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Exam Code: CWOCN
Exam Name: WOCNCB Certified Wound Ostomy Continence Nurse
Format: 175 multiple-choice questions
Questions: 150 scored- 25 unscored pretest questions.
Duration: 3 hours
Exam Type: Computer-based testing

- 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)
- 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

- 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]- moistureassociated 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

- 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)- anklebrachial index (ABI)- transcutaneous oxygen pressure (TcPO2)- duplex scanning)

- 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

- Recommend and/or perform wound bed preparation.
- Recommending appropriate wound cleansing regimen
- Wound bed preparation (e.g.- infection management- moisture management- wound edge optimization)

- 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

- 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)

- 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.- 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.- 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

- 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)
- 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 intervention
- Modifying interventions based on revised patient needs and goals

- 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)

- 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)

- 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