WALDEN UNIVERSITY NRNP6645
PSYCHOTHERAPY WITH MULTIPLE MODALITIES
MIDTERM EXAM 2
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. - ANSWER ->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
longterm 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:
PSYCHOTHERAPY WITH MULTIPLE MODALITIES
MIDTERM EXAM 2
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. - ANSWER ->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
longterm 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:
