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NSG 255 Exam 1 2025 LATEST SCORE A+
ageism
a negative attitude about age; an attitude that discriminates, separates, stigmatizes, or otherwise disadvantages older adults on the basis of chronological age
chronic illness
illness that is prolonged, does not resolve spontaneously, and is rarely cured completely
elder mistreatment
intentional acts by a caregiver or "trusted other" that cause harm or serious risk of harm to a vulnerable older adult and/or neglect meeting the basic needs of a vulnerable older adult
ethogeriatric
a term used to describe the specialty area of providing culturally competent care to ethnic elders
frail older adult
an older person (usually over 75) who has multiple physical or mental disabilities that may interfere with the ability to perform ADLs independently
gerontologic nursing
a specialty nursing practice in which the nurse approaches older adult patient with a whole-person (physical, psychologic, socioeconomic) perspective
medicaid
state-administered program that assists eligible low-income persons; coverage varies by state
medicare
federally funded health insurance program for people 65 and older as well as people with disabilities under 65 and for all people of all aged with end-stage renal disease requiring dialysis or transplant
old-old adults
a term used to represent adults who are 85 and older
young-old adults
A term used to represent adults who are 65 to 75 years of age.
a nurse is interesting in providing care for persons with chronic illness. where should the nurse identify that most chronic illnesses are managed?
a community setting
Chronic illnesses (other than the acute phase or acute exacerbations) are usually managed in a community setting such as in ambulatory care, at home, in an assisted living facility, or in a skilled
lack of financial resources to obtain prescribed medications.
Common causes of medication errors by older adults include poor eyesight, forgetting to take drugs, use of nonprescription over-the-counter drugs, use of medications prescribed for someone else, lack of financial resources to obtain prescribed medication, failure to understand instructions or importance of drug treatment, and refusal to take medication because of undesirable side effects. Drug half-life is increased in older adults.
The nurse is performing assessment of an older adult patient suspected of mistreatment. Which assessment findings would lead the nurse to notify social services?
Agitation and depression may be manifestations of psychologic abuse or neglect. Hypernatremia may signify dehydration caused by physical neglect. A loss of body weight, rather than weight gain, is another clinical manifestation of physical neglect.
A female patient with incontinence arrives early for appointments and social events so there is ready access to the restroom. Which tasks of the chronically ill is the patient demonstrating?
The patient's efforts to ensure that she can continue activities while accommodating the frequent elimination caused by the health problem are an example of controlling symptoms and preventing a personal crisis.
The nurse is interviewing an older adult patient. What is the priority nursing action during the interview process?
Ensure all assistive devices are in place.
All assistive devices, such as glasses and hearing aids, should be in place when interviewing an older patient. It is best to interview the patient and caregiver separately to ensure a reliable assessment related to any possible mistreatment. The patient should be free from pain during the assessment in order to gather accurate information and may need extra time to respond to questions.
A patient is diagnosed with chronic obstructive pulmonary disease (COPD). At what point should the nurse begin to include the patient's spouse in the teaching around the management of the disease?
as soon as possible
In the management of chronic illness, it is desirable to include family caregivers in patient education and symptom management efforts as early in the diagnosis as possible.
The nurse is administering medication to an older adult patient. Which consideration most related to aging should the nurse monitor when administering medications?
The ability of the medication to metabolize.
Because the liver mass shrinks and hepatic blood flow and enzyme activity decrease in older adults, metabolism of drugs drops 1/2 to 2/3 of the rate of young adults. This increases the chance of drug toxicity and adverse drug events.
The nurse is planning discharge for a frail older adult patient covered under Medicare Part A. Which medical supply would be covered if needed?
Durable medical equipment, such as a walker used daily, is covered by Medicare Part A, but home safety equipment is not. Medicare Part A does not cover hearing aids, dentures, or eyeglasses.
A patient has a history of hypertension and type 1 diabetes. The patient exercises and eats a healthy diet. Which factors will most likely have a positive impact on biologic aging?
Which criterion must a 65-yr-old person meet in order to qualify for Medicare funding?
To qualify for Medicare, a person must be entitled to receive Social Security benefits. Absence of caregivers and inadequate responses to treatment are not qualification criteria for Medicare, and the program does not cover residential care services.
what are the vaccines for older adults?
influenza, pneumococcal, herpes zoster, tetanus/diphtheria/pertussis (Td/Tdap), and hepatitis A and B
primary prevention of chronic illness
refers to measures such as eating a healthy diet, getting proper exercise, and receiving immunizations that prevent a specific disease.
secondary prevention of chronic illness
refers to actions aimed at health screening and early detection of disease. This can lead to interventions to prevent disease progression, such as colon cancer screening or breast cancer screening
tertiary prevention of chronic illness
refers to activities that limit disease progression such as rehabilitation
The fastest-growing segment of older Americans is people ages
85 or older
what % of the US population is over 65?
14.9%
who is old?
The answer to this question often depends on the respondent's age and attitude. Your "real" age is set by a date in time. Many factors influence how "old" you feel. These include emotional and physical health, developmental stage, socioeconomic status, culture, and ethnicity.
Biologic aging is a multifactorial process involving
genetics, diet, and environment
What are the most common chronic conditions of older adults?
hypertension, heart failure, coronary artery disease, chronic obstructive pulmonary disease (COPD), cancer, diabetes, and osteoarthritis
what type of memories decline during old age and what type of memories are not affected by age?
short term recall declines; long term recall is not impacted
what are the Key barriers to health care access for rural older adults?
transportation, limited supply of health care workers and facilities, lack of quality health care, social isolation, and financial limitations
Albumin, low
Loss or gain of weight
Eating problems (e.g., mechanical problems, such as impaired swallowing, poor dentition)
Shopping and food preparation problems
What is ACES?
Advancing Care Excellence for Seniors
A for ACES
Assess function and expectations
- look at ADLs, physical, emotional, socio-economic
- prioritize their expectations
- what do they want?
C for ACES
Coordinate and Manage Care
- multiple health problems
- geriatric syndrome
- polypharmacy
E for ACES
Evolving Knowledge
- not just an older adult; they have unique needs as an individual
- time of transitions in life
S for ACES
Situational Decisions
- Complexity of care
- wishes of the individual
- risks and benefits of decisions
who are the baby boomers or "sandwich generation"?
65 and older
13% of US population in 2010, but expected to be 20% by 2050
how fast are the baby boomers growing?
increasing at 2x the rate of the rest of the population
what is the average life expectancy? why is it increased?
83 years old
medical advances, early screenings, and early detection
This theory of aging says imbalances in hormones or loss of neuro transmitter chemicals cause aging.
Neuro Endocrine theory of aging
This theory of aging says it is predetermined.
genetics theory of aging
This theory of aging says we have a decrease in the immune response or an increase in autoimmune reactions as we age.
immune theory of aging
How does some one define healthy aging?
It is a personal point of view.
What is a barrier to promoting wellness for aging adults?
- HCP attributes problems to aging rather than treatable pathologic illness
- negative attitudes (ageism)
- current focus on treatment, not prevention
- belief that older adult cannot learn or implement health promotion
what is the #1 barrier for rural older adults?
transportation is the number 1 barrier to health care for rural older adults
attractive long term care setting with environment more like home and greater resident autonomy. residents require some assistance with ADLs but remain relatively independent within a partially protective setting
assisted living
a service that provides short-term relief or time off for people providing home care to an individual who is ill, disabled, or frail
respite care
these services are offered during the day to allow family members to maintain their lifestyles and employment and still provide home care for their relatives
adult day care
a system of family centered care that allows patient to live with comfort, independence, and dignity while easing the pains of terminal illness
hospice
Provides intermediate medical, nursing, or custodial care for clients recovering from acute illness or clients with chronic illnesses or disabilities. includes intermediate and skilled nursing facilities
extended care facility
what are the negatives attributes that cause aging to occur faster?
stress, obesity, cancer, CV disease, diabetes
what is the name of the nutritional assessment for older adults?
SCALES
S for SCALES
sadness (mood)
C for SCALES
cholesterol (is it high)?
A for SCALES
Albumin (is it low)?
L for SCALES
loss or gain of weight
E for SCALES
Eating problems (mechanical problems such as impaired swallowing, poor dentition)
S for SCALES
Shopping and food prep problems
Which types of cognitive function decrease with aging?
fluid intelligence
spatial perception
synthesis of new info
mental performance speed
short term recall memory
Which types of cognitive function increase with aging?
crystallized intelligence
vocab and verbal reasoning
which type of cognitive function remains constant with aging?
long term memory
what should be considered early in the hospital stay?
ADLs
activities of daily living include mobility, toilet and bathing, personal hygiene, and feeding
What happens to older adults in regards to psychoactive drugs?
brain receptors become more sensitive, making psychoactive drugs very potent
What happens to older adults in regards to metabolism?
- live mass shrinks
- hepatic blood flow decreases
- enzymes decrease
- metabolism decreases to 1/2 or 2/3 the rate of their younger self
- enzymes lose the ability to process some drugs thus prolonging their half life
what makes older adults at risk for drug toxicity?
- metabolism decreases because of changes in liver and enzymes losing ability to process drugs leading to prolonged half lives.
- excretion decreased because of kidney function decreasing
- changes in body mass - some drugs may stick to adipose tissue, some drugs need water so the dehydration raises concentration of drugs in system, some drugs get stuck in blood instead of absorbed because they are looking for protein binding sites and protein is decreased
What happens to older adults in regards to absorption?
- gastric emptying rate slows
- gastric motility (peristalsis) slows
- absorption capacity of cells and active transport mechanisms decline
What happens to older adults in regards to circulation?
- vascular nerve control is less stable
- anti-hypertensives may overshoot, dropping blood pressure too low
- digoxin may slow the HR too much
What happens to older adults in regards to excretion?
- in kidneys, renal blood flow, GFR, renal tubular secretion and reabsorption, and number of functional nephrons decline
- age related changes increase half life for renally excreted drugs
- oral antidiabetic drugs, among others, stay in the body longer
What happens to older adults in regards to distribution?
- lean body mass declines
- adipose tissue store increase - some drugs stick to adipose tissue
- total body water declines (water sticks to muscle and their muscle mass declines), this raises the concentration of water-soluble drugs
- plasma proteins decrease, reducing sites available for protein-bound drugs and raises drug blood levels of free drugs
