Certified Wound Care Nurse (CWCN) Practice Exam

What is the primary cause of neuropathic ulcers?

1. Venous insufficiency

2. Out of control blood sugars

3. Inadequate perfusion

4. Repetitive painless trauma

The correct answer is: Repetitive painless trauma

Neuropathic ulcers primarily occur due to repetitive painless trauma, often in individuals with neuropathy, such as those with diabetes. Neuropathy can result in a loss of sensation in the affected area, meaning that minor injuries or repetitive stress may go unnoticed. This lack of sensation leads to the continuous aggravation of the skin, which can result in ulcer formation over time. The skin fails to receive the necessary protective responses due to the diminished sensory input, allowing ulcers to develop from consistent pressure or friction, even though the individual does not experience pain. In contrast, venous insufficiency relates to poor blood flow and results in different types of ulcers, often found on the lower extremities. Out-of-control blood sugars can contribute to various complications in diabetes, such as vascular damage, but they are not directly responsible for the formation of neuropathic ulcers. Inadequate perfusion may lead to ischemic ulcers, but these are distinct from neuropathic ulcers that arise specifically due to nerve damage and subsequent loss of protective sensation. The distinction between these types of ulcers is crucial for effective management and treatment.