NURS 6540 Exam Study Guide (Latest
2023/2024): Advanced Practice Care of Frail
Elders – Walden / 2-3 MAJOR EXAMS VS
WEEKELY QUIZZES
Question
A 76-year-old patient has a wound that is not healing. There are no signs of infection, but
surrounding skin is red and tender. What is the best explanation?
A. Wound healing in older adults can take significantly longer due to decreased cellular
turnover
B. Let us discuss your diet, as this is the main cause
C. The wound would have healed instantly if you came earlier
D. I will prescribe antibiotics to prevent infection
Answer: A
Rationale:
Aging slows epidermal turnover (about 87 days vs 20 days in younger adults), leading to
delayed healing even without infection. Antibiotics are not indicated without infection.
Question
An elderly patient has fragile skin and frequent skin tears. What is the best explanation?
A. Lack of activity causes skin tearing
B. Fat redistribution exposes bony prominences, increasing risk of injury
C. Weight loss causes frequent falls leading to tears
D. Self-picking causes all skin damage
Answer: B
Rationale:
Aging causes fat loss in extremities and redistribution to the trunk, exposing bony areas and
increasing risk of friction and shear injury.
, Question
Bruising and skin tears in a 91-year-old patient should prompt concern because:
A. These are normal aging changes only
B. They may indicate inadequate care or possible neglect
C. The family requires reassurance only
D. Abuse is automatically confirmed
Answer: B
Rationale:
Although aging increases fragility, unexplained injuries may indicate neglect or poor care and
require investigation.
Question
A secondary skin lesion is defined as:
A. A lesion that develops from a primary lesion
B. A lesion caused only by infection
C. A lesion that is always malignant
D. A normal aging change
Answer: A
Rationale:
Secondary lesions arise from changes in primary lesions such as infection, trauma, or
progression.
Question
Which symptom indicates need for biopsy of a skin lesion?
A. History of detergent change
B. Minor trauma to hand
C. Lesion that changes, bleeds, or becomes painful
D. Difficulty wearing rings
Answer: C
Rationale:
Change, bleeding, and pain are warning signs of malignancy and require evaluation.
, Question
A burn with redness and blistering is classified as:
A. First degree only
B. Second degree only
C. Both first and second degree
D. Second and third degree
Answer: C
Rationale:
First-degree burns cause erythema; second-degree burns involve blistering.
Question
Best primary prevention for an elderly smoker includes:
A. Smoking cessation education and fire safety teaching
B. Threatening discharge
C. Involving family only
D. Avoiding discussion of smoking
Answer: A
Rationale:
Primary prevention focuses on education and risk reduction strategies.
Question
Burn risk in older adults is increased due to:
A. Thin skin
B. Reduced vascularity
C. Reduced nerve function
D. Weakened immune system
E. Faster wound healing
Answer: A, B, C, D
, Rationale:
Aging causes skin thinning, reduced blood flow, reduced sensation, and weaker immunity,
increasing burn severity and delaying healing.
Question
Why does a mixed second and third-degree burn hurt?
A. Deep tissue damage in center
B. Exposed nerve endings in partial thickness areas
C. Burn is worsening
D. Destroyed nerves cause pain
Answer: A, B
Rationale:
Second-degree burns are painful due to exposed nerve endings; third-degree burns may be
painless due to nerve destruction.
Question
Initial management of partial and full thickness burns includes:
A. Pain control
B. Cooling with water
C. Strong detergent cleansing
D. Removing loose tissue and preserving blisters
E. Mislabeling burn type
Answer: A, B, D
Rationale:
Immediate cooling and pain control reduce tissue damage; gentle wound care is essential.
Question
Localized red, painful, swollen arm with fever most likely indicates:
A. Influenza
B. Upper respiratory infection
2023/2024): Advanced Practice Care of Frail
Elders – Walden / 2-3 MAJOR EXAMS VS
WEEKELY QUIZZES
Question
A 76-year-old patient has a wound that is not healing. There are no signs of infection, but
surrounding skin is red and tender. What is the best explanation?
A. Wound healing in older adults can take significantly longer due to decreased cellular
turnover
B. Let us discuss your diet, as this is the main cause
C. The wound would have healed instantly if you came earlier
D. I will prescribe antibiotics to prevent infection
Answer: A
Rationale:
Aging slows epidermal turnover (about 87 days vs 20 days in younger adults), leading to
delayed healing even without infection. Antibiotics are not indicated without infection.
Question
An elderly patient has fragile skin and frequent skin tears. What is the best explanation?
A. Lack of activity causes skin tearing
B. Fat redistribution exposes bony prominences, increasing risk of injury
C. Weight loss causes frequent falls leading to tears
D. Self-picking causes all skin damage
Answer: B
Rationale:
Aging causes fat loss in extremities and redistribution to the trunk, exposing bony areas and
increasing risk of friction and shear injury.
, Question
Bruising and skin tears in a 91-year-old patient should prompt concern because:
A. These are normal aging changes only
B. They may indicate inadequate care or possible neglect
C. The family requires reassurance only
D. Abuse is automatically confirmed
Answer: B
Rationale:
Although aging increases fragility, unexplained injuries may indicate neglect or poor care and
require investigation.
Question
A secondary skin lesion is defined as:
A. A lesion that develops from a primary lesion
B. A lesion caused only by infection
C. A lesion that is always malignant
D. A normal aging change
Answer: A
Rationale:
Secondary lesions arise from changes in primary lesions such as infection, trauma, or
progression.
Question
Which symptom indicates need for biopsy of a skin lesion?
A. History of detergent change
B. Minor trauma to hand
C. Lesion that changes, bleeds, or becomes painful
D. Difficulty wearing rings
Answer: C
Rationale:
Change, bleeding, and pain are warning signs of malignancy and require evaluation.
, Question
A burn with redness and blistering is classified as:
A. First degree only
B. Second degree only
C. Both first and second degree
D. Second and third degree
Answer: C
Rationale:
First-degree burns cause erythema; second-degree burns involve blistering.
Question
Best primary prevention for an elderly smoker includes:
A. Smoking cessation education and fire safety teaching
B. Threatening discharge
C. Involving family only
D. Avoiding discussion of smoking
Answer: A
Rationale:
Primary prevention focuses on education and risk reduction strategies.
Question
Burn risk in older adults is increased due to:
A. Thin skin
B. Reduced vascularity
C. Reduced nerve function
D. Weakened immune system
E. Faster wound healing
Answer: A, B, C, D
, Rationale:
Aging causes skin thinning, reduced blood flow, reduced sensation, and weaker immunity,
increasing burn severity and delaying healing.
Question
Why does a mixed second and third-degree burn hurt?
A. Deep tissue damage in center
B. Exposed nerve endings in partial thickness areas
C. Burn is worsening
D. Destroyed nerves cause pain
Answer: A, B
Rationale:
Second-degree burns are painful due to exposed nerve endings; third-degree burns may be
painless due to nerve destruction.
Question
Initial management of partial and full thickness burns includes:
A. Pain control
B. Cooling with water
C. Strong detergent cleansing
D. Removing loose tissue and preserving blisters
E. Mislabeling burn type
Answer: A, B, D
Rationale:
Immediate cooling and pain control reduce tissue damage; gentle wound care is essential.
Question
Localized red, painful, swollen arm with fever most likely indicates:
A. Influenza
B. Upper respiratory infection
