NUR 202 EXAM 1 | COMPREHENSIVE STUDY GUIDE, NCLEX-STYLE PRACTICE
QUESTIONS AND ANSWERS 2026/2027
Elder Maltreatment - ANS ✔✔Physical, sexual, emotional, or psychological abuse, neglect,
abandonment, and financial or material exploitation of an elder person.
Assessment Tool: *SPICES* - ANS ✔✔*S* - Sleep D/Os
*P* - Problems with eating or feeding
*I* - Incontinence
*C* - Confusion
*E* - Evidence of falls
*S* - Skin breakdown
Cardiovascular System Changes with Age - ANS ✔✔- ↓ Cardiac Output
- Diminished ability to respond to stress
- Heart rate and stroke volume increase with max demand
- Slower heart rate recovery
- ↑ BP
*Recommend heart healthy diet, med compliance, and regular exercise*
Respiratory System Changes with Age - ANS ✔✔- ↑ Residual lung volume
- ↓ Muscle strength, endurance, VC
- ↓ Gas exchange/diffusing capacity
- ↓ Cough efficiency
,*Recommend regular exercise, appropriate fluid intake, avoidance of sick people, and Flu/PNA
vaccines*
Integumentary System Changes with Age - ANS ✔✔- ↓ Subcutaneous fat, interstitial fluid,
muscle tone, glandular activity & sensory receptors resulting in ↓ protection against trauma,
sun exposure & temp extremes
- Diminished secretion of natural oils, perspiration
- Capillary fragility
*Recommend SPF 15+, avoid sun, skin cream with mineral oils, avoidance of hot soaks, maintain
healthy diet and adequate fluid intake, and regular dermatology checks*
Reproductive System Changes with Age - ANS ✔✔*Male:*
- Less firm testes
- ↓ sperm production
*Female:*
- Vaginal narrowing
- ↓ Elasticity
- ↓ Vaginal secretions
Both with slower sexual responses
Genitourinary System Changes with Age - ANS ✔✔*Male:*
- BPH
*Female:*
,- Relaxed perineal muscles
- Detrusor instability (urge incontinence)
- Urethral dysfunction (stress incontinence)
*Increased risk of UTI's, recommend adequate fluid intake - seven 8 oz glasses/day*
GI System Changes with Age - ANS ✔✔- Malnutrition and anemia common
- ↓ sense of thirst, smell, & taste
- ↓ salvation
- Difficulty swallowing
- Delayed esophageal, gastric emptying (constipation)
- Reduces GI motility (constipation)
*Recommend regular oral care/dentist visits, small frequent meals, ↑ fiber ↓ fat, adequate
fluid intake, and avoidance of heavy activity after eating*
Musculoskeletal System Changes with Age - ANS ✔✔- Loss of bone density
- Loss of muscle strength, size
- Degenerated joint cartilage
- "Use it or lose it"
*Promote independence, reduce risk for falls, and recommend regular exercise*
Nervous System Changes with Age - ANS ✔✔- Reduces speed of nerve conduction (longer
reaction time)
- ↑ confusion with physical illness, loss of environmental cues
- Reduced cerebral circulation (becomes faint, loss of balance)
, *Recommend spatial orientation, slow conversations and allow for time to process information*
Vision Changes with Age - ANS ✔✔- Diminished ability to focus on close objects
- Inability to tolerate glare
- Difficulty adjusting to changes in light intensity
- ↓ ability to distinguish colors
Cataracts are *NOT* part of normal aging process
*Providing meaningful stimuli can help promote sensory retention*
Hearing Changes with Age - ANS ✔✔- ↓ Ability to hear high frequency sounds
- Tympanic membrane thins, loss of resiliency
- ↑ Cerumen build up
Presbiopia - ANS ✔✔loss of lens flexibility, thickens with age- decreased ability to focus (seeing
near)
Presbycusis - ANS ✔✔a gradual loss of sensorineural hearing that occurs as the body ages
Taste & Smell Changes with Age - ANS ✔✔- ↓ ability to taste & smell (salty and sweet are
diminished first
- Resulting malnutrition
Goal of Teaching with Elderly Patients - ANS ✔✔*Health promotion and disease prevention to
promote independence*
QUESTIONS AND ANSWERS 2026/2027
Elder Maltreatment - ANS ✔✔Physical, sexual, emotional, or psychological abuse, neglect,
abandonment, and financial or material exploitation of an elder person.
Assessment Tool: *SPICES* - ANS ✔✔*S* - Sleep D/Os
*P* - Problems with eating or feeding
*I* - Incontinence
*C* - Confusion
*E* - Evidence of falls
*S* - Skin breakdown
Cardiovascular System Changes with Age - ANS ✔✔- ↓ Cardiac Output
- Diminished ability to respond to stress
- Heart rate and stroke volume increase with max demand
- Slower heart rate recovery
- ↑ BP
*Recommend heart healthy diet, med compliance, and regular exercise*
Respiratory System Changes with Age - ANS ✔✔- ↑ Residual lung volume
- ↓ Muscle strength, endurance, VC
- ↓ Gas exchange/diffusing capacity
- ↓ Cough efficiency
,*Recommend regular exercise, appropriate fluid intake, avoidance of sick people, and Flu/PNA
vaccines*
Integumentary System Changes with Age - ANS ✔✔- ↓ Subcutaneous fat, interstitial fluid,
muscle tone, glandular activity & sensory receptors resulting in ↓ protection against trauma,
sun exposure & temp extremes
- Diminished secretion of natural oils, perspiration
- Capillary fragility
*Recommend SPF 15+, avoid sun, skin cream with mineral oils, avoidance of hot soaks, maintain
healthy diet and adequate fluid intake, and regular dermatology checks*
Reproductive System Changes with Age - ANS ✔✔*Male:*
- Less firm testes
- ↓ sperm production
*Female:*
- Vaginal narrowing
- ↓ Elasticity
- ↓ Vaginal secretions
Both with slower sexual responses
Genitourinary System Changes with Age - ANS ✔✔*Male:*
- BPH
*Female:*
,- Relaxed perineal muscles
- Detrusor instability (urge incontinence)
- Urethral dysfunction (stress incontinence)
*Increased risk of UTI's, recommend adequate fluid intake - seven 8 oz glasses/day*
GI System Changes with Age - ANS ✔✔- Malnutrition and anemia common
- ↓ sense of thirst, smell, & taste
- ↓ salvation
- Difficulty swallowing
- Delayed esophageal, gastric emptying (constipation)
- Reduces GI motility (constipation)
*Recommend regular oral care/dentist visits, small frequent meals, ↑ fiber ↓ fat, adequate
fluid intake, and avoidance of heavy activity after eating*
Musculoskeletal System Changes with Age - ANS ✔✔- Loss of bone density
- Loss of muscle strength, size
- Degenerated joint cartilage
- "Use it or lose it"
*Promote independence, reduce risk for falls, and recommend regular exercise*
Nervous System Changes with Age - ANS ✔✔- Reduces speed of nerve conduction (longer
reaction time)
- ↑ confusion with physical illness, loss of environmental cues
- Reduced cerebral circulation (becomes faint, loss of balance)
, *Recommend spatial orientation, slow conversations and allow for time to process information*
Vision Changes with Age - ANS ✔✔- Diminished ability to focus on close objects
- Inability to tolerate glare
- Difficulty adjusting to changes in light intensity
- ↓ ability to distinguish colors
Cataracts are *NOT* part of normal aging process
*Providing meaningful stimuli can help promote sensory retention*
Hearing Changes with Age - ANS ✔✔- ↓ Ability to hear high frequency sounds
- Tympanic membrane thins, loss of resiliency
- ↑ Cerumen build up
Presbiopia - ANS ✔✔loss of lens flexibility, thickens with age- decreased ability to focus (seeing
near)
Presbycusis - ANS ✔✔a gradual loss of sensorineural hearing that occurs as the body ages
Taste & Smell Changes with Age - ANS ✔✔- ↓ ability to taste & smell (salty and sweet are
diminished first
- Resulting malnutrition
Goal of Teaching with Elderly Patients - ANS ✔✔*Health promotion and disease prevention to
promote independence*
