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NRNP 6645 Psychotherapy Midterm & Final
Exam Study 2026/2027 | Questions & Verified
Answers with Detailed Rationales | Walden
Grade A
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. What is the best response regarding Mrs.
Williams' concern?
A. "Wound healing for older people may take up to four times longer than it does for
younger people."
B. "Let us talk about what you are eating."
C. "Had you come in earlier, I would have ordered medicine that would have healed that
right up."
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D. "I will order an antibiotic to prevent infection."
Correct Answer: A
Rationale: Skin renewal turnover time increases to approximately 87 days in older
adults, compared with 20 days during youth. The perceived extended healing time is not
related to diet. 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:
A. Her lack of activity causes the skin to tear.
B. 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.
C. She has lost weight and is in jeopardy of falling.
D. She picks at herself and causes skin breakdown.
Correct Answer: B
Rationale: 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
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shearing, friction forces, and pressure ulcer development. Lack of activity alone does not
cause skin breakdown.
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:
A. These markings on the patient's skin are part of aging skin.
B. Bruises and lacerations can indicate inadequate care.
C. The daughter needs assurance that her father is okay.
D. The patient is being abused.
Correct Answer: B
Rationale: 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. A
professional cannot assume abuse without good reason.
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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:
A. Arises from changes to a primary lesion.
B. Is a complication of an underlying disease.
C. Is difficult to treat.
D. Is a normal sign of aging.
Correct Answer: A
Rationale: Secondary lesions arise from changes to the primary lesion. They are not
necessarily the result of an underlying disease and can be treated with medications or
surgery.
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. Which question should the nurse
practitioner ask?
A. "Have you injured your hand recently?"
B. "Are you using a different detergent?"
C. "Has this growth changed, bled, or is it painful?"
D. "Has this growth made it difficult to put on your rings?"
NRNP 6645 Psychotherapy Midterm & Final
Exam Study 2026/2027 | Questions & Verified
Answers with Detailed Rationales | Walden
Grade A
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. What is the best response regarding Mrs.
Williams' concern?
A. "Wound healing for older people may take up to four times longer than it does for
younger people."
B. "Let us talk about what you are eating."
C. "Had you come in earlier, I would have ordered medicine that would have healed that
right up."
,2|Page
D. "I will order an antibiotic to prevent infection."
Correct Answer: A
Rationale: Skin renewal turnover time increases to approximately 87 days in older
adults, compared with 20 days during youth. The perceived extended healing time is not
related to diet. 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:
A. Her lack of activity causes the skin to tear.
B. 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.
C. She has lost weight and is in jeopardy of falling.
D. She picks at herself and causes skin breakdown.
Correct Answer: B
Rationale: 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
,3|Page
shearing, friction forces, and pressure ulcer development. Lack of activity alone does not
cause skin breakdown.
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:
A. These markings on the patient's skin are part of aging skin.
B. Bruises and lacerations can indicate inadequate care.
C. The daughter needs assurance that her father is okay.
D. The patient is being abused.
Correct Answer: B
Rationale: 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. A
professional cannot assume abuse without good reason.
, 4|Page
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:
A. Arises from changes to a primary lesion.
B. Is a complication of an underlying disease.
C. Is difficult to treat.
D. Is a normal sign of aging.
Correct Answer: A
Rationale: Secondary lesions arise from changes to the primary lesion. They are not
necessarily the result of an underlying disease and can be treated with medications or
surgery.
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. Which question should the nurse
practitioner ask?
A. "Have you injured your hand recently?"
B. "Are you using a different detergent?"
C. "Has this growth changed, bled, or is it painful?"
D. "Has this growth made it difficult to put on your rings?"
