1 | Page
PSYCHOTHERAPY NRNP 6645 QUESTIONS AND
ANSWERS 2025
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.
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. - correct answer-
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.
,2 | Page
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.
3. She has lost weight and is in jeopardy of falling.
4. She picks at herself and causes skin breakdown. - correct answer- 2.
Answer: 2
Page: 96
Feedback 1.
Lack of activity alone does not cause skin breakdown.
,3 | Page
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.
3. The daughter needs assurance that her father is okay.
4. The patient is being abused. - correct answer- 3. Answer: 2 Page: 97
, 4 | Page
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.
2. Is a complication of an underlying disease.
3. Is difficult to treat.
4. Is a normal sign of aging. - correct answer- 4. Answer: 1 Page: 97
PSYCHOTHERAPY NRNP 6645 QUESTIONS AND
ANSWERS 2025
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.
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. - correct answer-
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.
,2 | Page
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.
3. She has lost weight and is in jeopardy of falling.
4. She picks at herself and causes skin breakdown. - correct answer- 2.
Answer: 2
Page: 96
Feedback 1.
Lack of activity alone does not cause skin breakdown.
,3 | Page
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.
3. The daughter needs assurance that her father is okay.
4. The patient is being abused. - correct answer- 3. Answer: 2 Page: 97
, 4 | Page
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.
2. Is a complication of an underlying disease.
3. Is difficult to treat.
4. Is a normal sign of aging. - correct answer- 4. Answer: 1 Page: 97
