NU 300 EXAM 2 | INFECTION, INFLAMMATION & IMMUNE RESPONSE |
COMPREHENSIVE MEDICAL-SURGICAL NURSING STUDY GUIDE 2026/2027
What do the elderly have an increased need for? - ANS ✔✔calcium- bones
vitamin A- eye sight
Vitamin C- immune system
Vitamin D
fiber- decreases constipation
What helps decrease constipation? - ANS ✔✔fiber
motility
2 L water/day
How do the elderly get vitamin D? - ANS ✔✔go for walks 3-4 times a week
What causes geriatric failure to thrive? - ANS ✔✔•Under-nutrition
•Impaired physical functioning
•Depression
•Cognitive impairment
How does physical activity give an advantage over impaired mobility? - ANS ✔✔•Decreased fall risk
•Weight loss/maintenance
•Improved mood
•Decreased disease risks
What are the side effects of relocation stress syndrome? - ANS ✔✔•sleep disturbance, GI distress,
withdrawal, anxiety, anger, and depression
How can you help with relocation stress? - ANS ✔✔•Allow for the person to assist with decision making.
•Explain in detail all procedures and routines before they occur.
•Have family provide familiar things or keepsakes for the bedside.
•Reorient the older adult to their location if possible.
•Encourage family and friends to visit .
•Establish a trusting relationship.
•Avoid moving from room to room.
•Accompany the older adult for procedures or therapies so they do not feel alone.
What are some age related changes to the effects of drugs? - ANS ✔✔•Affect absorption
•Affect metabolism
•Reduce liver blood flow and serum enzyme activity
How do changes in kidneys affect the effect of drugs? - ANS ✔✔•Changes in kidneys result in high
plasma drug concentrations
What is creatinine clearance test? - ANS ✔✔•Measures glomerular filtration rate of kidneys
,What are some common adverse side effects? - ANS ✔✔•Edema
•n/v
•Dehydration
•Anorexia
•Dysrhythmias
•Fatigue/weakness
•Dizziness/syncope
•Urinary retention
•Diarrhea/constipation/impaction
•Hypotension
•Acute confusion
What are 1st generation antihistamines? - ANS ✔✔(ex: diphenhydramine, hydroxyzine, promethazine)
What is the Beer's list? - ANS ✔✔medications that should not be given to older adults
What is Meperidine (demoral)? - ANS ✔✔any patient with impaired kidney function should not use this
drug for pain
What is on the Beer's list? - ANS ✔✔•First-generation antihistamines (ex: diphenhydramine,
hydroxyzine, promethazine)
•Alpha1 blockers (ex: doxazosin)
•TCA (ex: amitriptyline)
•Estrogens with or without progestins
•Meperidine
•Proton Pump Inhibitors
How should you assess and teach older patients about medications? - ANS ✔✔•Assess medication use
per Healthy People 2020 recommendations
•Highlight all drugs that are part of Beers criteria
•Perform medication assessment every 6 months or more often as needed
•Collaborate with patient, family, providers, pharmacist
•Give verbal and written information
•Promote adherence to drug therapy regimen exactly as prescribed
•Encourage lifestyle changes and nonpharmacologic interventions
•Remind not to share/borrow drugs
Is it normal for an older patient to be confused? - ANS ✔✔no
How can you help impaired cognition? - ANS ✔✔•Learning new skills
•Physical activity
•Social engagement
•Nutrition
What are some considerations when treating veterans? - ANS ✔✔•Depression
•PTSD
•Severe anxiety
•Substance use (especially alcoholism)
,•Homelessness
What is depression? - ANS ✔✔•Mood disorder having cognitive, affective, physical manifestations
primary or secondary
How do you treat depression? - ANS ✔✔•Treatment includes drug therapy, psychotherapy
•Reminiscence or reflective therapies useful with older adults
What is the geriatric depression scale? - ANS ✔✔questionaire with 15 questions about depression
How is the geriatric depression scale scored? - ANS ✔✔>5= possible depression
>10=depression
What is dementia? - ANS ✔✔•Syndrome involving slow, progressive cognitive decline (also known as
chronic confusion)
•Global impairment of intellectual function; generally chronic and progressive
•Types
•Alzheimer's disease
•Multi-infarct dementia
What is delirium? - ANS ✔✔•Acute state of confusion, fluctuating onset
•Usually short-term; reversible within 1 month or less
•Often experienced by older adults in unfamiliar settings
•Can include physical and emotional manifestations (including psychosis)
What is the difference between dementia and delirium? - ANS ✔✔delirium is reversible, dementia is not
What things can cause delirium? - ANS ✔✔•Drug therapy
•Fluid and electrolyte imbalances
•Infections
•Fecal impaction or severe diarrhea
•Surgery
•Metabolic problems
•Neurological, circulatory, renal, pulmonary disorders
•Nutrition deficiencies
•Hypoxemia
How can you screen for delirium? - ANS ✔✔•Confusion Assessment Method (CAM)
•Delirium Index (DI)
•NEECHAM Confusion Scale
•Mini-Cog
What can substance abuse cause? - ANS ✔✔•Isolation, depression, delirium can result
What is the short Michigan alcoholism screening test for the geriatric? - ANS ✔✔•10 yes/no questions
•Each "yes" answer = 1 point
, •Total score of 2 or more points = individual has problem with alcohol
•Examples of questions
•Do you drink to take your mind off of your problems?
•When you feel lonely, does having a drink help?
What is the CAGE test? - ANS ✔✔•Four questions
•Have you ever tried to cut down on your drinking?
•Have people annoyed you by criticizing your drinking?
•Have you ever felt bad or guilty about your drinking?
•Have you ever had a drink first thing in the morning to settle your nerves? (eye-opener)
What is neglect? - ANS ✔✔Caregiver failure to provide basic needs
What are the forms of abuse? - ANS ✔✔•Physical—Use of physical force that results in bodily injury
•Financial—Mismanagement or misuse of property or resources
•Emotional—Intentional use of threats, humiliation, intimidation, isolation
How should you use restraints for medical purposes? - ANS ✔✔•Use least restrictive device
•Check patient every 30-60 minutes
•Release restraint every 2 hours
•Turn, reposition, toilet
What are chemical restraints? - ANS ✔✔•Antipsychotics
•Antianxiety drugs
•Antidepressants
•Sedative-hypnotics
What are the national patient safety goals? - ANS ✔✔•NPSG—must have program to prevent agency-
associated pressure injuries
•Nutrition support
•Avoid friction, shearing
•Reposition and provide support surfaces
•Increase mobility and activity (when appropriate)
•Clean skin, use moisture barriers
How do you care for a patient in an emergency situation? - ANS ✔✔safety
airway
breathing
circulation
Is acute or chronic more important? - ANS ✔✔acute is priority since chronic pain has adapted to change
What is culture? - ANS ✔✔Integrated patterns of behavior acquired over time. They include beliefs,
values, customs, norms, habits, language, thoughts and ways of life.
What is cultural diversity? - ANS ✔✔Differences among people which may or may not be visible
What is ethnicity? - ANS ✔✔•Common social customs, values and beliefs of a group. Not race.
COMPREHENSIVE MEDICAL-SURGICAL NURSING STUDY GUIDE 2026/2027
What do the elderly have an increased need for? - ANS ✔✔calcium- bones
vitamin A- eye sight
Vitamin C- immune system
Vitamin D
fiber- decreases constipation
What helps decrease constipation? - ANS ✔✔fiber
motility
2 L water/day
How do the elderly get vitamin D? - ANS ✔✔go for walks 3-4 times a week
What causes geriatric failure to thrive? - ANS ✔✔•Under-nutrition
•Impaired physical functioning
•Depression
•Cognitive impairment
How does physical activity give an advantage over impaired mobility? - ANS ✔✔•Decreased fall risk
•Weight loss/maintenance
•Improved mood
•Decreased disease risks
What are the side effects of relocation stress syndrome? - ANS ✔✔•sleep disturbance, GI distress,
withdrawal, anxiety, anger, and depression
How can you help with relocation stress? - ANS ✔✔•Allow for the person to assist with decision making.
•Explain in detail all procedures and routines before they occur.
•Have family provide familiar things or keepsakes for the bedside.
•Reorient the older adult to their location if possible.
•Encourage family and friends to visit .
•Establish a trusting relationship.
•Avoid moving from room to room.
•Accompany the older adult for procedures or therapies so they do not feel alone.
What are some age related changes to the effects of drugs? - ANS ✔✔•Affect absorption
•Affect metabolism
•Reduce liver blood flow and serum enzyme activity
How do changes in kidneys affect the effect of drugs? - ANS ✔✔•Changes in kidneys result in high
plasma drug concentrations
What is creatinine clearance test? - ANS ✔✔•Measures glomerular filtration rate of kidneys
,What are some common adverse side effects? - ANS ✔✔•Edema
•n/v
•Dehydration
•Anorexia
•Dysrhythmias
•Fatigue/weakness
•Dizziness/syncope
•Urinary retention
•Diarrhea/constipation/impaction
•Hypotension
•Acute confusion
What are 1st generation antihistamines? - ANS ✔✔(ex: diphenhydramine, hydroxyzine, promethazine)
What is the Beer's list? - ANS ✔✔medications that should not be given to older adults
What is Meperidine (demoral)? - ANS ✔✔any patient with impaired kidney function should not use this
drug for pain
What is on the Beer's list? - ANS ✔✔•First-generation antihistamines (ex: diphenhydramine,
hydroxyzine, promethazine)
•Alpha1 blockers (ex: doxazosin)
•TCA (ex: amitriptyline)
•Estrogens with or without progestins
•Meperidine
•Proton Pump Inhibitors
How should you assess and teach older patients about medications? - ANS ✔✔•Assess medication use
per Healthy People 2020 recommendations
•Highlight all drugs that are part of Beers criteria
•Perform medication assessment every 6 months or more often as needed
•Collaborate with patient, family, providers, pharmacist
•Give verbal and written information
•Promote adherence to drug therapy regimen exactly as prescribed
•Encourage lifestyle changes and nonpharmacologic interventions
•Remind not to share/borrow drugs
Is it normal for an older patient to be confused? - ANS ✔✔no
How can you help impaired cognition? - ANS ✔✔•Learning new skills
•Physical activity
•Social engagement
•Nutrition
What are some considerations when treating veterans? - ANS ✔✔•Depression
•PTSD
•Severe anxiety
•Substance use (especially alcoholism)
,•Homelessness
What is depression? - ANS ✔✔•Mood disorder having cognitive, affective, physical manifestations
primary or secondary
How do you treat depression? - ANS ✔✔•Treatment includes drug therapy, psychotherapy
•Reminiscence or reflective therapies useful with older adults
What is the geriatric depression scale? - ANS ✔✔questionaire with 15 questions about depression
How is the geriatric depression scale scored? - ANS ✔✔>5= possible depression
>10=depression
What is dementia? - ANS ✔✔•Syndrome involving slow, progressive cognitive decline (also known as
chronic confusion)
•Global impairment of intellectual function; generally chronic and progressive
•Types
•Alzheimer's disease
•Multi-infarct dementia
What is delirium? - ANS ✔✔•Acute state of confusion, fluctuating onset
•Usually short-term; reversible within 1 month or less
•Often experienced by older adults in unfamiliar settings
•Can include physical and emotional manifestations (including psychosis)
What is the difference between dementia and delirium? - ANS ✔✔delirium is reversible, dementia is not
What things can cause delirium? - ANS ✔✔•Drug therapy
•Fluid and electrolyte imbalances
•Infections
•Fecal impaction or severe diarrhea
•Surgery
•Metabolic problems
•Neurological, circulatory, renal, pulmonary disorders
•Nutrition deficiencies
•Hypoxemia
How can you screen for delirium? - ANS ✔✔•Confusion Assessment Method (CAM)
•Delirium Index (DI)
•NEECHAM Confusion Scale
•Mini-Cog
What can substance abuse cause? - ANS ✔✔•Isolation, depression, delirium can result
What is the short Michigan alcoholism screening test for the geriatric? - ANS ✔✔•10 yes/no questions
•Each "yes" answer = 1 point
, •Total score of 2 or more points = individual has problem with alcohol
•Examples of questions
•Do you drink to take your mind off of your problems?
•When you feel lonely, does having a drink help?
What is the CAGE test? - ANS ✔✔•Four questions
•Have you ever tried to cut down on your drinking?
•Have people annoyed you by criticizing your drinking?
•Have you ever felt bad or guilty about your drinking?
•Have you ever had a drink first thing in the morning to settle your nerves? (eye-opener)
What is neglect? - ANS ✔✔Caregiver failure to provide basic needs
What are the forms of abuse? - ANS ✔✔•Physical—Use of physical force that results in bodily injury
•Financial—Mismanagement or misuse of property or resources
•Emotional—Intentional use of threats, humiliation, intimidation, isolation
How should you use restraints for medical purposes? - ANS ✔✔•Use least restrictive device
•Check patient every 30-60 minutes
•Release restraint every 2 hours
•Turn, reposition, toilet
What are chemical restraints? - ANS ✔✔•Antipsychotics
•Antianxiety drugs
•Antidepressants
•Sedative-hypnotics
What are the national patient safety goals? - ANS ✔✔•NPSG—must have program to prevent agency-
associated pressure injuries
•Nutrition support
•Avoid friction, shearing
•Reposition and provide support surfaces
•Increase mobility and activity (when appropriate)
•Clean skin, use moisture barriers
How do you care for a patient in an emergency situation? - ANS ✔✔safety
airway
breathing
circulation
Is acute or chronic more important? - ANS ✔✔acute is priority since chronic pain has adapted to change
What is culture? - ANS ✔✔Integrated patterns of behavior acquired over time. They include beliefs,
values, customs, norms, habits, language, thoughts and ways of life.
What is cultural diversity? - ANS ✔✔Differences among people which may or may not be visible
What is ethnicity? - ANS ✔✔•Common social customs, values and beliefs of a group. Not race.
