Exam (elaborations)
NRNP 6645 MIDTERM AND FINAL EXAM/NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIES
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NRNP 6645 MIDTERM AND FINAL EXAM /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIES
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NRNP 6645 MIDTERM AND FINAL EXAM 2023 (5 DIFFERENT VERSIONSQS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIE
Study online at https://quizlet.com/_fpc6oj
1. Mrs. Williams is 76 years old and
comes in to have a wound checked on
1. Answer: 1
her right leg. She fell a month ago and
Page: 96
the wound has not healed. She is con-
cerned that something is wrong. The
nurse practitioner examines the wound
Feedback
and sees that it has been cleaned prop-
1.
erly and has no signs of infection. The
Skin renewal turnover time increases to
edges are approximated, but the skin
approximately 87 days in older adults,
around the wound is red and tender to
compared with 20 days during youth.
touch. The best response regarding Mrs.
2.
Williams' concern is:
The perceived extended healing time is
not related to diet.
1. Wound healing for older people may
3.
take up to four times longer than it does
This is false hope, as there is no medica-
for younger people.
tion that will heal this wound quickly.
2. Let us talk about what you are eating.
4.
3. Had you come in earlier, I would
Prophylactic antibiotics are not appropri-
have ordered medicine that would have
ate when there are no signs or symptoms
healed that right up.
of infection.
4. I will order an antibiotic to prevent in-
fection.
2. Answer: 2
2. The nurse practitioner is conducting
Page: 96
patient rounds in a long-term care facility.
As she talks with Mrs. Jones, she notices
that her arms and elbows are excoriat-
Feedback
ed and the skin is shearing. The nurse
1.
practitioner explains to the staff that Mrs.
Lack of activity alone does not cause skin
Jones needs frequent assessment of her
breakdown.
skin and protection provided to prevent
2.
skin breakdown because:
Fat is redistributed to the abdomen and
thighs, leaving bony surfaces, such as
1. Her lack of activity causes the skin to
the face, hands, and sacrum, exposed to
tear.
potential injury, especially skin tears from
2. Fat has redistributed to the abdomen
shearing, friction forces and pressure ul-
and thighs, leaving bony surfaces in
cer development.
areas such as the face, hands, and
3.
, NRNP 6645 MIDTERM AND FINAL EXAM 2023 (5 DIFFERENT VERSIONS
QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIE
Study online at https://quizlet.com/_fpc6oj
Although losing weight may be a risk fac-
sacrum. This can result in injury. tor for falling, it is not directly related to
3. She has lost weight and is in jeopardy skin breakdown.
of falling. 4.
4. She picks at herself and causes skin There is no evidence that she is picking
breakdown. at herself, as there is nothing reported
anywhere else on her arms.
3. Answer: 2
Page: 97
3. Mr. James is 91 years old. His daugh-
ter notices that he has bruises and lacer-
ations on his arms and reports this to the
Feedback
nurse practitioner, who tells her that old-
1.
er people bruise easily due to their frag-
Markings on the skin may be signs of
ile blood vessels. The skin lacerations
aging, a disease, or maltreatment.
happen because he has thin skin. Even
2.
so, the nurse practitioner assures the
Poorly healing wounds or chronic pres-
daughter that she will investigate further
sure ulcers may signal a problem not
to ensure that he is getting proper care.
only with the patient but with the care-
She says this because she understands
giver's ability to provide adequate care.
that:
Welts, lacerations, burns, and distinctive
markings may indicate a need for inter-
1. These markings on the patient's skin
vention.
are part of aging skin.
3.
2. Bruises and lacerations can indicate
This is a result of the nurse practitioner
inadequate care.
addressing it further rather than the rea-
3. The daughter needs assurance that
son for addressing it.
her father is okay.
4.
4. The patient is being abused.
A professional cannot assume abuse
without good reason.
4. Answer: 1
4. The nurse practitioner assesses a pa- Page: 97
tient's skin and finds an infectious lesion
on the lower leg. The lesion is considered
a secondary lesion. The nurse practition- Feedback
er explains that a secondary lesion is 1.
one that: Secondary lesions (infections) arise from
changes to the primary lesion.
, NRNP 6645 MIDTERM AND FINAL EXAM 2023 (5 DIFFERENT VERSIONS
QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIE
Study online at https://quizlet.com/_fpc6oj
2.
Secondary lesions are not necessarily
1. Arises from changes to a primary le- the result of an underlying disease.
sion. 3.
2. Is a complication of an underlying dis- Secondary lesions can be treated with
ease. medications or surgery.
3. Is difficult to treat. 4.
4. Is a normal sign of aging. Secondary lesions arise as a condition
not normal to aging.
5. Answer: 3
Page: 97
5. Ms. Rose, 88 years old, comes to the
nurse practitioner with a complaint about
a growth on her hand. She wants to have Feedback
a biopsy done. The nurse practitioner 1.
asks the following question: An injury would not stimulate growth.
2.
1. Have you injured your hand recently? A reaction to a detergent would more
2. Are you using a different detergent? likely be a rash.
3. Has this growth changed, bled, or is it 3.
painful? Lesions that warrant biopsy are those
4. Has this growth made it difficult to put that have changed, bleed, or are painful.
on your rings? 4.
The ability to put on her ring is not the
problem.
6. Answer: 3
Page: 98
6. A 60-year-old male enters the burn
center for triage and treatment due to
a burn he received at a campfire. His Feedback
left arm has an area that is erythema- 1.
tous and painful, and another area has a First-degree burns involving the epider-
blister. What does the nurse practitioner mis are erythematous and painful but do
record as the degree of burn? not blister.
2.
1. First degree Second-degree burns involve the dermis
and are characterized by blisters.
3.
, NRNP 6645 MIDTERM AND FINAL EXAM 2023 (5 DIFFERENT VERSIONS
QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIE
Study online at https://quizlet.com/_fpc6oj
The patient presents with erythematous
skin, painful with blisters, which indicates
2. Second degree both first- and second-degree burn ar-
3. First and second degree eas.
4. Second and third degree 4.
In third-degree burns there is no sensa-
tion when the wound is pinpricked.
7. Answer: 1
7. The nurse practitioner is concerned Page: 115, 116
with primary prevention strategies. How
can the nurse practitioner implement Feedback
primary prevention strategies for an 1.
80-year-old male patient who smokes? Primary prevention includes educational
programs designed to educate the pub-
1. Review home fire safety protocols, in- lic on safety. For example, the individual
cluding the proper use of smoke alarms, smoking in bed would hopefully benefit
and discuss smoking cessation. from smoking cessation programs in the
2. Inform him that if he does not stop community, as well as instruction in safe-
smoking, the nurse practitioner cannot ty precautions.
see him again. 2.
3. Have a conference with his family Threatening refusal of care is not ethical.
about his smoking. 3.
4. Plan a family meeting with the patient The patient is at risk, not the family.
to discuss benefits of his smoking cessa- 4.
tion. The fact that the patient smokes is not
the issue; safety is the issue.
8. Answer: 1, 2, 3, 4
Page: 98
8. The nurse practitioner is conducting a Feedback
safety class with community-living older 1.
adults. Which of the following should she As one ages, there are significant
include in her teaching of risks of burns changes in the skin, which becomes thin-
for this population? Select all that apply. ner, providing a less effective barrier to
external stimuli.
2.
With aging, there are fewer appendages
and decreased vascularity.
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