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

What is the first step in performing a Semmes-Weinstein monofilament test?

1. Testing the knee

2. Testing the thumb

3. Testing the toe pads

4. Testing the palm of the hand

The correct answer is: Testing the toe pads

The correct response is centered on the design and intention of the Semmes-Weinstein monofilament test, which is a standardized method used to assess sensory function, particularly in the feet to detect peripheral neuropathy. The initial step of this testing process typically involves the toe pads, specifically the big toe, as these areas are significant for recognizing loss of protective sensation, especially in individuals with conditions such as diabetes. By beginning the test on the toe pads, clinicians can effectively evaluate sensory threshold at a critical point of potential ulceration and injury. The rationale is grounded in the anatomical and functional priority of maintaining adequate sensory feedback from the lower extremities, which can be compromised in many patients. Testing the toe pads first ensures that the most vulnerable areas are assessed promptly, enabling timely intervention if necessary. In contrast, the other locations mentioned may yield less relevant data regarding the primary concerns of sensory loss related to lower limb issues. For example, testing the knee or palm may not reflect the same implications for foot health, making it less critical as the starting point for this assessment.