NURS 1002 Midterm Questions With Complete Solutions
abnormals ABCDE rules of melanoma Correct Answers
Asymmetry: One half does not match the other half.
Border irregularity: The edges are ragged, notched, blurred.
Colour: Not uniform in colour, mottled, red, white
Diameter: Bigger than pencil eraser or increasing.
Evolution: A change or "evolution" in size, shape, etc
age related changes in immune system Correct Answers The
thymus involutes with age
T-cell immunity tends to decline
Cytokine level and function may change with age
Humeral (B-cell) immunity declines with age
Reduced migration to site of inflammation/infection and altered
phagocytosis.
Autoantibodies increase with age.
age related changes in musculoskeletal system Correct Answers
Age-related changes that occur in the musculoskeletal system
are closely intertwined with changes seen in the neurological
and the endocrine systems. Loss of motor neurons as well as
changes in hormones such as estrogen and testosterone influence
the changes seen in muscle fibers and muscle strength.
Between ages 30 and 75, lean body mass decreases, primarily
due to loss of skeletal muscle mass. The number and size of
muscle fibers progressively decrease. This process is termed
sarcopenia.
,Changes in the central or peripheral nervous system, possibly
beginning during middle age, that may lead to a loss of motor
units;
If reduced levels of physical activity; reduced rate of skeletal
muscle protein synthesis.
In many elderly persons, loss of muscle mass may be
accelerated as a result of greater dietary protein requirements
coupled with reduced protein intake.
age related respiratory changes Correct Answers Decreased
chest expansion
kyphoscoliosis
calcification of intercostal cartilage
arthritis in costovertebral joints
Decreased elastic recoil of lungs
Reduced diaphragm function
Increased airways obstruction
Reduced Vital Capacity
Increased Residual Capacity
Reduced Vital Capacity
Increased Residual Capacity
Net result less gas exchange especially under increased demand
aging and intelligence Correct Answers Skills independent of
experience or learning: fluid intelligence
Learning and problem solving in novel situations
Performance
Knowledge and abilities acquired throughout person's life:
crystallized intelligence
,Verbal meaning, word association, social judgement, number
skills
Classic aging pattern:
tendency to perform poorly on performance tasks, but verbal
scores remain stable
May be related to changes in sensory and perceptual abilities as
well as psychomotor skills, lower cognitive processing speed,
slower reaction time
alternatives FICA Correct Answers F - Faith and Belief
"Do you consider yourself spiritual or religious?" or "Is
spirituality something important to you" or "Do you have
spiritual beliefs that help you cope with stress/ difficult times?"
(Contextualize to reason for visit if it is not the routine history).
If the patient responds "No," the health care provider might ask,
"What gives your life meaning?" Sometimes patients respond
with answers such as family, career, or nature.
(The question of meaning should also be asked even if people
answer yes to spirituality)
I - Importance
"What importance does your spirituality have in our life? Has
your spirituality influenced how you take care of yourself, your
health? Does your spirituality influence you in your healthcare
decision making? (e.g. advance directives, treatment etc.)
C - Community
"Are you part of a spiritual community? Communities such as
churches, temples, and mosques, or a group of like-minded
friends, family, or yoga, can serve as strong support systems for
some patients. Can explore further: Is this of support to you and
how? Is there a group of people you really love or who are
important to you?"
, A - Address in Care
"How would you like me, your healthcare provider, to address
these issues in your healthcare?"
(With the newer models including diagnosis of spiritual distress
A also refers to the Assessment and Plan of patient spiritual
distress or issues within a treatment or care plan
an alternative to the highly individualistic, decontextualized
approach Correct Answers The RN at a LTC facility
transferred a resident to the local ER at 0100 after she was found
on the floor in her bathroom.
The resident was very congested and confused.
The facility received a call from the ER a few hours later saying
that she was on her way back to the LTC facility. No
investigations had been done. There were no new orders.
The ER staff stated that the transfer had been unnecessary
because the resident was a DNR.
assessing cognitive function: formal assessment Correct
Answers testing using
Standardized instruments
scores, consider reference group,
stress, unfamiliar settings
& people
Mini-mental state examination (MMSE) (Folstein, et al., 1975)
Brief Cognitive Rating Scale (BCRS, Reisberg et al., 1988)
Frontal Assessment Battery (FAB) (Dubois, et al., 2000)
Mini-Cog (Borson, 2003)
MoCa (Nasreddine, et al., 2005)
abnormals ABCDE rules of melanoma Correct Answers
Asymmetry: One half does not match the other half.
Border irregularity: The edges are ragged, notched, blurred.
Colour: Not uniform in colour, mottled, red, white
Diameter: Bigger than pencil eraser or increasing.
Evolution: A change or "evolution" in size, shape, etc
age related changes in immune system Correct Answers The
thymus involutes with age
T-cell immunity tends to decline
Cytokine level and function may change with age
Humeral (B-cell) immunity declines with age
Reduced migration to site of inflammation/infection and altered
phagocytosis.
Autoantibodies increase with age.
age related changes in musculoskeletal system Correct Answers
Age-related changes that occur in the musculoskeletal system
are closely intertwined with changes seen in the neurological
and the endocrine systems. Loss of motor neurons as well as
changes in hormones such as estrogen and testosterone influence
the changes seen in muscle fibers and muscle strength.
Between ages 30 and 75, lean body mass decreases, primarily
due to loss of skeletal muscle mass. The number and size of
muscle fibers progressively decrease. This process is termed
sarcopenia.
,Changes in the central or peripheral nervous system, possibly
beginning during middle age, that may lead to a loss of motor
units;
If reduced levels of physical activity; reduced rate of skeletal
muscle protein synthesis.
In many elderly persons, loss of muscle mass may be
accelerated as a result of greater dietary protein requirements
coupled with reduced protein intake.
age related respiratory changes Correct Answers Decreased
chest expansion
kyphoscoliosis
calcification of intercostal cartilage
arthritis in costovertebral joints
Decreased elastic recoil of lungs
Reduced diaphragm function
Increased airways obstruction
Reduced Vital Capacity
Increased Residual Capacity
Reduced Vital Capacity
Increased Residual Capacity
Net result less gas exchange especially under increased demand
aging and intelligence Correct Answers Skills independent of
experience or learning: fluid intelligence
Learning and problem solving in novel situations
Performance
Knowledge and abilities acquired throughout person's life:
crystallized intelligence
,Verbal meaning, word association, social judgement, number
skills
Classic aging pattern:
tendency to perform poorly on performance tasks, but verbal
scores remain stable
May be related to changes in sensory and perceptual abilities as
well as psychomotor skills, lower cognitive processing speed,
slower reaction time
alternatives FICA Correct Answers F - Faith and Belief
"Do you consider yourself spiritual or religious?" or "Is
spirituality something important to you" or "Do you have
spiritual beliefs that help you cope with stress/ difficult times?"
(Contextualize to reason for visit if it is not the routine history).
If the patient responds "No," the health care provider might ask,
"What gives your life meaning?" Sometimes patients respond
with answers such as family, career, or nature.
(The question of meaning should also be asked even if people
answer yes to spirituality)
I - Importance
"What importance does your spirituality have in our life? Has
your spirituality influenced how you take care of yourself, your
health? Does your spirituality influence you in your healthcare
decision making? (e.g. advance directives, treatment etc.)
C - Community
"Are you part of a spiritual community? Communities such as
churches, temples, and mosques, or a group of like-minded
friends, family, or yoga, can serve as strong support systems for
some patients. Can explore further: Is this of support to you and
how? Is there a group of people you really love or who are
important to you?"
, A - Address in Care
"How would you like me, your healthcare provider, to address
these issues in your healthcare?"
(With the newer models including diagnosis of spiritual distress
A also refers to the Assessment and Plan of patient spiritual
distress or issues within a treatment or care plan
an alternative to the highly individualistic, decontextualized
approach Correct Answers The RN at a LTC facility
transferred a resident to the local ER at 0100 after she was found
on the floor in her bathroom.
The resident was very congested and confused.
The facility received a call from the ER a few hours later saying
that she was on her way back to the LTC facility. No
investigations had been done. There were no new orders.
The ER staff stated that the transfer had been unnecessary
because the resident was a DNR.
assessing cognitive function: formal assessment Correct
Answers testing using
Standardized instruments
scores, consider reference group,
stress, unfamiliar settings
& people
Mini-mental state examination (MMSE) (Folstein, et al., 1975)
Brief Cognitive Rating Scale (BCRS, Reisberg et al., 1988)
Frontal Assessment Battery (FAB) (Dubois, et al., 2000)
Mini-Cog (Borson, 2003)
MoCa (Nasreddine, et al., 2005)
