NR 601 Midterm Exam NR601 Midterm Exam Latest Questions and Correct Answers Rated A+

NR 601 Midterm Exam 2024 -2025 NR601 Midterm Exam Latest 2024 -2025 Questions and Correct Answers Rated A+ What are the 3 primary physiological changes of aging? - ANSWER -1. Reduced physiological reserve of most body systems, esp. cardiac, resp, renal. 2. Reduced homeostatic mechanisms that fail to adjust regulatory systems (i.e. temp control, f luid/lyte balance, etc.). 3. Impaired immunological function (infection risk is greater, autoimmune dz's more prevalent) What is the preferred amount of exercise for elderly? - ANSWER -30min/day 5 days/wk of moderate exercise. If trying to lose wt: 60min /day. What are PFTs? - ANSWER -Group of tests that provide quantifiable measurement of lung function, used to dx resp abnormalities or assess progression/resolution of lung dz. What is FEV1? - ANSWER -Forced Expiratory Volume in 1 second (80 -120%) What is FVC? - ANSWER -Forced Vital Capacity (80 -120%) What is normal FEV1/FVC ratio? - ANSWER -<0.7 (70%) What is GOLD 1 criteria? - ANSWER -Mild FEV1 >/= 80% predicted What is GOLD 2 criteria? - ANSWER -Moderate FEV1 50 -79% predicted What is GOLD 3 criteria? - ANSWER -Severe FEV1 30 -49% predicted What is GOLD 4 criteria? - ANSWER -Very severe FEV1 <30% predicted What are the signal symptoms of COPD? - ANSWER -Dyspnea Chronic cough w/sputum Decreased activity tolerance Wheezing What are characteristics of COPD? - ANSWER -Common, preventable, treatable. Characterized by persistent airflow limitation. Usually progressive, associated with enhanced chronic inflammatory response in airways and lungs to noxious particles/gases Airway fibrosis, luminal plugs, airway in flammation, increased airway resistance, small airway dz. Decreased elastic recoil of alveoli. What are risk factors for COPD? - ANSWER -Smoking (increasing w/number of pack years) Second hand smoke Environmental pollution (endotoxins, coal dust, mineral dust) What is seen on phys exam in COPD? - ANSWER -May be normal in early states As severity progresses: lung hyperinflation, decreased breath sounds, wheezes at bases, distant heart tones (b/c of hyperinflation, so S1/S2 sounds off in distance), accessor y muscle use, pursed lip breathing, increased expiratory phase, neck vein distention. How is COPD diagnosed? - ANSWER -Spirometry is gold standard (pre and post bronchodilator). Irreversible airflow limitation is hallmark. How is COPD treated? - ANSWER -Bronchodilators: beta agonists (long/short), anticholinergics (long/short), or combo. What is the MOA of beta agonists? - ANSWER -Stimulates beta -2-adrenergic receptors, increasing cyclic AMP, resulting in relaxing airways. What is the MOA of anticholinergi cs? - ANSWER -Block the effect of acetylcholine on muscarinic type 3 receptors, resulting in bronchodilation. Why are long -acting beta agonists prescribed for COPD? - ANSWER -They are for moderate airflow limitation. They relieve symptoms, increase exercis e tolerance, reduce number of exacerbations, improve QOL. What are some non pulmonary diagnoses that result in COPD -type symptoms? - ANSWER -CHF Hyperventilation syndrome Panic attacks Vocal cord dysfunction Obstructive sleep apnea Aspergillosis Chronic fa tigue syndrome What are signal symptoms of asthma? - ANSWER -Wheezing Shortness of breath Cough (esp at night) Chest tightness What is chronic bronchitis? - ANSWER -Daily chronic cough w/increased sputum for at least 3 consecutive months in at least 2 cons ecutive years. Usually worse on wakening. May or may not be associated with COPD. What is emphysema? - ANSWER -Characterized by obstruction to airflow caused by abnormal airspace enlargement distal to terminal bronchioles. Chronic inflammation/remodelin g, trapping air, hindering effective O2/CO2 exchange (all due to inflammatory mediators infiltrating airways). What are signal symptoms of ischemic heart dz? - ANSWER -Chest pain Chest tightness Chest discomfort What is ischemic heart dz? - ANSWER -Imbalan ce between supply and demand for blood flow to myocardium What are signal symptoms of lung CA? - ANSWER -Cough Dyspnea Wt loss Anorexia Hemoptysis What is lung CA? - ANSWER -Malignant neoplasm originating in parenchyma of lung/airways What are signal symp toms of MI? - ANSWER -Prolonged CP (>20min duration) SOB Confusion Weakness Worsening HF What is an MI? - ANSWER -Necrosis of heart tissue caused by lack of blood and O2 supply to the heart What are signal symptoms of pneumonia? - ANSWER -Fever Chills Hypot hermia New cough w/or w/out sputum Chest discomfort or dyspnea Fatigue HA Some older adults will be asymptomatic but may experience falls/confusion What is community acquired pneumonia? - ANSWER -Acute lower resp tract infection of lung parenchyma. Can be bacterial or viral. Bacterial is most common in older adults. What are signal symptoms of a PE? - ANSWER -Dyspnea CP on inspiration