NURS209 NEW EXAM QUESTIONS AND CORRECT ANSWERS
100% VERIFIED
Changing demographics - ANSWER More senior women than men lived below the
low-income cut-off, population of seniors is diverse and growing. Most seniors live in
private dwellings in the community (1/3 live alone, of that 1/2 are women). 7.9% live in
residential care facilities.
Elder abuse - ANSWER Abuse and neglect of older people. Includes physical,
psychological or emotional, sexual abuse, financial exploitation, and neglect or
abandonment. People who commit elder abuse are often in a position of trust.
Majority of aging - ANSWER Despite the stereotype, most people will age well
National Seniors Strategy (NSS) supporting pillars for aging - ANSWER 1. independent,
productive and engaged citizens
2. healthy and active lives.
3. care closer to home
4. support for unpaid caregivers
National Seniors Strategy (NSS) underlying principles - ANSWER 1. access
2. quality
3. value
4. choice
5. equity
Seniors and hospital services - ANSWER 63% of all inpatient days in Ontario are
accounted for by seniors, 70% of ALC days are associated with individuals over 75, less
than 10% of seniors account for 60% of utilization
,Common admitting seniors profile - ANSWER Physical frailty, associated social
vulnerability and multiple chronic disease
Food insecure household trend in Canada - ANSWER steadily increasing in the number
of people
Gender and aging - ANSWER women are found to be less healthy and report more
severe disability. Women report more multiple health problems associated with chronic
conditions and are more likely to report limitations in activities of daily living or disability
Race and ethnicity and aging ANSWER Aboriginal Canadians have a 6 year shorter life
expectancy, suffer from more chronic illnesses and disabilities, do not generally rate
their health as very good + Less than 1/2 of non-reserve Aboriginal 64+ report very
good+ health Poorer health conditions- including higher smoking rates, higher obesity
rates, and greater food insecurity
CIHI indicators measuring progress toward improving home and community care
Hospital stay extended until home care services or supports ready Caregiver distress
Long-term care provided at the appropriate time Wait times for home care services
Home care services helped the recipient stay at home Death at home instead of hospital
What increases the odds of admission to residential care? - ANSWER Assessed in
hospital, cognitive impairment, requiring physical assistance, living alone, caregiver
unable to continue, wandering
Aging theories - ANSWER Evolutionary theories, programmed theories, damage
theories, molecular biology of aging theories
Aging theories common denominator - ANSWER Inflammatory component- very strong
link between aging and inflammation as a biological phenomenon
Evolutionary theories - ANSWER Programmed death, antagonistic pleiotrophy
,Programmed theories - ANSWER Neuroendocrine, autoimmunity, genetic clock, limited
cell division
Damage theories - ANSWER General formulations (waste accumulation, wear and tear,
error catastrophe, circadian deregulation), individual mechanisms (chronic excess
inflammation, glycation, oxidative damage, free radial, DNA damage), stress-induced
premature senescence
Prevalence of frailty - ANSWER 6% of 18-79, 16% 65-74, 28.6% of 75-84, 52.1% 85+, 50%
in nursing homes, 42% of older cancer patients, and 60% of cardiovascular disease
patients
Frailty - ANSWER A state of increased vulnerability to poor resolution of homeostasis
after a stressor event, which increases the risk of adverse outcomes, including falls,
delirium, and disability. Geriatric syndrome characterized by weakness, weight loss,
and low activity that is associated with adverse health outcomes
Frailty manifestations Age-related, biological vulnerability to stressors and decreased
physiological reserves yielding a limited capacity to maintain homeostasis. can be
physical, social or cognitive.
Phenotype model of frailty - ANSWER Frailty is operationalized as a syndrome meeting
three or more of five phenotypic criteria: weakness as measured by low grip strength,
slowness by slowed walking speed, low level of physical activity, low energy or
self-reported exhaustion, and unintentional weight loss.
Culmulative deficit model of frailty - ANSWER As people age they accumulate health
deficits, and that more deficits confer greater risk. Frailty results because not everyone
of the same age has the same number of deficits.
Frailty cascade- ANSWER Genetic factors, environmental factors leading to cumulative
molecular and cellular damage leading to reduced physiological reserve impacted by
physical activity and nutritional factors leading to frailty, which leads to falls, delirium,
and fluctuating disability leading to increased care needs, hospital and long-term care
, admission
Factors related to frailty- ANSWER Sociodemographic- advanced age, female, ethnical
background, education, low socioeconomic position, living alone, loneliness
Clinical factors- multimorbidity and chronic diseases, obesity, malnutrition, impaired
cognition, depressive symptoms, polypharmacy.
Lifestyle- physical inactivity, dietary patterns, smoking, alcohol consumption
Biological- immune function, neuroendocrine dysregulation, micronutrient deficiencies,
sarcopenia, energy imbalances/ oxidative stress
Polypharmacy - ANSWER The use of more medications than are clinically indicated.
commonly defined as 5+ medications daily. Use of potentially inappropriate
medications, medication underuse and medication duplication,
Hyperpolypharmacy - ANSWER taking 10 or more medications
Polypharmacy statistics - ANSWER 30% among 65-79 year olds. In elderly patients,
44-60% of patients have no indication for use, are on unnecessary or ineffective drugs,
or have duplication of therapy.
Factors contributing to polypharmacy - ANSWER Presence of co-morbidities and
multiple providers. unclear, complex, or incomplete instructions regarding medications.
No efforts to simplify meds- assume that once started, should be continued, use of
non-prescribed drugs. Inappropriate prescribing. Prescribing cascade. Uncoordinated
care. No regular medical review. Prescribing for "symptoms" without investigation.
Ordering automatic refills. Lack of knowledge of geriatric pharmacology.
Pharmacokinetics - ANSWER Refers to how the body handles a drug from the time it is
ingested to the time it is excreted
ADME (absorption, distribution, metabolism, excretion)
Aging impact on absorption - ANSWER Reduced GI motility and blood flow, reduced
peristaltic force that reduces the mechanical influences on medication mixing with
100% VERIFIED
Changing demographics - ANSWER More senior women than men lived below the
low-income cut-off, population of seniors is diverse and growing. Most seniors live in
private dwellings in the community (1/3 live alone, of that 1/2 are women). 7.9% live in
residential care facilities.
Elder abuse - ANSWER Abuse and neglect of older people. Includes physical,
psychological or emotional, sexual abuse, financial exploitation, and neglect or
abandonment. People who commit elder abuse are often in a position of trust.
Majority of aging - ANSWER Despite the stereotype, most people will age well
National Seniors Strategy (NSS) supporting pillars for aging - ANSWER 1. independent,
productive and engaged citizens
2. healthy and active lives.
3. care closer to home
4. support for unpaid caregivers
National Seniors Strategy (NSS) underlying principles - ANSWER 1. access
2. quality
3. value
4. choice
5. equity
Seniors and hospital services - ANSWER 63% of all inpatient days in Ontario are
accounted for by seniors, 70% of ALC days are associated with individuals over 75, less
than 10% of seniors account for 60% of utilization
,Common admitting seniors profile - ANSWER Physical frailty, associated social
vulnerability and multiple chronic disease
Food insecure household trend in Canada - ANSWER steadily increasing in the number
of people
Gender and aging - ANSWER women are found to be less healthy and report more
severe disability. Women report more multiple health problems associated with chronic
conditions and are more likely to report limitations in activities of daily living or disability
Race and ethnicity and aging ANSWER Aboriginal Canadians have a 6 year shorter life
expectancy, suffer from more chronic illnesses and disabilities, do not generally rate
their health as very good + Less than 1/2 of non-reserve Aboriginal 64+ report very
good+ health Poorer health conditions- including higher smoking rates, higher obesity
rates, and greater food insecurity
CIHI indicators measuring progress toward improving home and community care
Hospital stay extended until home care services or supports ready Caregiver distress
Long-term care provided at the appropriate time Wait times for home care services
Home care services helped the recipient stay at home Death at home instead of hospital
What increases the odds of admission to residential care? - ANSWER Assessed in
hospital, cognitive impairment, requiring physical assistance, living alone, caregiver
unable to continue, wandering
Aging theories - ANSWER Evolutionary theories, programmed theories, damage
theories, molecular biology of aging theories
Aging theories common denominator - ANSWER Inflammatory component- very strong
link between aging and inflammation as a biological phenomenon
Evolutionary theories - ANSWER Programmed death, antagonistic pleiotrophy
,Programmed theories - ANSWER Neuroendocrine, autoimmunity, genetic clock, limited
cell division
Damage theories - ANSWER General formulations (waste accumulation, wear and tear,
error catastrophe, circadian deregulation), individual mechanisms (chronic excess
inflammation, glycation, oxidative damage, free radial, DNA damage), stress-induced
premature senescence
Prevalence of frailty - ANSWER 6% of 18-79, 16% 65-74, 28.6% of 75-84, 52.1% 85+, 50%
in nursing homes, 42% of older cancer patients, and 60% of cardiovascular disease
patients
Frailty - ANSWER A state of increased vulnerability to poor resolution of homeostasis
after a stressor event, which increases the risk of adverse outcomes, including falls,
delirium, and disability. Geriatric syndrome characterized by weakness, weight loss,
and low activity that is associated with adverse health outcomes
Frailty manifestations Age-related, biological vulnerability to stressors and decreased
physiological reserves yielding a limited capacity to maintain homeostasis. can be
physical, social or cognitive.
Phenotype model of frailty - ANSWER Frailty is operationalized as a syndrome meeting
three or more of five phenotypic criteria: weakness as measured by low grip strength,
slowness by slowed walking speed, low level of physical activity, low energy or
self-reported exhaustion, and unintentional weight loss.
Culmulative deficit model of frailty - ANSWER As people age they accumulate health
deficits, and that more deficits confer greater risk. Frailty results because not everyone
of the same age has the same number of deficits.
Frailty cascade- ANSWER Genetic factors, environmental factors leading to cumulative
molecular and cellular damage leading to reduced physiological reserve impacted by
physical activity and nutritional factors leading to frailty, which leads to falls, delirium,
and fluctuating disability leading to increased care needs, hospital and long-term care
, admission
Factors related to frailty- ANSWER Sociodemographic- advanced age, female, ethnical
background, education, low socioeconomic position, living alone, loneliness
Clinical factors- multimorbidity and chronic diseases, obesity, malnutrition, impaired
cognition, depressive symptoms, polypharmacy.
Lifestyle- physical inactivity, dietary patterns, smoking, alcohol consumption
Biological- immune function, neuroendocrine dysregulation, micronutrient deficiencies,
sarcopenia, energy imbalances/ oxidative stress
Polypharmacy - ANSWER The use of more medications than are clinically indicated.
commonly defined as 5+ medications daily. Use of potentially inappropriate
medications, medication underuse and medication duplication,
Hyperpolypharmacy - ANSWER taking 10 or more medications
Polypharmacy statistics - ANSWER 30% among 65-79 year olds. In elderly patients,
44-60% of patients have no indication for use, are on unnecessary or ineffective drugs,
or have duplication of therapy.
Factors contributing to polypharmacy - ANSWER Presence of co-morbidities and
multiple providers. unclear, complex, or incomplete instructions regarding medications.
No efforts to simplify meds- assume that once started, should be continued, use of
non-prescribed drugs. Inappropriate prescribing. Prescribing cascade. Uncoordinated
care. No regular medical review. Prescribing for "symptoms" without investigation.
Ordering automatic refills. Lack of knowledge of geriatric pharmacology.
Pharmacokinetics - ANSWER Refers to how the body handles a drug from the time it is
ingested to the time it is excreted
ADME (absorption, distribution, metabolism, excretion)
Aging impact on absorption - ANSWER Reduced GI motility and blood flow, reduced
peristaltic force that reduces the mechanical influences on medication mixing with
