Walden NRNP 6540 Final EXAM WITH CORRECT ANSWERS

Walden NRNP 6540 Final EXAM WITH |\ |\ |\ |\ |\ |\




CORRECT ANSWERS |\




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
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\


ANSWERS ✔✔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
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\


ANSWERS ✔✔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 ANSWERS ✔✔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 ANSWERS ✔✔4. Answer:
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\


1
Page: 97 |\