NRS 440 – Exam 1 Study Guide – [ODU] – Academic Year [2025/2026]
– Foundations of Professional Nursing Practice
critical care nursing - correct answer ✔✔ play a very important role in facilitating recovery for
very sick/injured patients
have much more advanced monitoring/support devices than can be found on a general care
unit
form the bases of rapid response teams; which equals earlier tx of potentially crashing patients -
> fewer codes
what are the common problems r/t the critically ill patient - correct answer ✔✔ anxiety
environmental stressors (sensory overload/deprivation)
delirium
sleep deprivation
pain
nutritional alterations
physiological instability
emergency situation (codes, ICU psychosis)
end of life issues (death is higher in the ICU pt population)
what interventions can be used in the critical care setting to decrease negative pt outcomes -
correct answer ✔✔ avoiding restraints
keeping the noise down
medication management: optimize pt's orientation/awareness
,what are some of the changes in health care delivery that we must consider as high acuity
nurses? - correct answer ✔✔ higher acuities, advancing technologies
older population: complex health problems/ multiple co-morbidities
increase in nosocomial infections
limited reimbursements
advent of RRT
nurses requiring advanced certifications
what are challenges with acute vs chronic illness management in the hospital and the
community? - correct answer ✔✔ home -> hospital -> LTC
-coordination and communication
-continuity of care
lack of resources
increasing preventable health problems
increasing co-morbidities
older adults and high acuity nursing - correct answer ✔✔ make up more than half of pts in
critical care units
,important to know and understand the characteristics and system changes in older adults so
that therapeutic interventions are provided
summary of changes in older adults - correct answer ✔✔ decreased adaptability
many physiologic changes
impaired stress response
greater risk for fxnal decline
CCN must consider all physiologic and psychologic factors to provide the best care
CV system changes - correct answer ✔✔ aorta and other arteries become stiff and less pliable -
> increased workload on heart to perfuse tissue
systolic and diastolic pressures increase, along with increase in systemic vascular resistance
(SVR) and decrease in CO
loss of capacity in myocardium and arterial system and decreased ability to respond and recover
from periods of physiologic and psychologic stress
respiratory system - correct answer ✔✔ lung tissue stiffens
diffusion of gases is impaired by 8% per yr after 65 yo
there is a decrease in vital capacity and maximal breathing capacity
renal system - correct answer ✔✔ decreased renal blood flow -> decreased GFR and decreased
renal tubule fxn
decreased elimination of physiologic substances
, older adults are predisposed to developing metabolic acidosis, volume depletion, and
hyperchloremia
GI system - correct answer ✔✔ decreased gastric emptying, splenic blood flow, and GI motility
increased GI pH and thinning or reduction of absorptive surface of gut
H. pylori infection and med effects increase the risk for GI bleeding
decreased absorption rates
neurological system - correct answer ✔✔ changes in gyro fxn, formation in neurofibrillary
tangles, decrease in brain volume, and increase in size of cerebral ventricles
increase plaque formation
changes in neurotransmitter synthesis and fxn, and degeneration of blood-brain barrier
immune system - correct answer ✔✔ increased gamma/delta and helper t-cells
decreased suppressor/cytotoxic T lymphocytes
decreased germinal centers of lymph nodes
increased plasma cells and lymphocytes in bone marrow
changed cell surface characteristics of lymphocytes
impaired humoral immune and antibody responses
– Foundations of Professional Nursing Practice
critical care nursing - correct answer ✔✔ play a very important role in facilitating recovery for
very sick/injured patients
have much more advanced monitoring/support devices than can be found on a general care
unit
form the bases of rapid response teams; which equals earlier tx of potentially crashing patients -
> fewer codes
what are the common problems r/t the critically ill patient - correct answer ✔✔ anxiety
environmental stressors (sensory overload/deprivation)
delirium
sleep deprivation
pain
nutritional alterations
physiological instability
emergency situation (codes, ICU psychosis)
end of life issues (death is higher in the ICU pt population)
what interventions can be used in the critical care setting to decrease negative pt outcomes -
correct answer ✔✔ avoiding restraints
keeping the noise down
medication management: optimize pt's orientation/awareness
,what are some of the changes in health care delivery that we must consider as high acuity
nurses? - correct answer ✔✔ higher acuities, advancing technologies
older population: complex health problems/ multiple co-morbidities
increase in nosocomial infections
limited reimbursements
advent of RRT
nurses requiring advanced certifications
what are challenges with acute vs chronic illness management in the hospital and the
community? - correct answer ✔✔ home -> hospital -> LTC
-coordination and communication
-continuity of care
lack of resources
increasing preventable health problems
increasing co-morbidities
older adults and high acuity nursing - correct answer ✔✔ make up more than half of pts in
critical care units
,important to know and understand the characteristics and system changes in older adults so
that therapeutic interventions are provided
summary of changes in older adults - correct answer ✔✔ decreased adaptability
many physiologic changes
impaired stress response
greater risk for fxnal decline
CCN must consider all physiologic and psychologic factors to provide the best care
CV system changes - correct answer ✔✔ aorta and other arteries become stiff and less pliable -
> increased workload on heart to perfuse tissue
systolic and diastolic pressures increase, along with increase in systemic vascular resistance
(SVR) and decrease in CO
loss of capacity in myocardium and arterial system and decreased ability to respond and recover
from periods of physiologic and psychologic stress
respiratory system - correct answer ✔✔ lung tissue stiffens
diffusion of gases is impaired by 8% per yr after 65 yo
there is a decrease in vital capacity and maximal breathing capacity
renal system - correct answer ✔✔ decreased renal blood flow -> decreased GFR and decreased
renal tubule fxn
decreased elimination of physiologic substances
, older adults are predisposed to developing metabolic acidosis, volume depletion, and
hyperchloremia
GI system - correct answer ✔✔ decreased gastric emptying, splenic blood flow, and GI motility
increased GI pH and thinning or reduction of absorptive surface of gut
H. pylori infection and med effects increase the risk for GI bleeding
decreased absorption rates
neurological system - correct answer ✔✔ changes in gyro fxn, formation in neurofibrillary
tangles, decrease in brain volume, and increase in size of cerebral ventricles
increase plaque formation
changes in neurotransmitter synthesis and fxn, and degeneration of blood-brain barrier
immune system - correct answer ✔✔ increased gamma/delta and helper t-cells
decreased suppressor/cytotoxic T lymphocytes
decreased germinal centers of lymph nodes
increased plasma cells and lymphocytes in bone marrow
changed cell surface characteristics of lymphocytes
impaired humoral immune and antibody responses
