Walden NRNP 6540 Final Exam - Questions With
Complete Solutions
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.
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.
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
,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
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.
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:
, 1. Have you injured your hand recently?
2. Are you using a different detergent?
3. Has this growth changed, bled, or is it painful?
4. Has this growth made it difficult to put on your rings? Correct Answer -
5. Answer: 3
Page: 97
Feedback
1.
An injury would not stimulate growth.
2.
A reaction to a detergent would more likely be a rash.
3.
Lesions that warrant biopsy are those that have changed, bleed, or are painful.
4.
The ability to put on her ring is not the problem.
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?
1. First degree
2. Second degree
3. First and second degree
4. Second and third degree Correct Answer - 6. Answer: 3
Page: 98
Feedback
1.
First-degree burns involving the epidermis are erythematous and painful but
do not blister.
2.
Second-degree burns involve the dermis and are characterized by blisters.
3.
Complete Solutions
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.
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.
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
,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
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.
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:
, 1. Have you injured your hand recently?
2. Are you using a different detergent?
3. Has this growth changed, bled, or is it painful?
4. Has this growth made it difficult to put on your rings? Correct Answer -
5. Answer: 3
Page: 97
Feedback
1.
An injury would not stimulate growth.
2.
A reaction to a detergent would more likely be a rash.
3.
Lesions that warrant biopsy are those that have changed, bleed, or are painful.
4.
The ability to put on her ring is not the problem.
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?
1. First degree
2. Second degree
3. First and second degree
4. Second and third degree Correct Answer - 6. Answer: 3
Page: 98
Feedback
1.
First-degree burns involving the epidermis are erythematous and painful but
do not blister.
2.
Second-degree burns involve the dermis and are characterized by blisters.
3.
