NUR 257 Midterm UPDATED ACTUAL
Exam Questions and CORRECT Answers
what are common not normal behaviors in an older adult? - CORRECT ANSWER -
severe mood swings, uncontrolled laughing or crying, changes in cognitive ability and excessive
forgetfulness
true or false: changes in mental status are part of the normal aging process - CORRECT
ANSWER - false
the most common affective or mood disorder of old age - CORRECT ANSWER -
depression
what might cause depression in an older adult? - CORRECT ANSWER - precipitating
events/loss, chronic illness, or chronic pain
what are s/s of depression in the older adult? - CORRECT ANSWER - fatigue,
diminished memory/concentration, irritability, somatic complaints, behavioral changes, feelings
of worthlessness, sleep disturbances, appetite disturbances with excessive weight loss/gain,
restlessness, impaired attention span, and suicidal ideation
why might depression go untreated in an older adult? - CORRECT ANSWER - it goes
unrecognized or the patient does not want to seek medical treatment for it
how can we combat the high suicide risk in the older adult population? - CORRECT
ANSWER - routine assessments/screenings
what assessment/screening tool is used for depression in older adults? - CORRECT
ANSWER - geriatric depression scale (GDS)
what is the treatment/management of depression? - CORRECT ANSWER - treat
underlying medical condition (chronic illness, chronic pain)
,antidepressant medications
what can older adults on antidepressants become at risk for? - CORRECT ANSWER -
adverse effects: anticholinergic, cardiac and orthostatic adverse effects
drug interaction: med toxicity, hypotensive, falls
what patient education is needed for older adults on antidepressants? - CORRECT
ANSWER - elders to understand that it may take even longer than the typical 4-6 weeks
for symptoms to diminish
change positions slowly
maintain adequate hydration to avoid common side effects (nausea, dizziness, and constipation)
acute confusional state - CORRECT ANSWER - delirium
what type of delirium has a higher mortality rate and why? - CORRECT ANSWER -
stupor (hypoalert-hypoactive) delirium because it tends not to be recognized; it is quiet and often
mistaken for depression
which type of delirium is easier to diagnose? - CORRECT ANSWER - excessive activity
(hyperalert-hyperactive) delirium
require more attention because patient's thinking is disoriented
in what setting is delirium most commonly seen in older adults? why? - CORRECT
ANSWER - the hospital setting because it often indicates a medical illness
,what happens if delirium is left untreated? - CORRECT ANSWER - changes in LOC,
irreversible brain damage, and death
what vital assessment piece do you need to know to determine dementia from delirium? -
CORRECT ANSWER - the patient's baseline
dementia is long term
delirium is abrupt onset
what screening tool is used for delirium in the hospital? - CORRECT ANSWER - CAM
what are the common causes of delirium? - CORRECT ANSWER - physical illness
infection (UTI or pneumonia)
medication polypharmacy
imbalanced fluid and electrolytes
alcohol or drug withdrawal
(it can be more than one of these at the same time)
why is delirium a medical emergency? - CORRECT ANSWER - it is acute, quick onset,
with an underlying cause
if left untreated, it can cause death or brain damage
how is delirium treated? - CORRECT ANSWER - treat underlying cause
manage patient safety
manage behavioral problems
what is the most common type of dementia? - CORRECT ANSWER - AD
, what are symptoms of early (mild) stages of AD? - CORRECT ANSWER - forgetfulness
and subtle memory loss
small difficulties in work or social activities but have adequate cognitive function to compensate
for the loss and continue to function independently.
what are symptoms of moderate stage of AD? - CORRECT ANSWER - forgetfulness is
manifested in many daily actions
impulsive behavior
difficulty with IADLs
personality changes
what are symptoms of terminal (severe) AD? - CORRECT ANSWER - patients are
usually immobile and require total care with ADLs
how does death occur with a patient diagnosed with AD? - CORRECT ANSWER -
complications such as pneumonia, malnutrition, or dehydration
second most common cause of dementia - CORRECT ANSWER - vascular dementia
how is vascular dementia caused? - CORRECT ANSWER - reduced blood flow to the
brain, which damages and eventually kills brain cells
how is vascular dementia characterized? - CORRECT ANSWER - by variable impairment
dependning on the affected sites in the brain
what are the prevention and management for vascular dementia? - CORRECT ANSWER -
similar to CV disease
Exam Questions and CORRECT Answers
what are common not normal behaviors in an older adult? - CORRECT ANSWER -
severe mood swings, uncontrolled laughing or crying, changes in cognitive ability and excessive
forgetfulness
true or false: changes in mental status are part of the normal aging process - CORRECT
ANSWER - false
the most common affective or mood disorder of old age - CORRECT ANSWER -
depression
what might cause depression in an older adult? - CORRECT ANSWER - precipitating
events/loss, chronic illness, or chronic pain
what are s/s of depression in the older adult? - CORRECT ANSWER - fatigue,
diminished memory/concentration, irritability, somatic complaints, behavioral changes, feelings
of worthlessness, sleep disturbances, appetite disturbances with excessive weight loss/gain,
restlessness, impaired attention span, and suicidal ideation
why might depression go untreated in an older adult? - CORRECT ANSWER - it goes
unrecognized or the patient does not want to seek medical treatment for it
how can we combat the high suicide risk in the older adult population? - CORRECT
ANSWER - routine assessments/screenings
what assessment/screening tool is used for depression in older adults? - CORRECT
ANSWER - geriatric depression scale (GDS)
what is the treatment/management of depression? - CORRECT ANSWER - treat
underlying medical condition (chronic illness, chronic pain)
,antidepressant medications
what can older adults on antidepressants become at risk for? - CORRECT ANSWER -
adverse effects: anticholinergic, cardiac and orthostatic adverse effects
drug interaction: med toxicity, hypotensive, falls
what patient education is needed for older adults on antidepressants? - CORRECT
ANSWER - elders to understand that it may take even longer than the typical 4-6 weeks
for symptoms to diminish
change positions slowly
maintain adequate hydration to avoid common side effects (nausea, dizziness, and constipation)
acute confusional state - CORRECT ANSWER - delirium
what type of delirium has a higher mortality rate and why? - CORRECT ANSWER -
stupor (hypoalert-hypoactive) delirium because it tends not to be recognized; it is quiet and often
mistaken for depression
which type of delirium is easier to diagnose? - CORRECT ANSWER - excessive activity
(hyperalert-hyperactive) delirium
require more attention because patient's thinking is disoriented
in what setting is delirium most commonly seen in older adults? why? - CORRECT
ANSWER - the hospital setting because it often indicates a medical illness
,what happens if delirium is left untreated? - CORRECT ANSWER - changes in LOC,
irreversible brain damage, and death
what vital assessment piece do you need to know to determine dementia from delirium? -
CORRECT ANSWER - the patient's baseline
dementia is long term
delirium is abrupt onset
what screening tool is used for delirium in the hospital? - CORRECT ANSWER - CAM
what are the common causes of delirium? - CORRECT ANSWER - physical illness
infection (UTI or pneumonia)
medication polypharmacy
imbalanced fluid and electrolytes
alcohol or drug withdrawal
(it can be more than one of these at the same time)
why is delirium a medical emergency? - CORRECT ANSWER - it is acute, quick onset,
with an underlying cause
if left untreated, it can cause death or brain damage
how is delirium treated? - CORRECT ANSWER - treat underlying cause
manage patient safety
manage behavioral problems
what is the most common type of dementia? - CORRECT ANSWER - AD
, what are symptoms of early (mild) stages of AD? - CORRECT ANSWER - forgetfulness
and subtle memory loss
small difficulties in work or social activities but have adequate cognitive function to compensate
for the loss and continue to function independently.
what are symptoms of moderate stage of AD? - CORRECT ANSWER - forgetfulness is
manifested in many daily actions
impulsive behavior
difficulty with IADLs
personality changes
what are symptoms of terminal (severe) AD? - CORRECT ANSWER - patients are
usually immobile and require total care with ADLs
how does death occur with a patient diagnosed with AD? - CORRECT ANSWER -
complications such as pneumonia, malnutrition, or dehydration
second most common cause of dementia - CORRECT ANSWER - vascular dementia
how is vascular dementia caused? - CORRECT ANSWER - reduced blood flow to the
brain, which damages and eventually kills brain cells
how is vascular dementia characterized? - CORRECT ANSWER - by variable impairment
dependning on the affected sites in the brain
what are the prevention and management for vascular dementia? - CORRECT ANSWER -
similar to CV disease
