NRNP 6552 SKILLS AND CASE REVIEW
QUESTIONS WITH COMPLETE SOLUTION
GUIDE
●● 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.
Answer: 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.
Answer: 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.
Answer: 4. Answer: 1
Page: 97
Feedback
1.
Secondary lesions (infections) arise from changes to the primary lesion.
2.
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 with a
complaint about a growth on her hand. She wants to have a biopsy done.
The nurse practitioner asks the following question:
1. Have you injured your hand recently?
2. Are you using a different detergent?
3. Has this growth changed, bled, or is it painful?
4. Has this growth made it difficult to put on your rings?
QUESTIONS WITH COMPLETE SOLUTION
GUIDE
●● 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.
Answer: 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.
Answer: 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.
Answer: 4. Answer: 1
Page: 97
Feedback
1.
Secondary lesions (infections) arise from changes to the primary lesion.
2.
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 with a
complaint about a growth on her hand. She wants to have a biopsy done.
The nurse practitioner asks the following question:
1. Have you injured your hand recently?
2. Are you using a different detergent?
3. Has this growth changed, bled, or is it painful?
4. Has this growth made it difficult to put on your rings?
