intravenous antibiotics and arrange immediate surgical exploration.
The CWSP exam also covers these domains. Drill them in the full free practice test:
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