SEM580 FINAL PAPER 2025/2026 QUESTIONS WITH
ANSWERS RATED A+
✔✔What is the normal range for Serum Albumin? - ✔✔3.5-5.0 mg/dL.
✔✔What Serum Albumin level indicates mild depletion? - ✔✔3.0-3.5 mg/dL.
✔✔What Serum Albumin level indicates moderate depletion? - ✔✔2.4-2.9 mg/dL.
✔✔What Serum Albumin level indicates severe depletion? - ✔✔<2.4 mg/dL.
✔✔What nutritional factors affect Serum Albumin levels? - ✔✔Certain nutritional factors
are known to reduce albumin.
✔✔What is the function of serum prealbumin? - ✔✔It is a carrier protein for thyroid
hormone and transports vitamin A.
✔✔What is a key advantage of serum prealbumin? - ✔✔It is influenced less by
intravascular fluid volume and is not affected as early or significantly by liver disease.
✔✔What is the half-life of serum prealbumin? - ✔✔2-3 days.
✔✔What is the normal range for serum prealbumin levels? - ✔✔16-35 mg/dl.
✔✔What serum prealbumin level indicates mild depletion? - ✔✔10-15 mg/dl.
✔✔What serum prealbumin level indicates moderate depletion? - ✔✔5-10 mg/dl.
✔✔What serum prealbumin level indicates severe depletion? - ✔✔<5 mg/dl.
✔✔Why is serum prealbumin considered a sensitive marker? - ✔✔It is a more sensitive
marker for protein and calorie deficiency and response to nutrition therapy.
✔✔In which conditions may serum prealbumin levels be decreased? - ✔✔End stage
liver disease, hyperthyroidism, severe protein calorie malnutrition, and zinc deficiency.
✔✔How does serum prealbumin respond in the acute phase of illness? - ✔✔It
decreases rapidly.
✔✔Intrinsic Risk Factors for MARSI - ✔✔Age extremes (neonate & elderly),
dehydration, malnutrition, dermatologic skin conditions, underlying conditions that affect
the skin (diabetes, infection, CKD, venous disease, immunosuppression), edema
, ✔✔MARSI: Mechanism of Injury w/Example - ✔✔Mechanical Trauma: skin stripping,
tension blisters, skin tears; Dermatitis: Irritant contact dermatitis, allergic contact
dermatitis; Other: Maceration, Folliculitis
✔✔Extrinsic Risk Factors for MARSI - ✔✔Dry skin d/t low humidity or harsh skin care
products, over hydrated skin, medications (steroids, chemo, anticoags, anti-
inflammatories), radiation treatment (past/present), excessive sun exposure, use of tape
or adhesive products
✔✔Adhesive Alternatives for Dressing Securement - ✔✔Tubular elastic net dressing,
elastic tubular bandage, self-adherent elastic bandage (Coban), conforming gauze
bandage (Soft-kling), abdominal dressing holders (Montgomery straps)
✔✔MARSI Staff Education & Problem Surveillance - ✔✔Adhesive product utilization &
standardization, protocols for use each type of adhesive product, protocols for
management of MARSI
✔✔Elderly Skin Changes - ✔✔Decreased melanocytes, decreased Langerhans' cells,
flattening of dermal-epidermal junction, decreased epidermal thickness, decreased
fibroblasts, decreased mast cells, decreased papillary network, decreased collagen,
decreased elastin, increased cellular senescence, reduce inflammatory response,
reduce vitamin D production, reduced sensory function, thinning of adipose layer, skin
pH rises with aging which compromises skin health and barrier function (reduced
activity of sebaceous and sweat glands)
✔✔Neonate Skin Changes - ✔✔Thinner & more permeable, higher ratio of surface area
to total body weight, higher risk of TEWL, increased systemic absorption of topically
applied substances, decreased temperature regulation, eccrine sweat glands minimally
developed, subcutaneous layer is thinner and less developed
✔✔Skin Tear Risk Factors - ✔✔Age extremes, female, Caucasian, previous skin tear,
presence of bruising, use of medical adhesives or devices, blood draws, falls,
dependency for ADLs, transfers-chair or bed bound, use assistive devices, decreased
cognition, sensory, visual & auditory status, malnutrition, dehydration, co-morbidities
(cardiovascular, pulmonary, incontinence), drugs (steroids, anticoags, polypharmacy,
chemo/radiation), ETOH use
✔✔Skin Tear Prevention Methods - ✔✔Pad furniture edges, twice daily skin moisturizer,
shin guards, proper footwear, protective sleeves, use palm of hand or lift sheets,
mechanical lifts, wheelchair sling protection, protective garments for extremities, safe
area for wandering, remove room obstacles, secure rugs, adequate lighting, consider
PT/OT referral to optimize mobility and safe transfers
ANSWERS RATED A+
✔✔What is the normal range for Serum Albumin? - ✔✔3.5-5.0 mg/dL.
✔✔What Serum Albumin level indicates mild depletion? - ✔✔3.0-3.5 mg/dL.
✔✔What Serum Albumin level indicates moderate depletion? - ✔✔2.4-2.9 mg/dL.
✔✔What Serum Albumin level indicates severe depletion? - ✔✔<2.4 mg/dL.
✔✔What nutritional factors affect Serum Albumin levels? - ✔✔Certain nutritional factors
are known to reduce albumin.
✔✔What is the function of serum prealbumin? - ✔✔It is a carrier protein for thyroid
hormone and transports vitamin A.
✔✔What is a key advantage of serum prealbumin? - ✔✔It is influenced less by
intravascular fluid volume and is not affected as early or significantly by liver disease.
✔✔What is the half-life of serum prealbumin? - ✔✔2-3 days.
✔✔What is the normal range for serum prealbumin levels? - ✔✔16-35 mg/dl.
✔✔What serum prealbumin level indicates mild depletion? - ✔✔10-15 mg/dl.
✔✔What serum prealbumin level indicates moderate depletion? - ✔✔5-10 mg/dl.
✔✔What serum prealbumin level indicates severe depletion? - ✔✔<5 mg/dl.
✔✔Why is serum prealbumin considered a sensitive marker? - ✔✔It is a more sensitive
marker for protein and calorie deficiency and response to nutrition therapy.
✔✔In which conditions may serum prealbumin levels be decreased? - ✔✔End stage
liver disease, hyperthyroidism, severe protein calorie malnutrition, and zinc deficiency.
✔✔How does serum prealbumin respond in the acute phase of illness? - ✔✔It
decreases rapidly.
✔✔Intrinsic Risk Factors for MARSI - ✔✔Age extremes (neonate & elderly),
dehydration, malnutrition, dermatologic skin conditions, underlying conditions that affect
the skin (diabetes, infection, CKD, venous disease, immunosuppression), edema
, ✔✔MARSI: Mechanism of Injury w/Example - ✔✔Mechanical Trauma: skin stripping,
tension blisters, skin tears; Dermatitis: Irritant contact dermatitis, allergic contact
dermatitis; Other: Maceration, Folliculitis
✔✔Extrinsic Risk Factors for MARSI - ✔✔Dry skin d/t low humidity or harsh skin care
products, over hydrated skin, medications (steroids, chemo, anticoags, anti-
inflammatories), radiation treatment (past/present), excessive sun exposure, use of tape
or adhesive products
✔✔Adhesive Alternatives for Dressing Securement - ✔✔Tubular elastic net dressing,
elastic tubular bandage, self-adherent elastic bandage (Coban), conforming gauze
bandage (Soft-kling), abdominal dressing holders (Montgomery straps)
✔✔MARSI Staff Education & Problem Surveillance - ✔✔Adhesive product utilization &
standardization, protocols for use each type of adhesive product, protocols for
management of MARSI
✔✔Elderly Skin Changes - ✔✔Decreased melanocytes, decreased Langerhans' cells,
flattening of dermal-epidermal junction, decreased epidermal thickness, decreased
fibroblasts, decreased mast cells, decreased papillary network, decreased collagen,
decreased elastin, increased cellular senescence, reduce inflammatory response,
reduce vitamin D production, reduced sensory function, thinning of adipose layer, skin
pH rises with aging which compromises skin health and barrier function (reduced
activity of sebaceous and sweat glands)
✔✔Neonate Skin Changes - ✔✔Thinner & more permeable, higher ratio of surface area
to total body weight, higher risk of TEWL, increased systemic absorption of topically
applied substances, decreased temperature regulation, eccrine sweat glands minimally
developed, subcutaneous layer is thinner and less developed
✔✔Skin Tear Risk Factors - ✔✔Age extremes, female, Caucasian, previous skin tear,
presence of bruising, use of medical adhesives or devices, blood draws, falls,
dependency for ADLs, transfers-chair or bed bound, use assistive devices, decreased
cognition, sensory, visual & auditory status, malnutrition, dehydration, co-morbidities
(cardiovascular, pulmonary, incontinence), drugs (steroids, anticoags, polypharmacy,
chemo/radiation), ETOH use
✔✔Skin Tear Prevention Methods - ✔✔Pad furniture edges, twice daily skin moisturizer,
shin guards, proper footwear, protective sleeves, use palm of hand or lift sheets,
mechanical lifts, wheelchair sling protection, protective garments for extremities, safe
area for wandering, remove room obstacles, secure rugs, adequate lighting, consider
PT/OT referral to optimize mobility and safe transfers
