Certified Wound Ostomy Nurse (CWON) Practice Test

How does an arterial ulcer typically present?

1. Pale, moist with a smooth base

2. Punched out appearance with pale, dry base

3. Red, swollen, and warm to touch

4. Large and superficial

The correct answer is: Punched out appearance with pale, dry base

An arterial ulcer typically presents with a “punched out” appearance and a pale, dry base. This type of ulcer occurs due to inadequate blood supply, usually resulting from peripheral artery disease. The lack of blood flow means there is a reduced supply of oxygen and nutrients to the tissues, which contributes to the ulcer's characteristic presentation. The pale base indicates a lack of blood flow, while the dry condition often reflects inadequate moisture in the area due to the compromised arterial circulation. In contrast, other presentations such as red, swollen, and warm ulcers are more associated with venous ulcers or infections, where blood flow is not the primary issue. Additionally, ulcers that are large and superficial might indicate different types of wounds, such as pressure ulcers or venous stasis ulcers, which do not match the typical features of an arterial ulcer. Thus, recognizing the distinct presentation of arterial ulcers is crucial for accurate diagnosis and appropriate management.