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100+ Free AWCC Practice Questions

Pass your NAWCCB Advanced Wound Care Certified exam on the first try — instant access, no signup required.

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What is the recommended frequency of complete wound reassessment for a patient with a chronic non-healing wound in an outpatient wound care center?

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2026 Statistics

Key Facts: AWCC Exam

100

Exam Questions

all scored, NAWCCB

2 hrs

Exam Time

NAWCCB

$380

Exam Fee

NAWCCB 2026

WCC req.

Prior Certification

Prerequisite

5 years

Certification Valid

Recertification cycle

≥20 hrs

Training Required

NAWCCB eligibility

The AWCC exam contains 100 questions in 2 hours. It requires an active foundational wound care certification (WCC or equivalent) plus 1 year of advanced wound care experience and an approved training course. The $380 exam is offered by NAWCCB and covers advanced topics beyond the WCC including atypical wound diagnosis, HBOT, biologics, and vascular assessment. Recertification is required every 5 years.

Sample AWCC Practice Questions

Try these sample questions to test your AWCC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A patient with a lower-extremity ulcer has livedo reticularis, painful ulceration, and elevated creatinine. Which atypical wound etiology is most likely?
A.Pyoderma gangrenosum
B.Calciphylaxis
C.Marjolin's ulcer
D.Vasculitic ulcer
Explanation: Calciphylaxis (calcific uremic arteriolopathy) causes painful ischemic ulcers with livedo reticularis in patients with chronic kidney disease due to medial vascular calcification and thrombosis.
2A long-standing venous stasis ulcer in a 70-year-old patient develops raised, hardened edges with pearly margins. What is the priority next step?
A.Increase compression therapy
B.Apply silver dressing
C.Perform wound biopsy
D.Initiate pentoxifylline
Explanation: Marjolin's ulcer (squamous cell carcinoma arising in a chronic wound) must be ruled out when wound edges become raised or indurated. Biopsy is mandatory before continuing wound care.
3Pyoderma gangrenosum (PG) is most reliably distinguished from necrotizing fasciitis by which feature?
A.Presence of fever and leukocytosis
B.Pathergy response and violaceous undermined wound edges
C.Rapid wound spread over 24–48 hours
D.Wound culture positive for polymicrobial organisms
Explanation: PG demonstrates pathergy (worsening after minimal trauma or debridement) and characteristic violaceous undermined borders. Pathergy is pathognomonic; aggressive debridement should be avoided.
4A patient with rheumatoid arthritis develops a painful ulcer with palpable purpura on the lower leg. ANA, RF, and ANCA are elevated. What is the likely diagnosis?
A.Arterial ulcer
B.Vasculitic ulcer
C.Diabetic neuropathic ulcer
D.Calciphylaxis
Explanation: Palpable purpura with elevated ANA, RF, and ANCA in the context of rheumatoid arthritis indicates small-vessel vasculitis causing skin and wound involvement.
5Which ABI value range best indicates moderate peripheral arterial disease and warrants vascular surgery referral before compression therapy?
A.0.9–1.3
B.0.6–0.8
C.0.41–0.59
D.< 0.40
Explanation: ABI 0.41–0.59 indicates moderate PAD. Compression is contraindicated without vascular surgical clearance; urgent revascularization workup is needed.
6Toe-brachial index (TBI) is preferred over ABI in patients with diabetes or renal failure because:
A.TBI measures capillary refill more accurately
B.Medial arterial calcification falsely elevates ABI, making TBI more reliable
C.TBI requires no Doppler equipment
D.TBI is less painful for the patient
Explanation: Non-compressible calcified vessels in DM/CKD produce falsely elevated ABI (>1.3). Digital arteries are less affected by calcification, so TBI (normal ≥0.70) is more accurate.
7A TcPO2 value below which threshold indicates critical ischemia and predicts poor wound healing without revascularization?
A.60 mmHg
B.40 mmHg
C.20 mmHg
D.10 mmHg
Explanation: TcPO2 <20 mmHg indicates critical ischemia with very low likelihood of healing without revascularization. Values 20–40 mmHg represent severe ischemia; >40 mmHg indicates reasonable healing potential.
8Which imaging study is considered the gold standard for defining anatomy prior to lower-extremity revascularization surgery?
A.CT angiography
B.Duplex ultrasound
C.Conventional (catheter-based) angiography
D.MR angiography
Explanation: Catheter-based digital subtraction angiography provides the highest spatial resolution and allows simultaneous endovascular intervention; it remains the gold standard for pre-revascularization planning.
9Sharp/surgical debridement is MOST appropriate for which clinical scenario?
A.Dry eschar on a heel in a patient with severe PAD
B.Stable, dry, necrotic toe in a diabetic without infection
C.Wet gangrenous foot ulcer with cellulitis extending to the ankle
D.Sloughy venous ulcer with adequate perfusion and no signs of infection
Explanation: Wet gangrene with advancing cellulitis requires urgent sharp/surgical debridement to control infection. Dry eschar on ischemic extremities should generally be preserved until perfusion is restored.
10A patient with an infected diabetic foot ulcer has mild cellulitis (<2 cm), no systemic signs, and adequate perfusion. Per IDSA guidelines, which antibiotic route is most appropriate?
A.IV vancomycin for 4–6 weeks
B.Oral amoxicillin-clavulanate
C.Oral trimethoprim-sulfamethoxazole only
D.IV piperacillin-tazobactam
Explanation: IDSA classifies mild diabetic foot infections as those with cellulitis ≤2 cm. Oral therapy with broad-spectrum coverage (amoxicillin-clavulanate) is appropriate; IV therapy is not warranted without systemic signs or deep infection.

About the AWCC Exam

The AWCC (Advanced Wound Care Certified) is an advanced-tier wound care credential from NAWCCB for NPs, PAs, physicians, DPMs, and experienced wound clinicians who already hold a foundational wound certification (WCC or equivalent). The exam consists of 100 questions in 2 hours and covers advanced differential diagnosis of atypical wounds, HBOT indications, cellular tissue products, vascular workup (ABI/TBI/TcPO2/duplex/angiography), antibiotic stewardship, debridement decision-making, billing/coding, and interprofessional team leadership.

Questions

100 scored questions

Time Limit

2 hours

Passing Score

Scaled passing score set by NAWCCB standard-setting

Exam Fee

$380 (NAWCCB (National Alliance of Wound Care and Ostomy Certifications Board))

AWCC Exam Content Outline

~25%

Advanced Wound Assessment & Differential Diagnosis

Atypical wounds (calciphylaxis, pyoderma gangrenosum, vasculitis, Marjolin's ulcer), biopsy criteria, advanced staging, wound bed preparation TIME framework

~30%

Advanced Treatment Selection

Debridement decision-making (sharp, enzymatic, autolytic, MIST/ultrasonic), NPWT settings, HBOT indications and contraindications, CTPs (Apligraf, Dermagraft), growth factors (becaplermin), advanced dressings

~20%

Vascular & Microvascular Assessment

ABI interpretation, TBI, TcPO2, duplex ultrasound for venous reflux, conventional angiography, revascularization referral criteria, Charcot neuroarthropathy vs osteomyelitis, microvascular DM mechanisms

~15%

Infection & Antibiotic Stewardship

Pathogen identification (MRSA, Pseudomonas, anaerobes), oral vs IV selection, biofilm detection and management, topical antimicrobials (cadexomer iodine, silver, honey), necrotizing fasciitis recognition

~10%

Professional Practice & Regulatory

CPT billing (97597, 97598, 97605-97608), E/M modifier -25, medical necessity documentation, HIPAA/wound photography, NPIAP pressure injury guidelines, CMS compliance, team leadership, research interpretation

How to Pass the AWCC Exam

What You Need to Know

  • Passing score: Scaled passing score set by NAWCCB standard-setting
  • Exam length: 100 questions
  • Time limit: 2 hours
  • Exam fee: $380

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

AWCC Study Tips from Top Performers

1Master atypical wound identification: calciphylaxis (CKD + livedo), pyoderma gangrenosum (pathergy), Marjolin's ulcer (malignant transformation in chronic wounds), vasculitic ulcers (ANCA/ANA patterns)
2Know UHMS-approved HBOT indications and absolute contraindications (untreated pneumothorax is absolute)
3Understand CTP selection criteria: clean non-infected wound + <40% area reduction at 4 weeks triggers escalation
4Memorize ABI interpretation ranges: normal 0.9-1.3, mild PAD 0.6-0.8, moderate 0.41-0.59, severe/critical <0.4
5Know TcPO2 thresholds: >40 mmHg adequate healing potential; <20 mmHg critical ischemia requiring revascularization
6Review antibiotic stewardship by wound type: S. aureus/MRSA in osteomyelitis, Pseudomonas in moist wounds, anaerobes in gas-forming infections
7Study CPT debridement codes: 97597 (bedside sharp, first 20 cm²), 97598 (add-on), 11042-11047 (surgical under anesthesia)
8Know modifier -25 requirement when billing E/M + procedure same day
9Review becaplermin black-box warning (malignancy with ≥3 tubes) and proper application protocol
10Understand CDT (complete decongestive therapy) as gold standard for lymphedema, and why diuretics are contraindicated

Frequently Asked Questions

What is the AWCC certification?

The AWCC (Advanced Wound Care Certified) is an advanced-tier wound care credential offered by NAWCCB. It validates higher-level clinical competency in complex wound management including atypical wound diagnosis, HBOT, advanced biologics, vascular workup, and antibiotic stewardship. It is designed for NPs, PAs, physicians, DPMs, and experienced wound clinicians who already hold a foundational wound certification.

What are the AWCC eligibility requirements?

To sit for the AWCC exam you must: (1) Hold an active wound care certification such as WCC, CWCN, CWON, CWOCN, CWS, CWCA, or CWSP; (2) Hold an active unrestricted healthcare license (RN, NP, PA, PT, OT, DPM, physician, etc.); (3) Have at least 1 year full-time or 2 years part-time advanced wound care experience; and (4) Complete an approved advanced wound training course of at least 20 hours.

How many questions are on the AWCC exam?

The AWCC exam contains 100 multiple-choice questions. All 100 questions are scored. Candidates have 2 hours to complete the exam. The exam fee is $380.

What content does the AWCC exam cover beyond the WCC?

The AWCC extends WCC content into advanced practice areas including: differential diagnosis of atypical wounds (calciphylaxis, pyoderma gangrenosum, vasculitic ulcers, Marjolin's ulcer); UHMS-approved HBOT indications and contraindications; advanced biologics (CTPs, becaplermin); vascular workup (ABI, TBI, TcPO2, duplex, angiography); antibiotic stewardship and biofilm management; CPT billing and medical necessity documentation; and interprofessional team leadership.

How long is AWCC certification valid?

AWCC certification is valid for 5 years. Recertification is required before expiration of the credentialing term per NAWCCB recertification requirements.

How should I prepare for the AWCC exam?

Build on your existing WCC or equivalent knowledge. Focus on advanced differential diagnosis of atypical wounds, HBOT UHMS-approved indications, cellular tissue product selection criteria, vascular assessment techniques (ABI/TBI/TcPO2), antibiotic stewardship by wound type, debridement decision trees, and billing/coding (CPT 97597/97598/97605-97608). Review NPIAP guidelines and CMS documentation requirements. Plan 8-14 weeks of study with 80-130 hours total preparation.