NRNP 6645 MIDTERM AND FINAL EXAM 2023
(5 DIFFERENT VERSIONS 500 QS & ANS)
/NRNP6645 PSYCHOTHERAPY WITH
MULTIPLE MODALITIES
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Terms in this set (179) Hide definitions
1. Mrs. Williams is 76 years old and comes in to have a 1. Answer: 1
wound checked on her right leg. She fell a month ago Page: 96
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 Feedback
has no signs of infection. The edges are approximated, 1.
but the skin around the wound is red and tender to touch. Skin renewal turnover time increases to approximately 87 days in older adults,
The best response regarding Mrs. Williams' concern is: compared with 20 days during youth.
2.
1. Wound healing for older people may take up to four The perceived extended healing time is not related to diet.
times longer than it does for younger people. 3.
2. Let us talk about what you are eating. This is false hope, as there is no medication that will heal this wound quickly.
3. Had you come in earlier, I would have ordered 4.
medicine that would have healed that right up. Prophylactic antibiotics are not appropriate when there are no signs or symptoms
4. I will order an antibiotic to prevent infection. of infection.
,2. The nurse practitioner is conducting patient rounds in a 2. Answer: 2
long-term care facility. As she talks with Mrs. Jones, she Page: 96
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 Feedback
skin and protection provided to prevent skin breakdown 1.
because: Lack of activity alone does not cause skin breakdown.
2.
1. Her lack of activity causes the skin to tear. Fat is redistributed to the abdomen and thighs, leaving bony surfaces, such as the
2. Fat has redistributed to the abdomen and thighs, face, hands, and sacrum, exposed to potential injury, especially skin tears from
leaving bony surfaces in areas such as the face, hands, shearing, friction forces and pressure ulcer development.
and sacrum. This can result in injury. 3.
3. She has lost weight and is in jeopardy of falling. Although losing weight may be a risk factor for falling, it is not directly related to
4. She picks at herself and causes skin breakdown. 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 3. Answer: 2
has bruises and lacerations on his arms and reports this to Page: 97
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 Feedback
nurse practitioner assures the daughter that she will 1.
investigate further to ensure that he is getting proper Markings on the skin may be signs of aging, a disease, or maltreatment.
care. She says this because she understands that: 2.
Poorly healing wounds or chronic pressure ulcers may signal a problem not only
1. These markings on the patient's skin are part of aging with the patient but with the caregiver's ability to provide adequate care. Welts,
skin. lacerations, burns, and distinctive markings may indicate a need for intervention.
2. Bruises and lacerations can indicate inadequate care. 3.
3. The daughter needs assurance that her father is okay. This is a result of the nurse practitioner addressing it further rather than the reason
4. The patient is being abused. for addressing it.
4.
A professional cannot assume abuse without good reason.
,4. The nurse practitioner assesses a patient's skin and 4. Answer: 1
finds an infectious lesion on the lower leg. The lesion is Page: 97
considered a secondary lesion. The nurse practitioner
explains that a secondary lesion is one that:
Feedback
1. Arises from changes to a primary lesion. 1.
2. Is a complication of an underlying disease. Secondary lesions (infections) arise from changes to the primary lesion.
3. Is difficult to treat. 2.
4. Is a normal sign of aging. 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 5. Answer: 3
with a complaint about a growth on her hand. She wants Page: 97
to have a biopsy done. The nurse practitioner asks the
following question:
Feedback
1. Have you injured your hand recently? 1.
2. Are you using a different detergent? An injury would not stimulate growth.
3. Has this growth changed, bled, or is it painful? 2.
4. Has this growth made it difficult to put on your rings? 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 6. Answer: 3
and treatment due to a burn he received at a campfire. Page: 98
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? Feedback
1.
1. First degree First-degree burns involving the epidermis are erythematous and painful but do
2. Second degree not blister.
3. First and second degree 2.
4. Second and third degree Second-degree burns involve the dermis and are characterized by blisters.
3.
The patient presents with erythematous skin, painful with blisters, which indicates
both first- and second-degree burn areas.
4.
In third-degree burns there is no sensation when the wound is pinpricked.
, 7. The nurse practitioner is concerned with primary 7. Answer: 1
prevention strategies. How can the nurse practitioner Page: 115, 116
implement primary prevention strategies for an 80-year-
old male patient who smokes? Feedback
1.
1. Review home fire safety protocols, including the proper Primary prevention includes educational programs designed to educate the
use of smoke alarms, and discuss smoking cessation. public on safety. For example, the individual smoking in bed would hopefully
2. Inform him that if he does not stop smoking, the nurse benefit from smoking cessation programs in the community, as well as instruction
practitioner cannot see him again. in safety precautions.
3. Have a conference with his family about his smoking. 2.
4. Plan a family meeting with the patient to discuss Threatening refusal of care is not ethical.
benefits of his smoking cessation. 3.
The patient is at risk, not the family.
4.
The fact that the patient smokes is not the issue; safety is the issue.
8. The nurse practitioner is conducting a safety class with 8. Answer: 1, 2, 3, 4
community-living older adults. Which of the following Page: 98
should she include in her teaching of risks of burns for
this population? Select all that apply. Feedback
1.
1. Thinner skin. As one ages, there are significant changes in the skin, which becomes thinner,
2. Less vascularity. providing a less effective barrier to external stimuli.
3. Diminished nerve function. 2.
4. A weakened immune system. With aging, there are fewer appendages and decreased vascularity.
5. The burden of various comorbidities leading to 3.
enhanced wound healing and reepithelialization after Thinner skin and diminished nerve function often result in a higher incidence of
burn injury. deeper burns.
4.
Advanced age results in a weakened immune system.
5.
Along with the burden of various comorbidities, the fragility of older skin leads to
delayed wound healing and reepithelialization after burn injury.
9. Mr. Edwards is 76 years old and received a burn on his 9. Answer: 1, 2
leg when he dozed off and dropped his cigarette. The Page: 98
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 Feedback
it hurts so much. What is the best answer? Select all that 1.
apply. Deep dermal burns extend further into the dermis; third-degree burns involve the
full dermis, extending into the subcutaneous tissue.
1. It means that this is a serious, deep burn in the center, 2.
and a less deep burn around the sides. In these burns there is pain from exposed nerve endings, but by the second day,
2. It hurts because the nerve endings are exposed in the pain is often described more as pressure.
second-degree area. 3.
3. It means that the burn is advancing and getting worse. The first step in treatment is to stop the burn.
4. It hurts because the nerves are destroyed. 4.
5. It hurts because the nerves in the second-degree areas Destroyed nerves do not register pain.
are exposed to the outside and are stimulated. 5.
Superficial dermal burns involve the dermis and are characterized by blisters. The
underlying tissue is pink, moist, and hypersensitive to touch.
(5 DIFFERENT VERSIONS 500 QS & ANS)
/NRNP6645 PSYCHOTHERAPY WITH
MULTIPLE MODALITIES
Leave the first rating
Save
Students also studied
Flashcard sets Study guides
PCCN: Professional Caring & Ethical... Gastrointestinal Assessment, Diagn... NUR 265 exam final Brunne
Teacher 15 terms Teacher 26 terms Teacher 152 terms 359 term
nguinoru982 Preview BRITAN934 Preview Dr_DAVID_MUTUAZ Preview Nex
Terms in this set (179) Hide definitions
1. Mrs. Williams is 76 years old and comes in to have a 1. Answer: 1
wound checked on her right leg. She fell a month ago Page: 96
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 Feedback
has no signs of infection. The edges are approximated, 1.
but the skin around the wound is red and tender to touch. Skin renewal turnover time increases to approximately 87 days in older adults,
The best response regarding Mrs. Williams' concern is: compared with 20 days during youth.
2.
1. Wound healing for older people may take up to four The perceived extended healing time is not related to diet.
times longer than it does for younger people. 3.
2. Let us talk about what you are eating. This is false hope, as there is no medication that will heal this wound quickly.
3. Had you come in earlier, I would have ordered 4.
medicine that would have healed that right up. Prophylactic antibiotics are not appropriate when there are no signs or symptoms
4. I will order an antibiotic to prevent infection. of infection.
,2. The nurse practitioner is conducting patient rounds in a 2. Answer: 2
long-term care facility. As she talks with Mrs. Jones, she Page: 96
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 Feedback
skin and protection provided to prevent skin breakdown 1.
because: Lack of activity alone does not cause skin breakdown.
2.
1. Her lack of activity causes the skin to tear. Fat is redistributed to the abdomen and thighs, leaving bony surfaces, such as the
2. Fat has redistributed to the abdomen and thighs, face, hands, and sacrum, exposed to potential injury, especially skin tears from
leaving bony surfaces in areas such as the face, hands, shearing, friction forces and pressure ulcer development.
and sacrum. This can result in injury. 3.
3. She has lost weight and is in jeopardy of falling. Although losing weight may be a risk factor for falling, it is not directly related to
4. She picks at herself and causes skin breakdown. 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 3. Answer: 2
has bruises and lacerations on his arms and reports this to Page: 97
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 Feedback
nurse practitioner assures the daughter that she will 1.
investigate further to ensure that he is getting proper Markings on the skin may be signs of aging, a disease, or maltreatment.
care. She says this because she understands that: 2.
Poorly healing wounds or chronic pressure ulcers may signal a problem not only
1. These markings on the patient's skin are part of aging with the patient but with the caregiver's ability to provide adequate care. Welts,
skin. lacerations, burns, and distinctive markings may indicate a need for intervention.
2. Bruises and lacerations can indicate inadequate care. 3.
3. The daughter needs assurance that her father is okay. This is a result of the nurse practitioner addressing it further rather than the reason
4. The patient is being abused. for addressing it.
4.
A professional cannot assume abuse without good reason.
,4. The nurse practitioner assesses a patient's skin and 4. Answer: 1
finds an infectious lesion on the lower leg. The lesion is Page: 97
considered a secondary lesion. The nurse practitioner
explains that a secondary lesion is one that:
Feedback
1. Arises from changes to a primary lesion. 1.
2. Is a complication of an underlying disease. Secondary lesions (infections) arise from changes to the primary lesion.
3. Is difficult to treat. 2.
4. Is a normal sign of aging. 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 5. Answer: 3
with a complaint about a growth on her hand. She wants Page: 97
to have a biopsy done. The nurse practitioner asks the
following question:
Feedback
1. Have you injured your hand recently? 1.
2. Are you using a different detergent? An injury would not stimulate growth.
3. Has this growth changed, bled, or is it painful? 2.
4. Has this growth made it difficult to put on your rings? 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 6. Answer: 3
and treatment due to a burn he received at a campfire. Page: 98
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? Feedback
1.
1. First degree First-degree burns involving the epidermis are erythematous and painful but do
2. Second degree not blister.
3. First and second degree 2.
4. Second and third degree Second-degree burns involve the dermis and are characterized by blisters.
3.
The patient presents with erythematous skin, painful with blisters, which indicates
both first- and second-degree burn areas.
4.
In third-degree burns there is no sensation when the wound is pinpricked.
, 7. The nurse practitioner is concerned with primary 7. Answer: 1
prevention strategies. How can the nurse practitioner Page: 115, 116
implement primary prevention strategies for an 80-year-
old male patient who smokes? Feedback
1.
1. Review home fire safety protocols, including the proper Primary prevention includes educational programs designed to educate the
use of smoke alarms, and discuss smoking cessation. public on safety. For example, the individual smoking in bed would hopefully
2. Inform him that if he does not stop smoking, the nurse benefit from smoking cessation programs in the community, as well as instruction
practitioner cannot see him again. in safety precautions.
3. Have a conference with his family about his smoking. 2.
4. Plan a family meeting with the patient to discuss Threatening refusal of care is not ethical.
benefits of his smoking cessation. 3.
The patient is at risk, not the family.
4.
The fact that the patient smokes is not the issue; safety is the issue.
8. The nurse practitioner is conducting a safety class with 8. Answer: 1, 2, 3, 4
community-living older adults. Which of the following Page: 98
should she include in her teaching of risks of burns for
this population? Select all that apply. Feedback
1.
1. Thinner skin. As one ages, there are significant changes in the skin, which becomes thinner,
2. Less vascularity. providing a less effective barrier to external stimuli.
3. Diminished nerve function. 2.
4. A weakened immune system. With aging, there are fewer appendages and decreased vascularity.
5. The burden of various comorbidities leading to 3.
enhanced wound healing and reepithelialization after Thinner skin and diminished nerve function often result in a higher incidence of
burn injury. deeper burns.
4.
Advanced age results in a weakened immune system.
5.
Along with the burden of various comorbidities, the fragility of older skin leads to
delayed wound healing and reepithelialization after burn injury.
9. Mr. Edwards is 76 years old and received a burn on his 9. Answer: 1, 2
leg when he dozed off and dropped his cigarette. The Page: 98
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 Feedback
it hurts so much. What is the best answer? Select all that 1.
apply. Deep dermal burns extend further into the dermis; third-degree burns involve the
full dermis, extending into the subcutaneous tissue.
1. It means that this is a serious, deep burn in the center, 2.
and a less deep burn around the sides. In these burns there is pain from exposed nerve endings, but by the second day,
2. It hurts because the nerve endings are exposed in the pain is often described more as pressure.
second-degree area. 3.
3. It means that the burn is advancing and getting worse. The first step in treatment is to stop the burn.
4. It hurts because the nerves are destroyed. 4.
5. It hurts because the nerves in the second-degree areas Destroyed nerves do not register pain.
are exposed to the outside and are stimulated. 5.
Superficial dermal burns involve the dermis and are characterized by blisters. The
underlying tissue is pink, moist, and hypersensitive to touch.
