NRNP-6645-2- Psychotherapy FINAL EXAM QUESTIONS AND ANSWERS graded a++.pdf

Midterm Exam NRNP 6645 NRNP6645 Psychot k k k k k




herapy with Multiple Modalities k k k




1. 1. Mrs.Williams is 76 years old and comes in to have a wound checked on her righ
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t leg. She fell a month ago and the wound has not healed. She is concerned that some
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thing is wrong.The nurse practitioner examines the wound and sees that it has be
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en cleaned properly and has no signs of infection.The edges are approximated, b
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ut the skin around the wound is red and tender to touch. The best response regar
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ding Mrs. Williams' concern is:
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1. Wound healing for older people may take up to four times longer than it does for
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younger people. k




2. Let us talk about what you are eating.
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3. Had you come in earlier, I would have ordered medicine that would have he
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aled that right up.
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4. I will order an antibiotic to prevent infection.: 1. Answer: 1 P
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age: 96 k




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,Feedback k




1.

Skin renewal turnover time increases to approximately 87 days in older adults, compar
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ed with 20 days during youth.
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2.

The perceived extended healing time is not related to diet. 3.
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This is false hope, as there is no medication that will heal this wound quickly. 4.
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Prophylactic antibiotics are not appropriate when there are no signs or symptoms of in
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fection.

2. 2. The nurse practitioner is conducting patient rounds in a long-
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term care facility. As she talks with Mrs. Jones, she notices that her arms and elb
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ows are excoriated and the skin is shearing. The nurse practitioner explains to th
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e staff that Mrs. Jones needs frequent assessment of her skin and protection pro
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vided to prevent skin breakdown because:
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1. Her lack of activity causes the skin to tear.
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2. Fat has redistributed to the abdomen and thighs, leaving bony surfaces in are
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as such as the face, hands, and sacrum. This can result in injury.
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3. She has lost weight and is in jeopardy of falling.
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,4. She picks at herself and causes skin breakdown.: 2. Answer: 2 Pag
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e: 96
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, Feedback k




1.

Lack of activity alone does not cause skin breakdown. 2.
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Fat is redistributed to the abdomen and thighs, leaving bony surfaces, such as the face, h
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ands, and sacrum, exposed to potential injury, especially skin tears from shearing, fricti
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on forces and pressure ulcer development.
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3.

Although losing weight may be a risk factor for falling, it is not directly related to skin bre
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akdown.

4.

There is no evidence that she is picking at herself, as there is nothing reported anywher
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e else on her arms.
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3. 3. Mr. James is 91 years old. His daughter notices that he has bruises and lacer
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ations on his arms and reports this to the nurse practitioner, who tells her that o
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lder people bruise easily due to their fragile blood vessels. The skin lacerations h
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appen because he has thin skin. Even so, the nurse practitioner assures the daug
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hter that she will investigate further to ensure that he is getting proper care. She
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