Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

How does an arterial ulcer typically present?

1. Large, shallow with a moist base

2. Pale, dry with a punched-out appearance

3. Deep, with surrounding redness

4. Widespread and oozing with pus

The correct answer is: Pale, dry with a punched-out appearance

An arterial ulcer typically presents as pale, dry with a punched-out appearance due to inadequate blood flow to the area, which is characteristic of arterial insufficiency. The absence of sufficient blood supply results in tissue ischemia, leading to necrosis and ulceration. The punched-out appearance is a distinctive feature, often described as having well-defined edges, and the surrounding skin may appear atrophic and pale, reflecting the lack of blood flow. This type of ulcer is usually found on areas that are prone to pressure, such as the toes, heels, and the lateral malleolus, and lacks the granulation tissue commonly seen in venous ulcers. The presence of dry tissue rather than moisture highlights the underlying arterial issues. Understanding the presentation of arterial ulcers is crucial for effective diagnosis and treatment, as it informs the care plan focused on improving blood circulation and managing the wound.