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NURS 3403 EXAM WIH VERIFIED ANSWERS
GRADED A+
by 2020 up to ____ of nurses' time will be spent with older adults CORRECT
ANSWER>>>75%
2/3 of those older than 60yo live in less developed areas in the world - going to grow to 4/5 by the year
____ CORRECT ANSWER>>> 2015
how do we define "old" CORRECT ANSWER>>>social, functional, biological, chronological
role of the nurse CORRECT ANSWER>>>- highest level of wellness
- empowerment
- use of resources
cellular functioning changes CORRECT ANSWER>>>- cells become disorganized
- cells no longer replicate
- cellular death occurs
oxidative stress theory CORRECT ANSWER>>>- the associated reductions in physiologic
functions are caused by a slow steady accumulation of oxidative damage to macromolecules
main causes of oxidative stress CORRECT ANSWER>>>- obesity
- diets in fat, sugar, etc
- exposure to radiation
- pollution
- exposure to pesticides
immunological theory CORRECT ANSWER>>>- damage to the immune system causes aging
and health problems
aging and DNA CORRECT ANSWER>>>- ROS and free radicals don't trigger process on their
own
telomere caps on the ends of DNA get ______ as we age CORRECT ANSWER>>>shorter
shortened telomeres have been observed in _____ CORRECT ANSWER>>>cancer, coronary
heart disease, hypertension, diabetes, and arthritis
epidermis changes CORRECT ANSWER>>>- thins
- lighter
- age spots
- seborrheic keratosis
dermis changes CORRECT ANSWER>>>- loses thickness
- blood vessels reduced
- collagen synthesis decreases
- elastin fibers thicken
hypodermis changes CORRECT ANSWER>>>- atrophy
hair changes CORRECT ANSWER>>>- thins
- increases hair in the nose, ears, eyebrows
- becomes white, pigmentation decreases
- cough and cilia are not as effective
renal changes CORRECT ANSWER>>>- kidney blood flow decreases
- size and function of the kidneys decrease
- urine creatinine clearance decreases
endocrine changes CORRECT ANSWER>>>- most glands shrink
- rate of secretion decreases
- increases insulin resistance
female sex changes CORRECT ANSWER>>>- no babies after ovulation
- breasts appear smaller
- ovaries, uterus, and cervix atrophy
- estrogen levels decrease
- drying of vagina
male sex changes CORRECT ANSWER>>>- testes shrink
- ejaculation is slower
- testosterone level reduces
- urinary retention in some
mouth changes CORRECT ANSWER>>>- enamel loss
- taste buds decline
- saliva lessens
stomach changes CORRECT ANSWER>>>- slow emptying (gerd can happen easier)
- decrease motility (feel full faster)
- decrease intrinsic factor
intestines changes CORRECT ANSWER>>>- villi lower functioning
- perstalisis slows
- constipation
liver changes CORRECT ANSWER>>>- reduced blood flow (affects medication solubility)
CNS changes CORRECT ANSWER>>>- brain size/weight decreases
- subtle changes in cognition and motor in very old
- mild memory changes
- balance changes
- length of tasks
PNS changes CORRECT ANSWER>>>- decrease in senses
eye changes CORRECT ANSWER>>>- near vision decreases
- eyelids drop
- ability to perceive color decreases
- dry eyes
- intraocular fluid resorption down
- decline peripheral vision
- helps to increase light right by what they're reading
ear changes CORRECT ANSWER>>>- ear lobes sag, elongate, wrinkle
- hairs
- ear wax changes
- hearing loss (especially high-frequency)
erikson's psychosoical stages of development CORRECT ANSWER>>>- crisis means challenge
- development is epigenetic
- successful to proceed successfully
- strength for each stage
- stages reflected in overall development
- culture important
generatively vs stagnation CORRECT ANSWER>>>- middle age
- core strength: caring for the development of others
- creative and productive activity via work
- caring for the future extends to the stage
- working for a better world
- symbolic link to immortality
ego-integrity vs despair CORRECT ANSWER>>>65+
ego-integrity CORRECT ANSWER>>>goal is to reflect on one's life and conclude that while
one had few regrets but was satisfied with the life lived core is wisdom
self-despair CORRECT ANSWER>>>unfulfilled hope, lack of purpose in life
core is self-disdain
maslow's hierarchy of needs CORRECT ANSWER>>>- assume that all ppl share the basic
human needs
- some needs are more basic than others
- most basic needs must be met before higher order needs can be met
cognition in aging CORRECT ANSWER>>>- processing time slows down a little bit
- attention span stays stable
- help cognition by stimulating the brain
fluid intelligence CORRECT ANSWER>>>- independent of experience or learning
- fluid intelligence tasks older adults perform more poorly
- ex: completing puzzles and problem solving
crystalized intelligence CORRECT ANSWER>>>- knowledge and skills gained through
experience and education and the ability to access that knowledge; intelligence that tends to increase over the life span
- crystallized intelligence of older adults is stable
cognition implications for nurses CORRECT ANSWER>>>- pay attention to cognitive health
- educate about ways to enhance cognitive health and brain plasticity
- share resources regarding computer and learning skills
- keep culture and background in mind
resiliency CORRECT ANSWER>>>most adults manage transitions and stressors through
resilience, hardiness, and resourcefulness
the individuals who can't get through with resiliency have ____ CORRECT ANSWER>>>- lack
of social supports
- accumulated stressors
- unresolved grief
- preexisting psychiatric illness
- cognitive impairment
- inadequate coping resources
external factors in health related decision making CORRECT ANSWER>>>type of decision,
power relationships, perception of risk and safety, options available
circle of control CORRECT ANSWER>>>family members, older adults, health care team
members should all be involved
vulnerability CORRECT ANSWER>>>a collection of individuals that are more likely to develop
health problems as a result as excess risks, limit to healthcare services, or relying on others for help
categorical vulnerability CORRECT ANSWER>>>nursing home, assisted living
functional vulnerability CORRECT ANSWER>>>those who are dependent on others
vulnerable population CORRECT ANSWER>>>- older adults
- people living in poverty
- people who are homeless
- immigrant populations
- people in abusive relationships
- people with substance abuse
- those with severe mental illness
- children
elder abuse CORRECT ANSWER>>>intentional, may be physical, psychological, medical,
financial, or sexual
elder neglect CORRECT ANSWER>>>- most often it is passive
- failure of action or care
- it is active when care is withheld deliberately and for malicious reasons
who is most likely to abuse? CORRECT ANSWER>>>- family member
- history of violence
- substance abuse
- isolated
- poor impulse control
- mental illness
who is most likely to get abused? CORRECT ANSWER>>>- confused
- dependent
- frail
- had abused in past or been abused
- alone
- women
- institution
- hard behavior
- feel they deserve it
self-neglect CORRECT ANSWER>>>a behavior in which people fail to meet their own basic
needs in the manner in which the average person would in similar circumstances
nurses are mandated reports of abuse and neglect!!! CORRECT ANSWER>>>this is the
intersection of nursing and the law. we don't need to be lawyers to be nurses, but we need to understand our legal responsibilities to our patients
legal issues in gerontologic nursing CORRECT ANSWER>>>financial issues, health care
decisions, consent to treatments, capacity
capacity CORRECT ANSWER>>>- can the person understand a problem and decision?
- how do they do performing tasks?
carroll article main points CORRECT ANSWER>>>- autonomy to make decisions about the
medical care we receive is a basic human right
- capacity is a measure of a person's ability to make an informed and logical decision about health care
- if a person lacks capacity, a surrogate must be appointed
- as nurses we have a role in helping determine a person's capacity to make health care decisions
plawecki article main points CORRECT ANSWER>>>- patients have the right to refuse
treatment
- it must be determined that the elderly patient is capable of understanding the health care information and able to make a decision
- nurses may be asked to obtain "informed consent" from patients, and need to understand their accountability and legal liability
ziminski article main points CORRECT ANSWER>>>- describe injury presentations in ED of
people older than 65 with and without cognitive impairment
- explore the relationship of injury presentations to injury etiology (cause) among those with and without cognitive impairment
- it's important to understand and recognize common injuries in older adults so then uncommon injuries, such as those form abuse, can be identified
- recognize that accidents and injuries are important reasons for older adults to come to ED for care normal finding of skin in an older adult?
- oily skin
- faster nail growth
- decreased elasticity
- increased facial hair in men CORRECT ANSWER>>>decreased elasticity what physiologic change is a normal part of aging?
- dementia
- diabetes
- heart disease
- decreased immunity CORRECT ANSWER>>>decreased immunity
what statements about the free radical theory of aging are correct? CORRECT ANSWER>>>-
exposure to environmental pollutants increases the rate of cell damage
- free radicals are natural by-products of cell activity
- diets that include natural antioxidants are healthful
for research papers CORRECT ANSWER>>>identify the conclusions of the study first !!!
which factors contribute to vitamin b12 deficiency in the older adults? CORRECT
ANSWER>>>- after age 50, the stomach makes less gastric acid, so b12 absorption is less efficient
- use of proton pump inhibitors of histamines for over a year
- use of metformin, colchicine, antibiotics, and anticonvulsant agents
social aging CORRECT ANSWER>>>determined by changes in roles
functional aging CORRECT ANSWER>>>taking multiple medications a day and using a walker
chronical aging CORRECT ANSWER>>>actual age in numbers
healthy people 2020 goals CORRECT ANSWER>>>- attain high quality, longer lives free of
preventable disease, disability, injury, and premature death
- achieve health equity, eliminate disparities, and improve the health of all groups
- create social and physical environments that promote good health for all
- promote quality of life, healthy development, and healthy behaviors across all life stages
health def CORRECT ANSWER>>>a state of complete physical, mental, and social well-being,
not merely the absence of disease or infirmity
preperation CORRECT ANSWER>>>making small changes
healthy eating would improve all of these diseases CORRECT ANSWER>>>heart disease,
stroke, cancer, chronic respiratory diseases, alzheimers, diabetes, pneumonia, kidney disease, influenza, septicemia the quality and quantity of a diet will help prevent, delay the onset of, and manage chronic disease
processes CORRECT ANSWER>>>!!
older adults need protein and ____ CORRECT ANSWER>>>B
obesity brings _____ CORRECT ANSWER>>>- higher healthcare costs
- functional impairments
- chronic disease
- nursing home admission
obesity paradox CORRECT ANSWER>>>some research found that persons who survived to
70 years had lower mortality rate if they were overweight
malnutrition CORRECT ANSWER>>>rising incidence, consequences can be serious (hip
fractures, anemia, hypertension, pressure sores, increased mortality)
1st trajectory of malnutrition CORRECT ANSWER>>>person doesn't consume enough
micronutrients and macronutrients to maintain organ function and healthy tissues
2nd trajectory of malnutrition CORRECT ANSWER>>>inflammation related malnutrition
occurs as a consequence of disease, injury, or surgery. then it triggers inflammatory mediators that increase the metabolic rate and impair nutrition use
factors affecting fulfillment of nutrition CORRECT ANSWER>>>transportation, housing,
medication, aging changes, chronic illnesses, socialization
dysphagia CORRECT ANSWER>>>trouble swallowing
risk factors for dysphagia CORRECT ANSWER>>>- stroke
- parkinson's
- ALS, MS, myasthenia gravis
- dementia
- head and neck cancer
- traumatic brain injury
- aspiration pneumonia
dysphagia interventions CORRECT ANSWER>>>- safe oral intake to maintain optimal
nutrition and caloric needs
- postural changes and proper positioning
- modification of bolus volume, consistency, temperature, and rate of presentation
- modified diets
- neuromuscular electrical stimulation
careful hand-feeding is better than NG tube in demented patients CORRECT ANSWER>>>!!!
components of a nutritional assessment CORRECT ANSWER>>>interview, history, physical
examination, anthropometric data, lab data, food and nutrient intake, functional assessment, measuring circumference of mid upper arm on non-dominant arm, shows decrease in muscle mass & that they are declining in nutritional status
oral health CORRECT ANSWER>>>- a basic need
- age related changes in the oral cavity, medical conditions, poor dental hygiene, and lack of dental care
- leads to poor nutrition and other negative outcomes
- implement comprehensive protocols such as the MOUTH
MOUTH CORRECT ANSWER>>>managing oral hygiene using threat reduction strategies
sleep problems mostly affect CORRECT ANSWER>>>women and older adults
sleep is a basic need and ____ occurs with sleep CORRECT ANSWER>>>rest
sleep occupies a ____ of our lives CORRECT ANSWER>>>third
sleep has ____ stages CORRECT ANSWER>>>five
with aging, the natural circadian rhythm may become less ____ to external stimuli CORRECT
ANSWER>>>responsive
REM sleep changes as we ____ CORRECT ANSWER>>>age
the older adults spend more time in bed before falling _____ CORRECT ANSWER>>>asleep
- they nap more during the day
- lighter sleep
factors influencing sleep CORRECT ANSWER>>>- drugs and substances
- lifestyle
- emotional stress
- exercise and fatigue
- environment
- food and calorie intake
- sleep patterns
insomnia CORRECT ANSWER>>>- affects sleep and quality and quantity
- can't sleep for at least a month and that impairment in daytime functioning results
- risk factor for cognitive decline
- occurs in half of ppl with dementia, may be due to the meds that treat dementia
insomnia and alzheimer's CORRECT ANSWER>>>- agitation, wandering, comorbid illnesses,
primary sleep disorders
- how to help: sleep hygiene education, daily walking, and increased light exposure
implications for gerontological nursing CORRECT ANSWER>>>- review of sleep patterns
- presence of contributing factors
- sleep diaries of logs
- sleep rating skills
- polysomnography
interventions for poor sleep CORRECT ANSWER>>>- cognitive behavioral therapy
(relaxation, rituals before bed like a warm bath or snack, getting someone out of bed if they can't sleep for 15 min)
- education & sleep diary (first-line treatment)
- pharmacologic treatment needs to be used in caution with older adults, avoid sedative hypnotics (no Tylenol PM, Ambien)
in nursing homes make sure people are getting up during the _____ CORRECT
ANSWER>>>day
