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NRNP 6645 MIDTERM AND FINAL EXAM (5 DIFFERENT VERSIONS 500 QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIES

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NRNP 6645 MIDTERM AND FINAL EXAM (5 DIFFERENT VERSIONS 500 QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIES/NRNP 6645 MIDTERM AND FINAL EXAM (5 DIFFERENT VERSIONS 500 QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE MODALITIES

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NRNP 6645 MIDTERM AND FINAL EXAM (5 DIFFERENT VERSIONS 500 QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE
MODALITIES




1. 1. Mrs. Williams is 76 years old and 1. Answer: 1
comes in to have Page: 96
a wound checked on her right leg. She
fell a month ago and the wound has
not healed. She is con- cerned that Feedback 1.
something is wrong. The nurse practi- Skin renewal turnover time increases to approximately 87 days in older adults, compared with 20
tioner examines the wound and sees days during youth.
that it 2.
has been The perceived extended healing time is not related to diet. 3.
cleaned properly and has no
This is false hope, as there is no medication that will heal this signs of infection.
The edges
are approximated, but the wound quickly.
skin around the wound is red and 4.
tender to touch. The best response Prophylactic antibiotics are not appropriate when there are no signs or symptoms of infection.
regard- ing 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 medi-
cine that would have healed that right up.
4. I will order an antibiotic to prevent
infection.






,NRNP 6645 MIDTERM AND FINAL EXAM (5 DIFFERENT VERSIONS 500 QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE
MODALITIES




2. 2. The nurse practitioner is conducting 2. Answer: 2
patient rounds in a long-term care Page: 96
facili- ty. As she talks with Mrs.
Jones,
sahrmes naontdiceelbsotwhsatarheeerxcori- Feedback 1.
Lack of activity alone does not cause skin breakdown.
ated and the skin is shear- ing.
The nurse practitioner explains to the 2.
staff that Mrs. Jones needs frequent Fat is redistributed to the abdomen and thighs, leaving bony surfaces, such as the face, hands, and
assessment of her skin and protection sacrum, exposed to po- tential injury, especially skin tears from shearing, friction forces and
provided to pre- vent skin breakdown pressure ulcer development.
be- cause: 3.
Although losing weight may be a risk factor for falling, it is not directly related to skin
breakdown.
1. Her lack of activity causes the skin
4.
to tear.
There is no evidence that she is picking at herself, as there is nothing reported anywhere else on her
2. Fat has redistributed to the abdomen arms.
and thighs, leaving bony surfaces in ar-
eas 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.

3. 3. Mr. James is 91 years old.

3. Answer: 2
His daughter notices that he Page: 97






,NRNP 6645 MIDTERM AND FINAL EXAM (5 DIFFERENT VERSIONS 500 QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE
MODALITIES




has bruises and lacerations on his arms
and reports this to the Feedback 1.
nurse practition- er, who tells her that Markings on the skin may be signs of aging, a disease, or mal- treatment.
older people bruise easily due to their 2.
fragile blood vessels. The skin Poorly healing wounds or chronic pressure ulcers may signal a problem not only with
lacerations happen because he has thin the patient but with the caregiver's ability to provide adequate care. Welts, lacerations,
skin. burns, and distinctive markings may indicate a need for intervention.
Even so, the nurse practi- tioner 3.
assures the daugh- ter that she will This is a result of the nurse practitioner addressing it further rather than the reason for addressing
investigate further to ensure that he it.
is getting proper care. She
says this because she under- 4.
A professional cannot assume abuse without good reason.
stands that:

1. These markings on the patient's
skin are part of ag- ing skin.
2. Bruises and lacerations 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 finds an Page: 97
infectious lesion on






,NRNP 6645 MIDTERM AND FINAL EXAM (5 DIFFERENT VERSIONS 500 QS & ANS) /NRNP6645 PSYCHOTHERAPY WITH MULTIPLE
MODALITIES



the lower leg. The lesion is considered a Feedback 1.
secondary le- sion. The nurse Secondary lesions (infections) arise from changes to the primary
practitioner
explains that a secondary le- lesion.
sion is one that: 2.
Secondary lesions are not necessarily the result of an underlying disease.
1. Arises from changes to a primary
3.
lesion.
2. Is a complication of an un- Secondary lesions can be treated with medications or surgery.
derlying disease. 4.
3. Is difficult to treat. Secondary lesions arise as a condition not normal to aging.
4. Is a normal sign of aging.

5. 5. Ms. Rose, 88 years old, comes 5. Answer: 3
to the nurse prac- Page: 97
titioner with a complaint about a
growth on her hand.
She wants to have a bio psy Feedback 1.
done.The nurse practitioner
An injury would not stimulate growth.
asks the following question:
2.
1. Have you injured your hand A reaction to a detergent would more likely be a rash. 3.
recently? Lesions that warrant biopsy are those that have changed, bleed, or are painful.
4.
2. Are you using a different
The ability to put on her ring is not the problem.
detergent?
3. Has this growth changed, bled, or
is it painful?
4. Has this growth made it difficult 6. Answer: 3
to put on your rings? Page: 98

6. 6. A 60-year-old male enters the burn
center for triage

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