NURS 6531 FINAL EXAM WEEK 11 NEWEST ACTUAL

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NURS 6531 FINAL EXAM WEEK 11 NEWEST | ACTUAL

EXAM 2 VERSIONS A&B WITH ALL 350 ACCURATE

QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED

ANSWERS) ALREADY GRADED A+ |WALDEN UNIVERSITY/

NURS 6531 PRACTICE CARE OF ADULTS LATEST FINAL

EXAM (BRAND NEW!!)

A patient asks about direct-to-consumer (DTC) genetic testing. What will the provider tell the patient?

• It is not useful for identifying genetic diseases.
• Much of the information does not predict disease risk.
• The results are shared with the patient's insurance company.

d. The results must be interpreted by a provider. - Correct Answer - ANS: B

DTC testing gives a lot of information, but much of it does not contribute to disease prediction, since mutations are not necessarily related to specific diseases. The tests are useful but must be interpreted accurately. The results are confidential and do not have to be interpreted by a provider.

What is an important part of patient care that can minimize the risk of a formal patient complaint even when a mistake is made?

• Ensuring informed consent for all procedures
• Maintaining effective patient communication
• Monitoring patient compliance and adherence

d. Providing complete documentation of visits - Correct Answer - ANS: B

Effective patient communication is key to building trust and rapport and ineffective communication is a predictor for malpractice claims. The other items are important aspects of care and may help the provider during the investigation of a claim, but do not minimize the risk. 1 / 4

pg. 2 What are some causes for failures or delays in diagnosing patients resulting in malpractice claims? (Select all that apply.)

• Failing to recognize a medication complication
• Failing to request appropriate consultations
• Improper performance of a treatment
• Not acting on diagnostic test results

e. Ordering a wrong medication - Correct Answer - ANS: B, D

Failing to obtain consultations when indicated or not acting on diagnostic test results can lead to diagnosis-related failures. Failing to recognize medication complications and ordering a wrong medication led to medication prescribing allegations. Improper performance of a treatment can led to treatment-related malpractice claims.

A primary care provider is performing a Tzanck test to evaluate possible herpes simplex lesions. To attain accurate results, the provider will perform what intervention?

• Blanch the lesions while examining them with a magnifying glass.
• Gently scrape the lesions with a scalpel onto a slide.
• Perform a gram stain of exudate from the lesions.
• Remove the top of the vesicles and obtain fluid from the lesions. - Correct Answer -

ANS: D

The Tzanck test requires removing the tops from vesicular lesions in order to obtain fresh fluid from the base of the lesions. Blanching of blue to red lesions under a microscope helps to evaluate whether blood is in the capillaries of the lesions. Scraping lesions onto a slide is done to evaluate the presence of hyphae and spores common with candidiasis or fungal infections. Gram staining is performed to distinguish gram- positive from gram-negative organisms in suspected bacterial infections.

When examining a patient's skin, a practitioner uses dermoscopy for what purpose?(Select all that apply.)

• Accentuating changes in color of pathologic lesions by fluorescence
• Assessing changes in pigmentation throughout various lesions
• Determining whether lesion borders are regular or irregular
• Differentiating fluid masses from cystic masses in the epidermis 2 / 4

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• Visualizing skin fissures, hair follicles, and pores in lesions - Correct Answer - ANS: B,

C, E Dermoscopy is used to visualize the epidermis and superficial dermis and can reveal changes in pigmentation throughout lesions, whether borders are regular or irregular, and the various fissures, follicles, and pores present in lesions. The Wood's light, or black light, is used to fluoresce lesions to accentuate changes in color. A direct light source is useful for differentiating fluid masses from cystic masses.

A patient has actinic keratosis and the provider elects to use cryosurgery to remove the lesions. How will the provider administer this procedure?

• Applying one or two freeze-thaw cycles to each lesion
• Applying two or more freeze-thaw cycles to each lesion
• Applying until the freeze spreads laterally 1 mm from the lesion edges
• Applying until the freeze spreads laterally 4 mm from the lesion edges - Correct

Answer - ANS: A

For actinic keratosis, one to two freeze-thaw cycles are usually enough. Two or more freeze-thaw cycles are generally required for thicker, seborrheic keratosis lesions. The freeze should spread laterally 3 to 4 mm from the edge of the lesions.

A provider is preparing to administer electrocautery to a patient who has several seborrheic keratoses. The patient tells the provider that he has a pacemaker. Which action is correct?

• Administer the electrocautery per the usual protocol.
• Apply electrocautery in short burst at low voltage.
• Refer the patient to a dermatologist for removal.

d. Suggest another method for removal of the lesions. - Correct Answer - ANS: B

Patients with pacemakers or implantable cardioverter-defibrillators may receive electrocautery if appropriate precautions, such as lower voltage and shorter bursts are taken. It is not necessary to suggest another method or to refer to a dermatologist.

Which type of office surgical procedure warrants sterile technique?

• Curettage
• Punch biopsy 3 / 4

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• Scissor excision

d. Shave biopsy - Correct Answer - ANS: B

Punch biopsy requires sterile technique. The other procedures require cleaning with alcohol and clean technique with universal precautions.

When recommending an over-the-counter topical medication to treat a dermatologic condition, which instruction to the patient is important to enhance absorption of the drug?

• Apply a thick layer of medication over the affected area.
• A solution spray preparation will be more effective on hairy areas.
• Put cool compresses over the affected area after application.
• Use a lotion or cream instead of an ointment preparation. - Correct Answer - ANS: B

Hairy areas are difficult to penetrate, so in these areas, a solution, foam, spray, or gel may work better. Applying a thicker layer does not increase skin penetration or effectiveness of a medication. Warm or inflamed skin absorbs medications more readily; cool compresses will decrease absorption. Lotions and creams are not as readily absorbed as ointments, which have occlusive properties.

A provider is prescribing a topical dermatologic medication for a patient who has open lesions on a hairy area of the body. Which vehicle type will the provider choose when prescribing this medication?

• Cream
• Gel
• Ointment

d. Powder - Correct Answer - ANS: B

Gels are an excellent vehicle for use on hairy areas of the body. Creams and ointments are not recommended for hairy areas. Powders should be avoided in open wounds.

An adult patient has been diagnosed with atopic dermatitis and seborrheic dermatitis with lesions on the forehead and along the scalp line. Which is correct when prescribing a corticosteroid medication to treat this condition?

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