CMSRN Review Questions with Verified
Correct Answers
Geriatrics: Temperature
Ability to generate a fever diminishes with age.
Temperature is an UNRELIABLE sign of infection for elderly
**If dyspneic, use rectal/axillary/tympanic temperatures.
**Hypothermia is a more frequent occurrence; normothermia may be the response to
infection.
Geriatrics: RR
no changes with aging
> 28/min indicates acute illness, CHF, pulmonary infection
Geriatrics: Pulse
Apical pulse for 1 minute is most accurate
Incidence of Dysrhythmias increase with age
>100 could indicate acute illness/infection
May have slower heart rate as valves become thick and rigid due to calcium deposits,
fibrosis, sclerosis.
Geriatrics: Blood pressure
Take routinely supine and upright bilaterally
Gradual increase in SBP and DBP and widening of pulse pressure occurs due to increased
arterial rigidity and decreased blood vessel resiliency.
Stages of dementia
,1. Early stage: forgetfulness, apathy, social withdrawal.
2. Middle stage: major gaps in memory and deficits in cognitive function. Disorientation.
Personality changes. Impaired judgement. Some assistance with ADLs needed.
3. Late stage: lose ability to respond to environment, speak, or control movements.
Incontinence. Rigid. Swallowing impaired.
Geriatrics: atypical clinical manifestations of commonly occurring illnesses.
MI: restlessness, confusion.
Pneumonia: Dyspnea and confusion
PE: Dyspnea and confusion, restlessness
UTI: most common indication is confusion
Bariatric physiologic changes
*Axillary temps not accurate due to increased adipose tissue
*RR increased
*Oxygen consumption increases
*HR increased due to increase in workload and pressure on heart
*BP increased
*Abnormal or decreased production of GRH, LH and FSH can cause menstrual irregularity or
decreased sperm production
*Risk for wound production and decreased healing due to poor vascularization, inadequate
oxygenation
*Risk for fungal infections in folds.
*Risk for left ventricular hypertrophy due to increased workload and contractility; leads to
decreased efficiency
BMI scale
, Albumin
3.5-5 g/dL
maintains oncotic pressure and is a carrier protein.
<3.5 can indicate poor nutrition, dehydration, organ dysfunction, inflammatory processes.
C-reactive protein
A nonspecific protein, produced in the liver, that becomes elevated during episodes of acute
inflammation or infection or STRESS.
<0.6 mg/dL
WBC count
4,500-10,000 cells/mcL
reflection of inflammatory conditions and infectious processes.
Signs of hypercalcemia
Apathy, lethargy
Anorexia, nausea, constipation
Polyuria, thirst
Kidney stones
Arrhythmias, prolonged strong cardiac contractions, increased blood pressure
Foods that decrease urine pH and reduce formation of calcium calculi
cereals
meats
poultry
Correct Answers
Geriatrics: Temperature
Ability to generate a fever diminishes with age.
Temperature is an UNRELIABLE sign of infection for elderly
**If dyspneic, use rectal/axillary/tympanic temperatures.
**Hypothermia is a more frequent occurrence; normothermia may be the response to
infection.
Geriatrics: RR
no changes with aging
> 28/min indicates acute illness, CHF, pulmonary infection
Geriatrics: Pulse
Apical pulse for 1 minute is most accurate
Incidence of Dysrhythmias increase with age
>100 could indicate acute illness/infection
May have slower heart rate as valves become thick and rigid due to calcium deposits,
fibrosis, sclerosis.
Geriatrics: Blood pressure
Take routinely supine and upright bilaterally
Gradual increase in SBP and DBP and widening of pulse pressure occurs due to increased
arterial rigidity and decreased blood vessel resiliency.
Stages of dementia
,1. Early stage: forgetfulness, apathy, social withdrawal.
2. Middle stage: major gaps in memory and deficits in cognitive function. Disorientation.
Personality changes. Impaired judgement. Some assistance with ADLs needed.
3. Late stage: lose ability to respond to environment, speak, or control movements.
Incontinence. Rigid. Swallowing impaired.
Geriatrics: atypical clinical manifestations of commonly occurring illnesses.
MI: restlessness, confusion.
Pneumonia: Dyspnea and confusion
PE: Dyspnea and confusion, restlessness
UTI: most common indication is confusion
Bariatric physiologic changes
*Axillary temps not accurate due to increased adipose tissue
*RR increased
*Oxygen consumption increases
*HR increased due to increase in workload and pressure on heart
*BP increased
*Abnormal or decreased production of GRH, LH and FSH can cause menstrual irregularity or
decreased sperm production
*Risk for wound production and decreased healing due to poor vascularization, inadequate
oxygenation
*Risk for fungal infections in folds.
*Risk for left ventricular hypertrophy due to increased workload and contractility; leads to
decreased efficiency
BMI scale
, Albumin
3.5-5 g/dL
maintains oncotic pressure and is a carrier protein.
<3.5 can indicate poor nutrition, dehydration, organ dysfunction, inflammatory processes.
C-reactive protein
A nonspecific protein, produced in the liver, that becomes elevated during episodes of acute
inflammation or infection or STRESS.
<0.6 mg/dL
WBC count
4,500-10,000 cells/mcL
reflection of inflammatory conditions and infectious processes.
Signs of hypercalcemia
Apathy, lethargy
Anorexia, nausea, constipation
Polyuria, thirst
Kidney stones
Arrhythmias, prolonged strong cardiac contractions, increased blood pressure
Foods that decrease urine pH and reduce formation of calcium calculi
cereals
meats
poultry
