Exam (elaborations)
NRNP 6645 MIDTERM AND FINAL EXAM 2024 (5 DIFFERENT VERSIONS 500 QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIES
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NRNP 6645 MIDTERM ANDFINAL EXAM 2024 (5
DIFFERENT VERSIONS 500 QS &
ANS) /NRNP6645
PSYCHOTHERAPY WITH
MULTIPLE MODALITIES
1. Mrs. Williams is 76 years old and comes in to have a wound checked on her
right leg. She fell a month ago and the wound has not healed. She is concerned
that something is wrong. The nurse practitioner examines the wound and sees
that it has been cleaned properly and has no signs of infection. The edges are
approximated, but the skin around the wound is red and tender to touch. The
best response regarding mrs. Williams' concern is:
1. Wound healing for older people may take up to four times longer than it does
for younger people.ÖÖ
2. Let us talk about what you are eating.
3. Had you come in earlier, i would have ordered medicine that would have
healed that right up.
4. I will order an antibiotic to prevent infection.
1. Answer: 1
page: 96
feedback
1.
,Skin renewal turnover time increases to approximately 87 days in older adults,
compared with 20 days during youth.
2.
The perceived extended healing time is not related to diet.
3.
This is false hope, as there is no medication that will heal this wound quickly.
4.
Prophylactic antibiotics are not appropriate when there are no signs or
symptoms of infection.
2. The nurse practitioner is conducting patient rounds in a long-term care
facility. As she talks with mrs. Jones, she notices that her arms and elbows are
excoriated and the skin is shearing. The nurse practitioner explains to the staff
that mrs. Jones needs frequent assessment of her skin and protection provided to
prevent skin breakdown because:
1. Her lack of activity causes the skin to tear.
2. Fat has redistributed to the abdomen and thighs, leaving bony surfaces in
areas such as the face, hands, and sacrum. This can result in injury. ÖÖ
3. She has lost weight and is in jeopardy of falling.
4. She picks at herself and causes skin breakdown.
2. Answer: 2
page: 96
feedback
1.
Lack of activity alone does not cause skin breakdown.
2.
Fat is redistributed to the abdomen and thighs, leaving bony surfaces, such as
,the face, hands, and sacrum, exposed to potential injury, especially skin tears
from shearing, friction forces and pressure ulcer development.
3.
Although losing weight may be a risk factor for falling, it is not directly related
to skin breakdown.
4.
There is no evidence that she is picking at herself, as there is nothing reported
anywhere else on her arms.
3. Mr. James is 91 years old. His daughter notices that he has bruises and
lacerations on his arms and reports this to the nurse practitioner, who tells her
that older people bruise easily due to their fragile blood vessels. The skin
lacerations happen because he has thin skin. Even so, the nurse practitioner
assures the daughter that she will investigate further to ensure that he is getting
proper care. She says this because she understands that:
1. These markings on the patient's skin are part of aging skin.
2. Bruises and lacerations can indicate inadequate care. ÖÖ
3. The daughter needs assurance that her father is okay.
4. The patient is being abused.
3. Answer: 2
page: 97
feedback
1.
Markings on the skin may be signs of aging, a disease, or maltreatment.
2.
Poorly healing wounds or chronic pressure ulcers may signal a problem not only
with the patient but with the caregiver's ability to provide adequate care. Welts,
, lacerations, burns, and distinctive markings may indicate a need for
intervention.
3.
This is a result of the nurse practitioner addressing it further rather than the
reason for addressing it.
4.
A professional cannot assume abuse without good reason.
4. The nurse practitioner assesses a patient's skin and finds an infectious lesion
on the lower leg. The lesion is considered a secondary lesion. The nurse
practitioner explains that a secondary lesion is one that:
1. Arises from changes to a primary lesion. ÖÖ
2. Is a complication of an underlying disease.
3. Is difficult to treat.
4. Is a normal sign of aging.
4. Answer: 1
page: 97
feedback
1.
Secondary lesions (infections) arise from changes to the primary lesion.
2.
Secondary lesions are not necessarily the result of an underlying disease.
3.
Secondary lesions can be treated with medications or surgery.
4.
Secondary lesions arise as a condition not normal to aging.
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