NRNP 6645 MIDTERM AND FINAL EXAM
2025 (5 DIFFERENT VERSIONS 500 QS &
ANS) /NRNP6645 PSYCHOTHERAPY
WITH MULTIPLE MODALITIES A+
GRADED AND VERIFIED
Mrs. K 95 years old, comes to the nurse practitioner with her daughter to discuss her
medical regime. She complains that she thinks some of the therapies are doing more
harm than good. Mrs. K wants to discontinue some of the medical orders. The nurse
practitioner reviews her medical plan and discusses a new model of care called
minimally disruptive medicine (MDM). She explains to the daughter and to Mrs. K that
this model does which of the following? Select all that apply. - CORRECT ANSWER.
-Recognizes the difference between patient-centered and disease-centered treatment.
-May suggest limitations on some traditional therapies for the frail patient with MCCs.
-Revises clinical practice guidelines to consider minimally disruptive medicine.
-Has clinicians use approaches that include patient values so that better decisions are
made.
The nurse practitioner is asked to order medication for pain and disease control for a
60-year-old patient who has suffered with RA for years. Which is the most common
treatment? Select all that apply. - CORRECT ANSWER Corticosteroids
NSAIDs
Analgesics
Biological disease-modifying antirheumatic drugs (DMARDs)
Tumor necrosis factor (TNF) receptor antagonists
Mark, 82 years old, is in a rehabilitation center for therapy post-knee replacement. The
nurse practitioner is visiting Mark and finds him confused, disoriented, and with speech
difficulty. The staff nurse says that his condition changed quickly over the last few
hours. The nurse practitioner orders which of the following? Select all that apply. -
CORRECT ANSWER Pulse oximetry
Evaluation for infections
Assessment of change in medications
Brain scan
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. - CORRECT 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 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. - CORRECT 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. - CORRECT 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. - CORRECT 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? - CORRECT ANSWER 5.
Answer: 3
Page: 97
Feedback
1.
An injury would not stimulate growth.
2.
A reaction to a detergent would more likely be a rash.
3.
Lesions that warrant biopsy are those that have changed, bleed, or are painful.
4.
The ability to put on her ring is not the problem.
6. A 60-year-old male enters the burn center for triage and treatment due to a burn he
received at a campfire. His left arm has an area that is erythematous and painful, and
another area has a blister. What does the nurse practitioner record as the degree of
burn?
1. First degree
2. Second degree
3. First and second degree
4. Second and third degree - CORRECT ANSWER 6. Answer: 3
Page: 98
Feedback
1.
First-degree burns involving the epidermis are erythematous and painful but do not
blister.
2.
Second-degree burns involve the dermis and are characterized by blisters.
2025 (5 DIFFERENT VERSIONS 500 QS &
ANS) /NRNP6645 PSYCHOTHERAPY
WITH MULTIPLE MODALITIES A+
GRADED AND VERIFIED
Mrs. K 95 years old, comes to the nurse practitioner with her daughter to discuss her
medical regime. She complains that she thinks some of the therapies are doing more
harm than good. Mrs. K wants to discontinue some of the medical orders. The nurse
practitioner reviews her medical plan and discusses a new model of care called
minimally disruptive medicine (MDM). She explains to the daughter and to Mrs. K that
this model does which of the following? Select all that apply. - CORRECT ANSWER.
-Recognizes the difference between patient-centered and disease-centered treatment.
-May suggest limitations on some traditional therapies for the frail patient with MCCs.
-Revises clinical practice guidelines to consider minimally disruptive medicine.
-Has clinicians use approaches that include patient values so that better decisions are
made.
The nurse practitioner is asked to order medication for pain and disease control for a
60-year-old patient who has suffered with RA for years. Which is the most common
treatment? Select all that apply. - CORRECT ANSWER Corticosteroids
NSAIDs
Analgesics
Biological disease-modifying antirheumatic drugs (DMARDs)
Tumor necrosis factor (TNF) receptor antagonists
Mark, 82 years old, is in a rehabilitation center for therapy post-knee replacement. The
nurse practitioner is visiting Mark and finds him confused, disoriented, and with speech
difficulty. The staff nurse says that his condition changed quickly over the last few
hours. The nurse practitioner orders which of the following? Select all that apply. -
CORRECT ANSWER Pulse oximetry
Evaluation for infections
Assessment of change in medications
Brain scan
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. - CORRECT 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 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. - CORRECT 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. - CORRECT 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. - CORRECT 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? - CORRECT ANSWER 5.
Answer: 3
Page: 97
Feedback
1.
An injury would not stimulate growth.
2.
A reaction to a detergent would more likely be a rash.
3.
Lesions that warrant biopsy are those that have changed, bleed, or are painful.
4.
The ability to put on her ring is not the problem.
6. A 60-year-old male enters the burn center for triage and treatment due to a burn he
received at a campfire. His left arm has an area that is erythematous and painful, and
another area has a blister. What does the nurse practitioner record as the degree of
burn?
1. First degree
2. Second degree
3. First and second degree
4. Second and third degree - CORRECT ANSWER 6. Answer: 3
Page: 98
Feedback
1.
First-degree burns involving the epidermis are erythematous and painful but do not
blister.
2.
Second-degree burns involve the dermis and are characterized by blisters.
