NUR 163 Exam 2 2026/2027 | Concepts of Practical Nursing: Care of Elderly Patients | Hondros College | Actual Exam Verified Answers with Detailed Rationales | Grade A | Gerontology & LPN/LVN Nursing Prep | Downloadable PDF

INSTANT PDF DOWNLOAD — This is the comprehensive Exam 2 preparation guide for NUR 163 - Concepts of Practical Nursing: Care of Elderly Patients (2026/2027) at Hondros College of Nursing, featuring actual exam verified answers with detailed rationales. Designed for practical nursing (LPN/LVN) students, this resource consolidates the essential gerontological nursing concepts required to master the NUR 163 Exam 2 and achieve a Grade A. The guide is meticulously aligned with Hondros College curriculum, NCLEX-PN® test plan, and current evidence-based geriatric nursing practice standards. This verified resource provides comprehensive coverage of key NUR 163 Care of Elderly Patients Exam 2 topics, including: Normal Physiological Changes of Aging (integumentary—skin thinning (loss of collagen and elastin, decreased dermal thickness), decreased subcutaneous fat (loss of insulation, padding, contributes to wrinkling, skin tears, pressure injury risk), decreased sweat and sebaceous glands (dry skin (xerosis), decreased thermoregulation (heat intolerance, heat stroke risk), decreased vitamin D synthesis), decreased melanocytes (gray hair, increased photosensitivity, actinic keratosis, skin cancer risk), increased capillary fragility (easy bruising (senile purpura), petechiae, ecchymosis), skin tears (common in elderly due to fragile skin, prevent with gentle handling, use lift sheets, avoid tape (use paper tape, non-adhesive dressings, tubular net bandages), moisturize skin twice daily), pressure injuries (increased risk due to thinning skin, decreased subcutaneous fat, reduced mobility, incontinence, poor nutrition, comorbidities (diabetes, vascular disease), prevention (turn q2h, pressure redistribution surfaces (mattresses, cushions), offload heels, nutrition (protein, calories, vitamins, minerals), incontinence care (frequent changes, barrier creams, skin cleansers)), musculoskeletal—sarcopenia (age-related loss of muscle mass (3-8% per decade after age 30, accelerates after age 60), loss of muscle strength (1.5% per year after age 50), loss of type II (fast-twitch) muscle fibers (power, strength), decreased protein synthesis, decreased physical activity, increased inflammatory cytokines (IL-6, TNF-α)), interventions (resistance exercise (strength training 2-3x/week), adequate protein intake (1.0-1.2 g/kg/day, up to 1.5 g/kg/day in acute illness, injury, malnutrition), vitamin D (800-1000 IU/day), treat underlying conditions), osteoporosis (decreased bone mineral density (loss of 0.5-1% per year after age 40, accelerates in women after menopause (3-5% per year for 5-10 years)), increased fracture risk (hip, spine, wrist, pelvis, proximal humerus), risk factors (female, advanced age, Caucasian/Asian, family history, low body weight, smoking, alcohol, sedentary lifestyle, low calcium/vitamin D, corticosteroids, hypogonadism, hyperthyroidism, malabsorption, chronic kidney disease, rheumatoid arthritis, COPD, anticonvulsants (phenytoin, phenobarbital, carbamazepine), PPIs (long-term), SSRIs), screening (DXA (dual-energy x-ray absorptiometry) recommended for women ≥65, men ≥70, younger with risk factors, T-score (osteoporosis ≤ -2.5, osteopenia -1.0 to -2.5, normal ≥ -1.0)), prevention (calcium (1200 mg/day from diet and supplements, diet preferred (dairy, leafy greens, fortified foods, sardines, salmon with bones, almonds, tofu), supplements calcium carbonate (take with food, less expensive, requires gastric acid), calcium citrate (take without food, better absorption in elderly, achlorhydria, PPIs), do not exceed mg/day (kidney stones, vascular calcification)), vitamin D (800-1000 IU/day (some recommend up to 2000 IU/day for deficiency), weight-bearing exercise (walking, jogging, stair climbing, resistance training), smoking cessation, limit alcohol, fall prevention), treatment (bisphosphonates (alendronate (Fosamax) (once weekly, take with full glass water, remain upright 30-60 minutes, do not lie down, do not eat/drink (except water) for 30-60 minutes after dose, can cause esophagitis, esophageal ulcer, dysphagia, chest pain, heartburn), risedronate (Actonel) (once weekly or monthly), ibandronate (Boniva) (monthly oral, IV every 3 months), zoledronic acid (Reclast) (IV once yearly, most potent, can cause acute phase reaction (fever, myalgias, flu-like symptoms) after first dose, treat with acetaminophen or ibuprofen, also risk of hypocalcemia (ensure adequate calcium/vitamin D before infusion), renal impairment (contraindicated if CrCl 35), osteonecrosis of jaw (rare, risk with dental procedures, poor oral hygiene, dental disease, corticosteroids, cancer, chemotherapy, radiation, ensure dental exam before starting bisphosphonates, avoid elective dental surgery while on bisphosphonates, especially IV), atypical femoral fracture (stress fracture in subtrochanteric region or femoral shaft, bilateral, prodromal thigh/groin pain, after long-term use (≥5 years), discontinue bisphosphonate, surgery), drug holiday (after 3-5 years for oral, 3 years for IV, if low fracture risk, T-score -2.5, no prior fracture, consider holiday for 2-3 years, reassess), denosumab (Prolia) (RANKL inhibitor, monoclonal antibody, subcutaneous injection every 6 months, not cleared by kidneys (safe in renal impairment), no drug holiday (rebound vertebral fractures upon discontinuation, do not stop without switching to bisphosphonate), hypocalcemia risk (ensure calcium/vitamin D replete), osteonecrosis of jaw, atypical femoral fracture, increased infection risk (skin, urinary tract, respiratory), teriparatide (Forteo) (recombinant PTH, anabolic (stimulates bone formation), daily subcutaneous injection, for severe osteoporosis (T-score ≤ -3.0, or with fragility fracture, or failed/intolerant bisphosphonates), maximum 2 years (risk of osteosarcoma in animal studies, not seen in humans but Black Box Warning), adverse effects (nausea, leg cramps, dizziness, orthostatic hypotension, hypercalcemia), abaloparatide (Tymlos) (similar to PTHrP, anabolic, daily subcutaneous injection, for postmenopausal women with high fracture risk, up to 2 years), romosozumab (Evenity) (sclerostin inhibitor, monoclonal antibody, anabolic + anti-resorptive, monthly subcutaneous injection for 12 months (one course), for postmenopausal women with high fracture risk, Black Box Warning (increased risk of MI, stroke, cardiovascular death, contraindicated in patients with prior MI or stroke), adverse effects (joint pain, headache, injection site reactions, hypocalcemia), raloxifene (Evista) (SERM (selective estrogen receptor modulator), estrogen agonist in bone (increases BMD), antagonist in breast and uterus (reduces breast cancer risk, no endometrial hyperplasia), for postmenopausal women, reduces vertebral fractures (not hip fractures), adverse effects (hot flashes, leg cramps, increased risk DVT/PE, fatal stroke (in women with coronary heart disease or at high risk), calcitonin (salmon calcitonin (Miacalcin), nasal spray.