ESTUDYR
WALDEN NRNP 6540 FINAL EXAM (2025/2026)
MOST TESTED QUESTIONS AND ANSWERS
GRADED A+ WITH RATIONALES
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. 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. What is the best response regarding Mrs. Williams'
concern?
A. Wound healing for older people may take up to four times longer than it does for younger people.
B. Let us talk about what you are eating.
C. Had you come in earlier, I would have ordered medicine that would have healed that right up.
D. I will order an antibiotic to prevent infection.
Answer: A. Wound healing for older people may take up to four times longer than it does for younger
people.
Rationale: Skin renewal turnover time increases to approximately 87 days in older adults, compared
with 20 days during youth. This explains the delayed healing process.
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:
A. Her lack of activity causes the skin to tear.
B. 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.
C. She has lost weight and is in jeopardy of falling.
D. She picks at herself and causes skin breakdown.
Answer: B. 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.
Rationale: Fat redistribution in older adults leaves bony surfaces exposed, increasing the risk of skin
tears and pressure ulcers.
,ESTUDYR
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. The nurse practitioner 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:
A. These markings on the patient's skin are part of aging skin.
B. Bruises and lacerations can indicate inadequate care.
C. The daughter needs assurance that her father is okay.
D. The patient is being abused.
Answer: B. Bruises and lacerations can indicate inadequate care.
Rationale: Poorly healing wounds or chronic pressure ulcers may signal a problem with the caregiver's
ability to provide adequate care.
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:
A. Arises from changes to a primary lesion.
B. Is a complication of an underlying disease.
C. Is difficult to treat.
D. Is a normal sign of aging.
Answer: A. Arises from changes to a primary lesion.
Rationale: Secondary lesions arise from changes to the primary lesion, such as infection or trauma.
5. Ms. Rose, 88 years old, comes to the nurse practitioner with a complaint about a growth on her
hand. She wants to have a biopsy done. The nurse practitioner asks the following question:
A. Have you injured your hand recently?
B. Are you using a different detergent?
C. Has this growth changed, bled, or is it painful?
D. Has this growth made it difficult to put on your rings?
Answer: C. Has this growth changed, bled, or is it painful?
Rationale: Lesions that warrant biopsy are those that have changed, bleed, or are painful, as these may
indicate malignancy.
,ESTUDYR
6. A 60-year-old male enters the burn center for triage and treatment due to a burn he received at a
campfire. His left arm has an area that is erythematous and painful, and another area has a blister.
What does the nurse practitioner record as the degree of burn?
A. First degree
B. Second degree
C. First and second degree
D. Second and third degree
Answer: C. First and second degree
Rationale: Erythematous and painful skin indicates a first-degree burn, while blisters indicate a second-
degree burn.
7. The nurse practitioner is concerned with primary prevention strategies. How can the nurse
practitioner implement primary prevention strategies for an 80-year-old male patient who smokes?
A. Review home fire safety protocols, including the proper use of smoke alarms, and discuss smoking
cessation.
B. Inform him that if he does not stop smoking, the nurse practitioner cannot see him again.
C. Have a conference with his family about his smoking.
D. Plan a family meeting with the patient to discuss the benefits of his smoking cessation.
Answer: A. Review home fire safety protocols, including the proper use of smoke alarms, and discuss
smoking cessation.
Rationale: Primary prevention includes educational programs designed to educate the public on safety,
such as fire safety and smoking cessation.
8. The nurse practitioner is conducting a safety class with community-living older adults. Which of the
following should she include in her teaching of risks of burns for this population? (Select all that
apply.)
A. Thinner skin.
B. Less vascularity.
C. Diminished nerve function.
D. A weakened immune system.
E. The burden of various comorbidities leading to enhanced wound healing and reepithelialization after
burn injury.
Answer: A, B, C, D
Rationale: Older adults have thinner skin, less vascularity, diminished nerve function, and a weakened
immune system, all of which increase the risk of burns and delayed healing.
, ESTUDYR
9. Mr. Edwards is 76 years old and received a burn on his leg when he dozed off and dropped his
cigarette. The nurse practitioner examines his leg for the degree of burn and classifies it as second
degree with some third degree in the center. Mr. Edwards asks what that means and why it hurts so
much. What is the best answer? (Select all that apply.)
A. It means that this is a serious, deep burn in the center, and a less deep burn around the sides.
B. It hurts because the nerve endings are exposed in the second-degree area.
C. It means that the burn is advancing and getting worse.
D. It hurts because the nerves are destroyed.
E. It hurts because the nerves in the second-degree areas are exposed to the outside and are stimulated.
Answer: A, B
Rationale: Second-degree burns involve the dermis and are painful due to exposed nerve endings, while
third-degree burns involve deeper tissue destruction.
10. Mrs. Thomas is 82 years old and burned her hand while cooking. The nurse practitioner assesses
second- and third-degree burns over approximately half of the back of her hand. The nurse
practitioner chooses which of the following for initial treatment? (Select all that apply.)
A. Administer appropriate pain medication.
B. Rinse with cool tap water.
C. Clean with a strong detergent.
D. Remove any loose tissue but allow the blisters to remain.
E. Diagnose as first- and third-degree burns.
Answer: A, B, D
Rationale: Initial treatment for burns includes pain management, cooling the burn, and removing loose
tissue while leaving blisters intact.
11. Mr. Watson, 75 years old, comes to the urgent care center with complaints of fever, fast
heartbeat, a swollen gland under his right arm, and redness in his upper left arm that has hurt for 2 to
3 days. The nurse practitioner suspects which of the following? (Select all that apply.)
A. Influenza
B. Upper respiratory infection
C. Cellulitis of the upper left arm
D. Necrotizing fasciitis
E. Lymphangitis
WALDEN NRNP 6540 FINAL EXAM (2025/2026)
MOST TESTED QUESTIONS AND ANSWERS
GRADED A+ WITH RATIONALES
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. 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. What is the best response regarding Mrs. Williams'
concern?
A. Wound healing for older people may take up to four times longer than it does for younger people.
B. Let us talk about what you are eating.
C. Had you come in earlier, I would have ordered medicine that would have healed that right up.
D. I will order an antibiotic to prevent infection.
Answer: A. Wound healing for older people may take up to four times longer than it does for younger
people.
Rationale: Skin renewal turnover time increases to approximately 87 days in older adults, compared
with 20 days during youth. This explains the delayed healing process.
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:
A. Her lack of activity causes the skin to tear.
B. 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.
C. She has lost weight and is in jeopardy of falling.
D. She picks at herself and causes skin breakdown.
Answer: B. 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.
Rationale: Fat redistribution in older adults leaves bony surfaces exposed, increasing the risk of skin
tears and pressure ulcers.
,ESTUDYR
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. The nurse practitioner 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:
A. These markings on the patient's skin are part of aging skin.
B. Bruises and lacerations can indicate inadequate care.
C. The daughter needs assurance that her father is okay.
D. The patient is being abused.
Answer: B. Bruises and lacerations can indicate inadequate care.
Rationale: Poorly healing wounds or chronic pressure ulcers may signal a problem with the caregiver's
ability to provide adequate care.
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:
A. Arises from changes to a primary lesion.
B. Is a complication of an underlying disease.
C. Is difficult to treat.
D. Is a normal sign of aging.
Answer: A. Arises from changes to a primary lesion.
Rationale: Secondary lesions arise from changes to the primary lesion, such as infection or trauma.
5. Ms. Rose, 88 years old, comes to the nurse practitioner with a complaint about a growth on her
hand. She wants to have a biopsy done. The nurse practitioner asks the following question:
A. Have you injured your hand recently?
B. Are you using a different detergent?
C. Has this growth changed, bled, or is it painful?
D. Has this growth made it difficult to put on your rings?
Answer: C. Has this growth changed, bled, or is it painful?
Rationale: Lesions that warrant biopsy are those that have changed, bleed, or are painful, as these may
indicate malignancy.
,ESTUDYR
6. A 60-year-old male enters the burn center for triage and treatment due to a burn he received at a
campfire. His left arm has an area that is erythematous and painful, and another area has a blister.
What does the nurse practitioner record as the degree of burn?
A. First degree
B. Second degree
C. First and second degree
D. Second and third degree
Answer: C. First and second degree
Rationale: Erythematous and painful skin indicates a first-degree burn, while blisters indicate a second-
degree burn.
7. The nurse practitioner is concerned with primary prevention strategies. How can the nurse
practitioner implement primary prevention strategies for an 80-year-old male patient who smokes?
A. Review home fire safety protocols, including the proper use of smoke alarms, and discuss smoking
cessation.
B. Inform him that if he does not stop smoking, the nurse practitioner cannot see him again.
C. Have a conference with his family about his smoking.
D. Plan a family meeting with the patient to discuss the benefits of his smoking cessation.
Answer: A. Review home fire safety protocols, including the proper use of smoke alarms, and discuss
smoking cessation.
Rationale: Primary prevention includes educational programs designed to educate the public on safety,
such as fire safety and smoking cessation.
8. The nurse practitioner is conducting a safety class with community-living older adults. Which of the
following should she include in her teaching of risks of burns for this population? (Select all that
apply.)
A. Thinner skin.
B. Less vascularity.
C. Diminished nerve function.
D. A weakened immune system.
E. The burden of various comorbidities leading to enhanced wound healing and reepithelialization after
burn injury.
Answer: A, B, C, D
Rationale: Older adults have thinner skin, less vascularity, diminished nerve function, and a weakened
immune system, all of which increase the risk of burns and delayed healing.
, ESTUDYR
9. Mr. Edwards is 76 years old and received a burn on his leg when he dozed off and dropped his
cigarette. The nurse practitioner examines his leg for the degree of burn and classifies it as second
degree with some third degree in the center. Mr. Edwards asks what that means and why it hurts so
much. What is the best answer? (Select all that apply.)
A. It means that this is a serious, deep burn in the center, and a less deep burn around the sides.
B. It hurts because the nerve endings are exposed in the second-degree area.
C. It means that the burn is advancing and getting worse.
D. It hurts because the nerves are destroyed.
E. It hurts because the nerves in the second-degree areas are exposed to the outside and are stimulated.
Answer: A, B
Rationale: Second-degree burns involve the dermis and are painful due to exposed nerve endings, while
third-degree burns involve deeper tissue destruction.
10. Mrs. Thomas is 82 years old and burned her hand while cooking. The nurse practitioner assesses
second- and third-degree burns over approximately half of the back of her hand. The nurse
practitioner chooses which of the following for initial treatment? (Select all that apply.)
A. Administer appropriate pain medication.
B. Rinse with cool tap water.
C. Clean with a strong detergent.
D. Remove any loose tissue but allow the blisters to remain.
E. Diagnose as first- and third-degree burns.
Answer: A, B, D
Rationale: Initial treatment for burns includes pain management, cooling the burn, and removing loose
tissue while leaving blisters intact.
11. Mr. Watson, 75 years old, comes to the urgent care center with complaints of fever, fast
heartbeat, a swollen gland under his right arm, and redness in his upper left arm that has hurt for 2 to
3 days. The nurse practitioner suspects which of the following? (Select all that apply.)
A. Influenza
B. Upper respiratory infection
C. Cellulitis of the upper left arm
D. Necrotizing fasciitis
E. Lymphangitis
