Certified Wound Ostomy Nurse (CWON) Practice Test

What characterizes the typical presentation of a venous ulcer?

1. Located on the toes with thickened skin

2. Regular edges and necrotic base

3. Located around the medial malleolus with irregular edges

4. Small, shallow, and dry with minimal exudate

The correct answer is: Located around the medial malleolus with irregular edges

The typical presentation of a venous ulcer is characterized by its location and appearance. Venous ulcers most commonly occur around the medial malleolus (the inner aspect of the ankle) due to poor venous return and increased pressure in the veins of the lower extremities. This location is significant because it reflects the underlying venous insufficiency that is a primary factor in the development of these ulcers. These ulcers are also recognized for their irregular, often poorly defined edges. This irregularity happens due to the chronic nature of venous ulcers and the surrounding skin changes associated with long-standing venous hypertension. In contrast to well-defined wounds that might be found in other conditions, the edges of a venous ulcer can be jagged and are often accompanied by surrounding skin changes such as edema, pigmentation, and in some cases, lipodermatosclerosis. Understanding these characteristics is crucial for accurate diagnosis and appropriate treatment planning. It helps in distinguishing venous ulcers from other types, such as arterial ulcers or diabetic ulcers, which have distinct presentations and require different management strategies.