NRNP 6540 ADVANCED PHARMACOLOGY
APPLICATION IN PRIMARY CARE QUESTION
BANK 2026
◉ 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.
APPLICATION IN PRIMARY CARE QUESTION
BANK 2026
◉ 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.
