Midterm Exam: NRNP 6645/ NRNP6645
Psychotherapy with Multiple Modalities (Grade A) |
Questions and Answers 2025/2026 | Verified 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. - :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. - :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. Biotransformation means chemical alteration of things such as nutrients, amino
acids, toxins, and drugs in the body. In which organ does biotransformation occurs?
1. Intestines
2. Liver
3. Pancreas
4. Bile - :answers :3. Answer: 2
Page: 470
Feedback
1.
The intestines are vital organs in the GI tract of our digestive system and their functions
are to digest food and enable the nutrients released from that food to enter the
bloodstream.
2.
Biotransformation occurs in all body tissues, but primarily in the liver, where enzymatic
activity alters and detoxifies the drug and prepares it for excretion.
3.
The pancreas plays an essential role in converting the food we eat into fuel for the body's
cells.
4.
The bile is critical for digestion and absorption of fats and fat-soluble vitamins in the
small intestine.
, 4. Which of the following is most affected by pharmacokinetic change?
1. Distribution of drugs.
2. Elimination of drugs.
3. Absorption of drugs.
4. Metabolism of drugs. - :answers :4. Answer: 2
Page: 471
Feedback
1.
Drug distribution relies on the bioavailability of the drug.
2.
Kidney function changes, normal with aging, may prolong the half-lives of drugs. This is
particularly important for drugs that are excreted unchanged in the urine and for drug
categories known to be particularly nephrotoxic in older persons.
3.
Drug absorption is generally thought to have a less significant impact on
pharmacokinetics.
4.
Being familiar with age-related pharmacokinetics of drugs is of the utmost importance
when determining the initial and maintenance dosages, especially in the metabolism of
drugs. When prescribing for an older patient, it is critical to understand whether the
drug inhibits or induces the cytochromes P450 (CYP) enzymes.
5. A patient is started on a low dose of a drug for safety but is never advanced to a
therapeutic
dose while another drug is added. Which of the following does this describe?
1. Preferences of care.
Psychotherapy with Multiple Modalities (Grade A) |
Questions and Answers 2025/2026 | Verified 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. - :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. - :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. Biotransformation means chemical alteration of things such as nutrients, amino
acids, toxins, and drugs in the body. In which organ does biotransformation occurs?
1. Intestines
2. Liver
3. Pancreas
4. Bile - :answers :3. Answer: 2
Page: 470
Feedback
1.
The intestines are vital organs in the GI tract of our digestive system and their functions
are to digest food and enable the nutrients released from that food to enter the
bloodstream.
2.
Biotransformation occurs in all body tissues, but primarily in the liver, where enzymatic
activity alters and detoxifies the drug and prepares it for excretion.
3.
The pancreas plays an essential role in converting the food we eat into fuel for the body's
cells.
4.
The bile is critical for digestion and absorption of fats and fat-soluble vitamins in the
small intestine.
, 4. Which of the following is most affected by pharmacokinetic change?
1. Distribution of drugs.
2. Elimination of drugs.
3. Absorption of drugs.
4. Metabolism of drugs. - :answers :4. Answer: 2
Page: 471
Feedback
1.
Drug distribution relies on the bioavailability of the drug.
2.
Kidney function changes, normal with aging, may prolong the half-lives of drugs. This is
particularly important for drugs that are excreted unchanged in the urine and for drug
categories known to be particularly nephrotoxic in older persons.
3.
Drug absorption is generally thought to have a less significant impact on
pharmacokinetics.
4.
Being familiar with age-related pharmacokinetics of drugs is of the utmost importance
when determining the initial and maintenance dosages, especially in the metabolism of
drugs. When prescribing for an older patient, it is critical to understand whether the
drug inhibits or induces the cytochromes P450 (CYP) enzymes.
5. A patient is started on a low dose of a drug for safety but is never advanced to a
therapeutic
dose while another drug is added. Which of the following does this describe?
1. Preferences of care.
