NRNP 6645 MIDTERM AND FINAL EXAM 2023 (5 DIFFERENT VERSIONS 500 QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIES
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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 sig...
NRNP 6645 MIDTERM AND FINAL EXAM 2023 (5 DIFFERENT VERSIONS
QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIE
Study online at https://quizlet.com/_fpc6oj
1. 1. Mrs. Williams is 76 years 1. Answer: 1
old and comes in to have Page: 96
a wound checked on her
right leg. She fell a month
ago and the wound has not Feedback
healed. She is concerned 1.
that something is wrong. Skin renewal turnover time increases to ap-
The nurse practitioner ex- proximately 87 days in older adults, compared
amines the wound and sees with 20 days during youth.
that it has been cleaned 2.
properly and has no signs The perceived extended healing time is not
of infection. The edges are related to diet.
approximated, but the skin 3.
around the wound is red This is false hope, as there is no medication
and tender to touch. The that will heal this wound quickly.
best response regarding 4.
Mrs. Williams' concern is: Prophylactic antibiotics are not appropriate
when there are no signs or symptoms of in-
1. Wound healing for older fection.
people may take up to four
times longer than it does for
younger people.
2. Let us talk about what you
are eating.
3. Had you come in earlier,
I would have ordered medi-
cine that would have healed
that right up.
4. I will order an antibiotic to
prevent infection.
2. 2. The nurse practitioner is 2. Answer: 2
conducting patient rounds Page: 96
in a long-term care facili-
ty. As she talks with Mrs.
Jones, she notices that her Feedback
arms and elbows are exco- 1.
riated and the skin is shear- Lack of activity alone does not cause skin
ing. The nurse practitioner breakdown.
, NRNP 6645 MIDTERM AND FINAL EXAM 2023 (5 DIFFERENT VERSIONS
QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIE
Study online at https://quizlet.com/_fpc6oj
explains to the staff that 2.
Mrs. Jones needs frequent Fat is redistributed to the abdomen and
assessment of her skin and thighs, leaving bony surfaces, such as the
protection provided to pre- face, hands, and sacrum, exposed to poten-
vent skin breakdown be- tial injury, especially skin tears from shear-
cause: ing, friction forces and pressure ulcer devel-
opment.
1. Her lack of activity causes 3.
the skin to tear. Although losing weight may be a risk factor for
2. Fat has redistributed to falling, it is not directly related to skin break-
the abdomen and thighs, down.
leaving bony surfaces in ar- 4.
eas such as the face, hands, There is no evidence that she is picking at
and sacrum. This can result herself, as there is nothing reported anywhere
in injury. else on her arms.
3. She has lost weight and is
in jeopardy of falling.
4. She picks at herself and
causes skin breakdown.
3. 3. Mr. James is 91 years old. 3. Answer: 2
His daughter notices that he Page: 97
has bruises and lacerations
on his arms and reports this
to the nurse practitioner, Feedback
who tells her that older peo- 1.
ple bruise easily due to their Markings on the skin may be signs of aging,
fragile blood vessels. The a disease, or maltreatment.
skin lacerations happen be- 2.
cause he has thin skin. Even Poorly healing wounds or chronic pressure
so, the nurse practitioner ulcers may signal a problem not only with the
assures the daughter that patient but with the caregiver's ability to pro-
she will investigate further vide adequate care. Welts, lacerations, burns,
to ensure that he is getting and distinctive markings may indicate a need
proper care. She says this for intervention.
because she understands 3.
that: This is a result of the nurse practitioner ad-
dressing it further rather than the reason for
1. These markings on the addressing it.
, NRNP 6645 MIDTERM AND FINAL EXAM 2023 (5 DIFFERENT VERSIONS
QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIE
Study online at https://quizlet.com/_fpc6oj
patient's skin are part of ag- 4.
ing skin. A professional cannot assume abuse without
2. Bruises and lacerations good reason.
can indicate inadequate
care.
3. The daughter needs as-
surance that her father is
okay.
4. The patient is being
abused.
4. 4. The nurse practitioner as- 4. Answer: 1
sesses a patient's skin and Page: 97
finds an infectious lesion on
the lower leg. The lesion is
considered a secondary le- Feedback
sion. The nurse practitioner 1.
explains that a secondary Secondary lesions (infections) arise from
lesion is one that: changes to the primary lesion.
2.
1. Arises from changes to a Secondary lesions are not necessarily the re-
primary lesion. sult of an underlying disease.
2. Is a complication of an un- 3.
derlying disease. Secondary lesions can be treated with med-
3. Is difficult to treat. ications or surgery.
4. Is a normal sign of aging. 4.
Secondary lesions arise as a condition not
normal to aging.
5. 5. Ms. Rose, 88 years old, 5. Answer: 3
comes to the nurse prac- Page: 97
titioner with a complaint
about a growth on her hand.
She wants to have a biopsy Feedback
done. The nurse practitioner 1.
asks the following question: An injury would not stimulate growth.
2.
1. Have you injured your A reaction to a detergent would more likely be
hand recently? a rash.
, 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. Are you using a different 3.
detergent? Lesions that warrant biopsy are those that
3. Has this growth changed, have changed, bleed, or are painful.
bled, or is it painful? 4.
4. Has this growth made The ability to put on her ring is not the prob-
it difficult to put on your lem.
rings?
6. 6. A 60-year-old male enters 6. Answer: 3
the burn center for triage Page: 98
and treatment due to a burn
he received at a campfire.
His left arm has an area Feedback
that is erythematous and 1.
painful, and another area First-degree burns involving the epidermis are
has a blister. What does the
erythematous and painful but do not blister.
nurse practitioner record as
2.
the degree of burn? Second-degree burns involve the dermis and
are characterized by blisters.
1. First degree 3.
2. Second degree The patient presents with erythematous skin,
3. First and second degree painful with blisters, which indicates both first-
4. Second and third degree and second-degree burn areas.
4.
In third-degree burns there is no sensation
when the wound is pinpricked.
7. 7. The nurse practitioner is 7. Answer: 1
concerned with primary pre- Page: 115, 116
vention strategies. How can
the nurse practitioner im- Feedback
plement primary prevention 1.
strategies for an 80-year-old
Primary prevention includes educational pro-
male patient who smokes? grams designed to educate the public on safe-
ty. For example, the individual smoking in bed
1. Review home fire safe- would hopefully benefit from smoking cessa-
ty protocols, including the tion programs in the community, as well as
proper use of smoke instruction in safety precautions.
alarms, and discuss smok- 2.
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