NUR 410 Test #2 UPDATED ACTUAL
Exam Questions and CORRECT Answers
4 M's of Medical Complexity - CORRECT ANSWER -- Multiple chronic conditions
- Many medications
- Managing social networks as they change
- More risk for acute changes in condition
+ Acute exacerbation of chronic disease (HF, COPD)
"acute on chronic"
+ New acute illness (infection, flu-UTI-pneumonia)
+Drug adverse effects
+ Drug-drug interactions
+ Drug-induced medical problems (falls, delirium, UI)
3 Types of Atypical Illness Presentation
-Vague
-Altered
-Non-presentation - CORRECT ANSWER -- Vague presentation of illness: non-specific
symptoms that signal an impending acute illness
-Example: refusal to eat and drink, new onset of falling or functional decline
-Altered presentation of illness: presentation of a symptom or a group of symptoms that does not
compare to the classic presentation of common illnesses in the general adult population
-Symptoms are not traceable to the underlying organ dysfunction
- Example: absence of pain in conditions or diseases known to produce pain
-Non-presentation of illness: illnesses in older adults goes unrecognized for many years
-Example: failure to show classic signs of infection such as elevated temp or increased WBC's
,Risk Factors for Medical Complexity - CORRECT ANSWER -- Over age 85
- Multiple medical illnesses
- Multiple medications
- Poor vision and hearing
- Cognitive impairment
- Functional impairment
- Surgery, anesthesia
Examples of vague, non-specific symptoms - CORRECT ANSWER --Apathy
-Fatigue
-Weakness
-Dyspnea
-Incontinence
-Altered mental status, confusion
-Self-neglect, poor hygiene
-Refusal or failure to eat or drink
-New onset of falling
-New onset functional decline
Altered Presentation of Illness - CORRECT ANSWER -- Classic presentations of common
illnesses do not hold true.
- May not see chest pain with MI
- May not see burning with UTI
- May not see "sadness" with depression
- Change in mental status- most frequently seen symptom of acute illness
,Non-Presentation of Illness - CORRECT ANSWER -Many conditions remain hidden and
undiagnosed for many years.
- The insidious nature of the onset of many illnesses.
- Vague symptoms.
- Regard symptoms as "normal" aging.
- Attribute new symptoms or a change in symptoms to existing medical problems.
- Reluctance to complain -concerns about the need for medical tests and treatments, being
labeled as complainer, being ignored or withheld treatment.
- Communication deficits- hearing, vision, speech.
Hidden, Undiagnosed Conditions
Consequences - CORRECT ANSWER -- Osteoarthritis
- Falling
- Incontinence
- Hearing and vision decline
- Poor nutrition
- Dental problems
- Depression
- Dementia
- Chronic pain
- Alcoholism
Consequences:
- Increased morbidity
- Increased mortality
- Missed diagnosis
- Unnecessary health care utilization
, * Emergency departments
* Hospitalizations
Early Detection is Important
ATYPICAL PRESENTATION and DELIRIUM - CORRECT ANSWER -Major
indicators are acute confusion and changes in behavior
Patient has problems with:
I. Attention and awareness
II. Thinking and memory
III. Emotions
IV. Muscle control
V. Sleeping and waking pattern
Infection (Urinary tract, Pneumonia, GI) in older adults - CORRECT ANSWER -- No
fever
- Sepsis without leukocytosis and fever
- Falls
- ↓appetite and fluid intake
- Confusion, anxiety, restlessness
- Change in functional status
Usually, patients with infection have fever and increased WBC
"Silent" Acute Abdomen in older adults vs normal - CORRECT ANSWER -- Absence of
symptoms (silent)
- Mild abdominal discomfort
- Constipation
Exam Questions and CORRECT Answers
4 M's of Medical Complexity - CORRECT ANSWER -- Multiple chronic conditions
- Many medications
- Managing social networks as they change
- More risk for acute changes in condition
+ Acute exacerbation of chronic disease (HF, COPD)
"acute on chronic"
+ New acute illness (infection, flu-UTI-pneumonia)
+Drug adverse effects
+ Drug-drug interactions
+ Drug-induced medical problems (falls, delirium, UI)
3 Types of Atypical Illness Presentation
-Vague
-Altered
-Non-presentation - CORRECT ANSWER -- Vague presentation of illness: non-specific
symptoms that signal an impending acute illness
-Example: refusal to eat and drink, new onset of falling or functional decline
-Altered presentation of illness: presentation of a symptom or a group of symptoms that does not
compare to the classic presentation of common illnesses in the general adult population
-Symptoms are not traceable to the underlying organ dysfunction
- Example: absence of pain in conditions or diseases known to produce pain
-Non-presentation of illness: illnesses in older adults goes unrecognized for many years
-Example: failure to show classic signs of infection such as elevated temp or increased WBC's
,Risk Factors for Medical Complexity - CORRECT ANSWER -- Over age 85
- Multiple medical illnesses
- Multiple medications
- Poor vision and hearing
- Cognitive impairment
- Functional impairment
- Surgery, anesthesia
Examples of vague, non-specific symptoms - CORRECT ANSWER --Apathy
-Fatigue
-Weakness
-Dyspnea
-Incontinence
-Altered mental status, confusion
-Self-neglect, poor hygiene
-Refusal or failure to eat or drink
-New onset of falling
-New onset functional decline
Altered Presentation of Illness - CORRECT ANSWER -- Classic presentations of common
illnesses do not hold true.
- May not see chest pain with MI
- May not see burning with UTI
- May not see "sadness" with depression
- Change in mental status- most frequently seen symptom of acute illness
,Non-Presentation of Illness - CORRECT ANSWER -Many conditions remain hidden and
undiagnosed for many years.
- The insidious nature of the onset of many illnesses.
- Vague symptoms.
- Regard symptoms as "normal" aging.
- Attribute new symptoms or a change in symptoms to existing medical problems.
- Reluctance to complain -concerns about the need for medical tests and treatments, being
labeled as complainer, being ignored or withheld treatment.
- Communication deficits- hearing, vision, speech.
Hidden, Undiagnosed Conditions
Consequences - CORRECT ANSWER -- Osteoarthritis
- Falling
- Incontinence
- Hearing and vision decline
- Poor nutrition
- Dental problems
- Depression
- Dementia
- Chronic pain
- Alcoholism
Consequences:
- Increased morbidity
- Increased mortality
- Missed diagnosis
- Unnecessary health care utilization
, * Emergency departments
* Hospitalizations
Early Detection is Important
ATYPICAL PRESENTATION and DELIRIUM - CORRECT ANSWER -Major
indicators are acute confusion and changes in behavior
Patient has problems with:
I. Attention and awareness
II. Thinking and memory
III. Emotions
IV. Muscle control
V. Sleeping and waking pattern
Infection (Urinary tract, Pneumonia, GI) in older adults - CORRECT ANSWER -- No
fever
- Sepsis without leukocytosis and fever
- Falls
- ↓appetite and fluid intake
- Confusion, anxiety, restlessness
- Change in functional status
Usually, patients with infection have fever and increased WBC
"Silent" Acute Abdomen in older adults vs normal - CORRECT ANSWER -- Absence of
symptoms (silent)
- Mild abdominal discomfort
- Constipation
